Top back pain can be a bit like a salsa or buffalo wings – we know, bear with us.


  • First, there is a lightweight: just a little taste if we talk the sauce, and a little pain that is easily ignored when it reaches the upper back.
  • Then there is a medium / moderate: now we get somewhere. You will feel it, but usually only if you take a deep breath or sneeze or move too fast.
  • Finally, we have spicy: equivalent to pain so you feel burning from doing the simplest everyday tasks, or even at all!
  • The problem is, back pain affects everyone differently. Some of it is because there are so many possible reasons for your back (also middle back). The first step in solving your back pain problem is to understand why it happened. To do that, start by studying your anatomy.


What is the upper back?

If you want to understand the upper back pain, start with anatomy lessons.


Pain at the top and / or mid back is less common than lower back pain or neck. One 2015 Mayo Clinic Review Study shows that about one third of people get lower back pain or neck (a little higher for the lower back, slightly lower for the neck), compared to less than a fifth of back pain reporting.


The upper back is the area under the cervical spine (neck) and above the lower back (Lumbar spine). The upper back is called the thoracic spine, and it is the most stable part of the spine. The range of motion on the back is limited because of the spinal attachment to the ribs (ribs).


  • Think of your spine as a tree trunk. It makes you stand upright. It connects the parts of your skeleton to each other. This carries your upper body weight.
  • Because it’s a big job, the spine itself shares some physical burden with the nearest muscles, some of which include:
  • Trapezius: Near your shoulder bar, help you stand up straight and throw
  • Latsimus Dorsi: Lower on your back, help with arm and breathing movements
  • Rhomboid: adjacent to Trapezius, supports your shoulders and helps you draw


Top back pain can be a bit like salsa or buffalo wings – we know, bear with us.

When you hurt the top or mid, do the work of the yard or play tennis, chances are that you have hurt one of these muscles. “The most common reason we see people with top back pain is simple musculoskeletal tension,” said Reginald Knight, MD, Director of the Bassett Spine Care Institute in Cooperstown, NY.

The spinal cord injury is less common, albeit possible – especially because of a traumatic injury between age groups, or osteoporosis in people older than 65.

Your spine is a bone length column (vertebra), which is separated by discs that act as shock absorbers. Strong but not solid disk, with exterior cartilage and core like gel. The spinal column protects the spinal cord, which has a nerve that carries a message from the brain to other parts of the body. (Nerves also poke from spaces among vertebrae.)

Even though you might think of your spine as a long structure, the doctor sees it as a shorter three: cervical spine (neck), thoracic spine (top and middle) and the lumbar spine (low back).