Managing Upper Right Back Pain: Causes, Symptoms, and Treatment

What’s Causing My Upper Right Back Pain and How Do I Treat It?

Upper right back pain can be a debilitating condition that affects your daily activities and mobility. This article aims to provide an overview of the causes of upper right back pain and the appropriate treatment options. It is important to note that while many cases of upper right back pain are related to muscle strain, herniated discs, or conditions such as osteoarthritis, there are also uncommon causes that should be considered. Seeking medical advice for a proper diagnosis and treatment plan is recommended.

Overview

The upper right quadrant of your back encompasses the area from the base of your neck to the right side of your rib cage, including the top of the thoracic spine. This region is composed of various structures, including vertebrae, spinal discs, muscles, ligaments, tendons, and nerves. Any issues affecting these structures can lead to pain in the upper right back. It’s important to recognize that in some cases, upper right back pain can be a symptom of serious conditions like spinal infections, lung cancer, pulmonary embolism, or cholecystitis (inflammation of the gallbladder).

Causes of Upper Right Back Pain

1. Overuse, muscle strain, or injury:

   • Muscle strain: A twist or tear in a muscle or tendon caused by overexertion or repetitive movements. Activities like shoveling snow, leaning over a computer, or playing sports can result in muscle strain.
   • Injuries: Sudden twisting, heavy lifting, falls, car collisions, or impacts can cause mild to severe back injuries, such as muscle strains, sprains, or spasms.

2. Pressure on the spinal nerves:

   • Herniated discs: Lifting heavy objects or injuries like whiplash can cause the soft inside of a spinal disc to push out through a tear in its outer coating. This condition can lead to pressure on the spinal nerves and result in upper back pain. Herniated discs are more common in the lower back but can also occur in the neck.

3. Vertebrae fractures:

   • Spinal fractures caused by falls, sports collisions, car crashes, or other injuries can result in broken or fragmented bones in the spine. Severe fractures may pinch or puncture the spinal cord or nerves, leading to back pain, neck pain, muscle spasms, weakness, tingling sensations, difficulty moving the arms, or even paralysis.

4. Osteoporosis:

   • Osteoporosis is a bone disease that increases the risk of fractures. Compression fractures in spinal vertebrae can occur in people with osteoporosis, leading to sudden back pain onset, heightened pain when standing or walking, loss of height, receding gums, weak hand grip, and brittle nails.

5. Osteoarthritis:

   • Osteoarthritis (OA) affects the joints, and the facet joints connecting most of the spine’s vertebrae make this area susceptible to OA. Upper right back pain can result from this condition, often accompanied by scoliosis. Symptoms may include radiating pain into the neck, arms, or shoulders, weakness, numbness, muscle cramps, and stiffness.

6. Myofascial pain syndrome (MPS):

   • MPS is characterized by chronic pain in the connective tissues (fascia) covering muscles and may occur within the intervertebral discs of the spine. Repetitive motion activities are often the cause of MPS, which can generate deep muscle pain or referred pain in other areas of the body. Symptoms include tender spots deep in muscles and worsening pain over time.

7. Stress:

   • Feelings of stress, nervousness, and anxiety can cause back pain. Stress triggers a fight-or-flight response, leading to muscle tightness. Additional symptoms may include a rapid heartbeat, headache, rapid breathing, and a nervous stomach.

Uncommon Causes

While less common, these causes should also be considered when experiencing upper right back pain:

• Lung conditions: Pneumonia, respiratory infections, lung cancer (especially when metastasized to the spine or chest), and pulmonary embolism (blood clot in the lung) can cause pain in the upper right back.
• Gallbladder ailments: Although the gallbladder is not located near the upper back, conditions like gallstones can cause referred pain in the upper right back. Inflammation of the gallbladder (cholecystitis) is a potentially serious condition that can also lead to pain in this area, which may indicate a ruptured gallbladder.
• Spinal infection: Infections in the spine caused by bacteria, viruses, or fungi can occur in individuals with weakened immune systems or as a result of surgical procedures. Spinal infections may affect the discs, bones, or spinal cord and are often accompanied by symptoms like numbness, chills, fever, or tingling.

Seeking Medical Evaluation and Treatment

Proper diagnosis and treatment are essential for managing upper right back pain effectively. If you experience persistent or severe pain, it is recommended to consult a healthcare professional. They can evaluate your condition and recommend appropriate treatment options, which may include medication, physical therapy, exercises, lifestyle changes, or, in some cases, surgical intervention.

Specific Symptoms and Causes

Upper Right Back Pain under Shoulder Blade:

• Location: Middle of the shoulder blades, may radiate to one or both sides.
• Causes: Muscle strain, sprains, and spasms affecting the rhomboid muscles.
• Contributing factors: Overuse, poor posture, odd sleeping positions.

Upper Right Back Pain When Breathing:

• Description: Pain intensifies when taking deep breaths.
• Potential cause: Pulmonary embolism (blood clot in the lung).
• MEDICAL EMERGENCY: Seek immediate medical help if severe pain is accompanied by sudden shortness of breath, dizziness, weakness, high temperature, chest pain, rapid/irregular heartbeat, or coughing up blood.

Upper Right Back Pain Treatment

Effective treatment options for upper right back pain include:

1. OTC Pain Medication:

   • NSAIDs or acetaminophen (Tylenol) can reduce pain and inflammation.

2. Heat and Ice Therapy:

   • Heat: Use a hot water bottle or sit in a whirlpool bath to relieve back spasms and tightness.
   • Ice: Apply ice packs to reduce inflammation, swelling, and pain from injury or muscle strain.

3. Exercise:

   • Gentle stretching exercises and shoulder rolls can alleviate pain and stiffness.

4. Massage:

   • Massaging the lower neck and shoulder blades can help reduce muscle knots.

5. Rest:

   • Bed rest for a limited period (few hours at a time, one to two days only) can aid in acute back pain relief.

Risk Factors

Several risk factors may contribute to upper right back pain or chronic back pain, including:

• Obesity or excess weight
• Lack of exercise leading to weak back and abdominal muscles
• Aging
• Chronic stress or depression
• Improper lifting techniques, repetitive motions, and poor posture
• Smoking, which reduces blood flow and slows healing

When to See a Doctor

Consult a healthcare professional under the following circumstances:

• Back pain persists or worsens after one week of at-home treatment.
• Back pain is a result of an injury or is accompanied by additional symptoms like bowel or bladder problems, muscle weakness, tingling, numbness, or fever.

Takeaway

Upper right back pain is often manageable with self-care measures. However, if the pain persists or is accompanied by concerning symptoms, it is important to seek medical attention to rule out underlying serious conditions.