Upper back pain is common, often from everyday activities or minor injuries. While it frequently resolves on its own, it can sometimes indicate serious underlying health conditions, including those involving the heart. Understanding pain characteristics helps determine when medical attention is necessary.
Cardiac Causes of Upper Back Pain
The connection between upper back pain and heart conditions, such as a heart attack or angina, lies in referred pain. This occurs because nerves serving the heart share pathways with nerves in other body parts, including the upper back, neck, jaw, and arms. When the heart experiences issues, the brain can misinterpret these signals, leading to pain being felt in areas distant from the heart itself.
A heart attack occurs when blood flow to a part of the heart muscle is blocked, leading to tissue damage. While chest discomfort is the most common symptom, some individuals may experience atypical symptoms like pressure or tightness in the upper back. This pain can be diffuse and may come and go. Other accompanying symptoms include shortness of breath, nausea, lightheadedness, and unusual fatigue.
Angina, chest pain caused by reduced blood flow to the heart muscle, can also manifest as pain in the upper back. This pain may feel like a pressing, squeezing, or crushing sensation, and it can spread to the arms, shoulders, neck, or jaw. Angina often occurs during physical exertion and subsides with rest.
Common Non-Cardiac Causes of Upper Back Pain
Upper back pain is more frequently caused by issues unrelated to the heart, often stemming from musculoskeletal problems. Muscle strains and sprains are common culprits, resulting from activities like improper lifting, repetitive movements, or overexertion. Poor posture, especially prolonged slouching, can also weaken back muscles and contribute to pain.
Nerve compression, sometimes called a “pinched nerve,” can also cause upper back pain. This occurs when surrounding tissues, such as bone or muscle, put pressure on a nerve, leading to sharp pain, numbness, or tingling that might radiate to the arms or chest. Degenerative conditions like osteoarthritis or herniated discs can also irritate nerves and cause localized or radiating pain.
Conditions affecting the lungs, such as pleurisy (inflammation of the lung lining) or severe coughing from conditions like asthma or COPD, can lead to upper back pain, especially when breathing. Digestive issues, including gastritis or gastroesophageal reflux disease (GERD), can cause discomfort in the upper abdomen that radiates to the back, often described as burning or bloating. Other digestive problems like gallstones or pancreatitis may also cause pain extending to the upper back.
Recognizing Urgent Symptoms and Seeking Medical Advice
Distinguishing between benign upper back pain and a serious condition, like a heart attack, is important. While many instances resolve with rest, certain accompanying symptoms warrant immediate medical attention. Any sudden, severe upper back pain, particularly if it feels like pressure, squeezing, or a tearing sensation, should be considered an emergency.
If upper back pain occurs alongside chest discomfort that spreads to areas like the arms, neck, jaw, or stomach, it could indicate a heart attack. Other concerning symptoms include shortness of breath, a cold sweat, nausea or vomiting, lightheadedness, or unusual fatigue. These symptoms can vary in intensity and may not always include chest pain; women often experience more subtle signs.
If any urgent symptoms are present, call emergency services immediately. Delaying care can lead to significant heart damage and poorer outcomes. EMS personnel can begin treatment en route to the hospital, which is faster and more effective than self-transport.
For persistent upper back pain not accompanied by emergency symptoms but causing concern, consult a doctor. This includes pain that does not improve after a week, pain with tingling or numbness in the legs, severe muscle spasms, or new symptoms like fever or unexplained weight loss. A healthcare professional can accurately diagnose the cause and recommend appropriate treatment.