Upper right back pain is often related to a muscle, ligament, or tendon injury in the neck or shoulder region. It can also be related to more serious conditions such as cancer or a spinal infection. Mild pain often subsides quickly, while more severe pain may require intervention.
What are the Symptoms of Upper Right Back Pain
The symptoms of upper right back pain depend on the cause of the pain. They may include neck pain, muscle spasms, sharp, shooting pain in the arms, weakness, pins and needles, or a constant dull ache.
Causes of Upper Right Back Pain
There are many different causes of upper right back pain. Damaged muscles, nerves, tendons, or ligaments, herniated discs, scoliosis, poor posture, fractures, osteoporosis, lung conditions, and gallbladder ailments can all contribute to the development of upper right back pain.[1]
The most common cause of upper right back pain is an issue in the spine, including:
1. Foraminal stenosis
Foramina are the openings on each side of the vertebrae from which the nerves exit the spine. Foraminal stenosis is when the spinal nerves become compressed due to a narrowing of the foramina, resulting in a sharp shooting pain that radiates into the upper back or arm.[2] It is often caused by degenerative conditions such as osteoarthritis or disc herniations.
2. Bulging Disc
Discs act as the shock absorbers of the spine. When discs become bulged, the soft pulp inside the disc bulges out into the spaces where the spinal nerves exit the spine. A bulging disc often causes radiating pain, tingling, weakness, and numbness in the upper back and arms. Bulging discs occur from injuries such as whiplash or degenerative conditions such as osteoarthritis.
3. Vertebral fractures
Vertebral fractures are cracks or breaks in the bones that make up the spine. Vertebral fractures in the upper back or neck often cause pain on one side. Vertebral fractures occur after an impact such as a fall, a car collision, or a sports injury. They are also more common in people with osteoporosis, a condition where the bones become weak and porous.
4. Osteoarthritis
Osteoarthritis is the most common type of arthritis of the spine.[3] A degenerative condition, osteoarthritis is when the cartilage that lines the spine's joints wears away. As a result, the injured cartilage rubs against the cartilage adjacent to it, causing friction and further injury. It often causes inflammation and pain in the joints and usually affects people over 50.
5. Muscle strain or injury
A muscle strain is a stretched or torn muscle. Muscle strains can occur on both sides of the upper back or neck. They are often caused by repetitive movements, lifting heavy objects, poor posture, or a sudden sharp movement of the neck or shoulders. The pain from a muscle strain can be anything from a dull ache to an intense burn.
6. Osteoporosis
Osteoporosis of the upper spine can cause pain on one or both sides of the upper back. Osteoporosis is a condition in which the bones of the spine become brittle or porous, usually as a result of hormonal changes or a deficiency of calcium or vitamin D. When the vertebrae become fragile, they do not support your body's weight as well, which can result in the muscles, ligaments, and tendons having to overcompensate to make up for the weakened vertebrae. It can also result in compression fractures.
Other causes of upper right back pain include:
7. Stress
When you are stressed, anxious, or depressed, your breathing often becomes shallow, causing your shoulders to hunch forward, resulting in pain and tension in the mid to upper back.
8. Lung infections
Infections such as bronchitis and pneumonia often cause upper back pain. This is because the lungs span from above the shoulder blades to the bottom of the ribs. Pleurisy or inflammation of the lining of the lungs can also cause sharp pain in the upper back.
9. Lung cancer
Lung cancer can also cause upper back pain, especially if it has metastasized and spreads. It may put pressure on the structures in the spine, including the spinal cord or nerves, which leads to pain in the upper back.
10. Pulmonary embolism
Pulmonary embolisms are small blood clots that lodge in the arteries of the lungs. In addition to upper and middle back pain, symptoms of pulmonary embolisms include shortness of breath, excessive coughing, chest pain, and dizziness or lightheadedness. If you suspect you may have a pulmonary embolism, seek immediate medical care.
11. Cholecystitis and gallstones
Cholecystitis is when the gallbladder becomes inflamed. It occurs when bile (a digestive juice) gets trapped in the gallbladder. In most cases, cholecystitis happens because gallstones block the ducts where the bile drains out of the gallbladder, resulting in a buildup of bile. Cholecystitis causes severe pain in the upper right abdomen that radiates to the upper right back.
12. Costochondritis
Costochondritis is inflammation of the cartilage that lines the joints of the ribs. When the ribs of the upper back are affected, it may be difficult to breathe, bend forward or rotate the upper back.
Diagnosing Upper Right Back Pain
Diagnosing upper right back pain can be complex. It often requires a physical examination, detailed medical history, and often some form of diagnostic testing.
The physical examination consists of inspecting the upper back for swelling and inflammation, assessing your movements, and looking at your posture. The examiner will ask you to move in different directions to ascertain how your movement affects your upper back pain. Additionally, the examiner may perform special clinical tests to try and exacerbate the symptoms.
Often, other imaging tests are necessary to understand what is causing the pain. These include X-rays, magnetic resonance imaging (MRI) scans, an EMG (in case of suspected heart issues), ultrasound scans, bone density tests, scopes, or blood tests. The medical history and physical examination will determine which test will be required.
Treatment for Upper Right Back Pain
The treatment of upper right back pain depends on the underlying cause. In most cases, upper right back pain is not serious and can be treated with home remedies such as:
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Gentle stretches and exercises to keep the spine moving and improve muscle strength.
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Over-the-counter non-steroidal anti-inflammatories, such as naproxen or ibuprofen.
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Ice to reduce pain and inflammation.
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Heat to reduce stiffness and improve mobility.
More severe pain may require more serious treatment, including:
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Injections and prescription medications to relieve the pain.
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Surgery in severe cases of upper right back pain, including disc herniations, vertebral fractures, and foraminal stenosis.
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Physiotherapy to restore movement, increase muscle strength, and improve posture.
If you suspect your upper back pain may be caused by a vertebral fracture, foraminal stenosis, pulmonary embolisms, cholecystitis or gallstones, lung cancer, or a lung infection, seek immediate medical care.
Outlook
There are many causes of upper right back pain, including spinal issues, muscle strain, degenerative conditions such as osteoarthritis and osteoporosis, and organ pain.
Upper back pain is diagnosed through a detailed physical exam and other investigative tests. Minor pain usually resolves within a matter of weeks, while more severe or chronic (long-lasting) pain may require more serious intervention.
