Upper Back and Neck Pain: Causes, Symptoms & Treatment
Upper back and neck pain are common complaints in the modern world. These symptoms are often caused by poor posture—such as looking down at your cell phone for a long time or leaning over a workbench all day long.
Other causes include osteoarthritis, injuries, whiplash, and age-related changes of the spine. Less often, a sore neck and upper back can be a sign of a more serious problem such as an infection or cancer in the spine.
“The usual symptoms are muscle aches and pain in the neck and shoulders and upper back area,” says Dr. Alice Holland, a physical therapist at Stride Strong Physical Therapy in Portland, Oregon. “Chronically, this could cause nerve entrapment and bulging discs in the cervical spine.”
Upper back and neck pain may show up as:
- General soreness or aching
- Muscle stiffness, tightness, or spasms
- Decreased ability to move your head or upper back
- A dull, burning, or sharp pain
- Headache or other symptoms
- Difficulty looking down or texting for long periods of time
- Inflammation or swelling around the neck and upper back regions
If your pain worsens or prevents you from doing your daily activities, see your doctor.
Seek medical care right away if your symptoms are due to an injury, such as a motor vehicle accident or fall, or if you have any of the following:
- Severe upper back and neck pain
- Pain during coughing or deep breathing
- Difficulty breathing
- Numbness, tingling or weakness in the arms, legs, chest, or belly
- Loss of control of the bowel or bladder
- Pain that is accompanied by a headache
Neck pain is common and can last for a long time. One study estimated that almost 15 percent of people have neck pain at any given point. Another study found that about half of people had neck pain that lasted for at least a year.
The neck has a greater range of motion than the upper back, so pain may be more likely to occur in the neck. Movement in the upper back, though, is limited by the rib cage connecting to the upper (thoracic) part of the spine.
Because the head sits on top of the spine, the neck is also sensitive to poor posture.
“Your head weighs the same as a bowling ball and you can strain your muscles by looking down for long periods of time,” said Dr. Eugene Charles, a chiropractic physician and applied kinesiologist in New York City.
Positions such as looking down while using cell phones, computers and other electronic devices can cause upper back and lower neck pain, including what’s known as “tech neck.”
However, the upper back can also be a source of pain. You may even have upper back pain when moving the neck. This may be due to problems with the spine or with the muscles, tendons and connective tissues that connect the upper back to the shoulder blades and shoulders.
“The most common cause of upper back pain is a combination of weakness and poor posture,” says Holland. Especially in our modern society, where “phones, computers and bad ergonomics have caused our postures to be very stooped over for a large part of our day.”
Holland added that when you pair poor posture with lack of exercise—especially upper body and back strengthening—“you get a bad combination of weak muscles trying to keep a heavy head upright.”
Charles says upper back and neck pain can also occur when the spinal bones (vertebrae) become “locked in place” or misaligned. This can result in a dull or sharp pain.
Other causes include:
- Muscle overuse, strain or injury.
- Injuries, such as from diving accidents, falls, and motor vehicle accidents. Rear-end collisions are a common cause of neck injuries, or whiplash.
- A herniated disc. The vertebrae are cushioned by spongy discs. When the outer layer of the disc is weakened, the inner part can be pushed out. This may press on the spinal nerves.
- A fracture of one of the vertebrae due to injury or trauma.
- Osteoarthritis. This condition causes the cartilage that protects the vertebrae to wear down, which can cause pain. Bone spurs can also form and affect the motion of the joint or press on the spinal nerves.
- Myofascial pain syndrome. This is a chronic pain condition that affects the connective tissue that surrounds the muscles.
Less common conditions can also cause upper back pain, including gallbladder disease, cancer, or an infection. Conditions such as fibromyalgia, Lyme disease, and rheumatoid arthritis can cause neck pain.
Several things can increase your risk of having neck and upper back pain, such as:
- Older age
- Being physically inactive
- Repetitive motions
- Poor posture
- Overweight or obesity
- Other medical conditions, such as arthritis or cancer
- Smoking, which can cause you to strain your back muscles while coughing
You can’t change some of these risk factors, such as age and certain medical conditions. But there are steps you can take to avoid neck and upper back pain.
Holland says a large part of reducing device-related pain involves “habit retraining,” such as:
- Spend less time looking down at your phone
- Use a handle or other support to keep your electronic device at eye level
- Set up your computer workstation for good posture, or ergonomics
- Pay attention to your posture throughout the day
“What your mother told you is right,” says Holland. “Sitting up straight matters a lot.”
Other steps you can take for preventing upper back and neck pain include:
- Take frequent breaks to change position and stretch
- Exercise regularly to strengthen the muscles that support your back and neck
- Sleep in a good position, with your head and neck aligned with your body
- Maintain a healthy weight
- Quit smoking
Finding relief for upper back and neck pain depends on the underlying cause. Often you will be able to ease the pain on your own.
Holland recommends these steps for reducing upper back and neck pain:
- Increase the flexibility in the upper spine by stretching and using a foam roller
- Strengthen the neck and upper back muscles, including the ones that stabilize the shoulder blades
- Maintain an upright posture with your head stacked on top of your spine
Other methods include:
- Over-the-counter pain medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
- Heat or ice packs
- Stretching, yoga, or Pilates
- Manual therapy, such as massage, physical therapy, or chiropractic or osteopathic manipulation
Charles recommends that if you have upper back or neck pain, you should see a chiropractor or osteopath who uses applied kinesiology methods. They can correct some of the most common causes of this type of pain.
If you have chronic upper back and neck pain that isn’t helped by these methods, you may need additional treatments such as steroid injections or prescription medications.
Surgery is less common but may be needed for treating spine conditions such as a herniated disc or degenerative disc disease.
The best way to deal with upper back and neck pain, though, is to be proactive, rather than waiting for it to go away. Doing nothing may only lead to a worsening of symptoms.
“Upper back and neck pain can eventually lead to shoulder and arm pain or weakness,” says Charles. “Or it may eventually affect the heart and lungs due to restriction of your thoracic (mid-back) spine and ribs.”