A pinched nerve is an injury that occurs when a nerve is stretched too far or is squeezed by surrounding bone or tissue. In the upper back, the spinal nerve is vulnerable to injury from a variety of sources.

In some cases, a pinched nerve in your upper back can be brought on by poor posture or a sports or weightlifting injury. A pinched nerve in your upper back can cause pain, tingling, or numbness at the site of the injury and elsewhere in your upper body.

A pinched nerve in your upper back can trigger sharp pain that may hurt more when you turn to one side or when you adjust your posture. You may feel pain more on your right or left side, depending on where the nerve is being stretched or compressed.

Sometimes the pain can radiate down the spine or through your torso so you feel it in your shoulders and chest. You may also feel a tingling, or “pins and needles” sensation in those same areas.

Other symptoms of a pinched nerve in your upper back include muscle weakness in your back and shoulders or any muscle that is animated by the affected nerve.

Your back muscles may not cooperate when you try to bend over or lean back. You could feel stiff when trying to move. Even sitting for a long time may be difficult with a pinched nerve in your upper back.

To learn how spinal nerves can become compressed, it helps to understand more about the anatomy of the spinal column.

You have 24 vertebrae, which are bones separated by discs. The discs help hold the bones together and act as cushions between them. Together the bones and discs form the spinal column, a tough, flexible rod that allows you to stand, sit, walk, and move from side to side and front to back.

Running down the middle of all the vertebrae is the spinal cord, a tube made up of nerve tissue. Extending from the spinal cord through the discs are spinal nerve roots that connect to a massive network of nerves throughout your body.

A common cause of pinched nerves in the back is a herniated disc. This occurs when the soft center of a disc, known as the nucleus, pushes through the harder outer disc layer, called the annulus.

If the nucleus pushes against a nerve in the spinal column, you can have a pinched nerve and some or all of its accompanying symptoms. This is called radiculopathy.

Radiculopathy can develop in any part of the spine. Your back is defined as having three parts:

  • the lumbar, or lower back
  • the cervical, or neck
  • the thoracic, which is the upper back in between the lumbar and cervical sections

The main cause of disc herniation is age-related wear and tear. Discs lose some of their fluid through the years and become less flexible and more vulnerable to cracking and herniation.

This disc degeneration can happen in the upper back slowly over time. It can also be accelerated by lifting something heavy over your head.

Pressure on the spinal nerves can also come from bone spurs, which are abnormal growths of bone triggered by osteoarthritis or trauma to the bone. Bone spurs that form on your vertebrae can pinch nearby nerves.

Rheumatoid arthritis, an inflammatory disease that affects the joints, can sometimes develop in your spine. The inflammation of the spinal joint can put pressure on the spinal nerve.

Your doctor may be able to diagnose a pinched nerve in your upper back by learning about your symptoms, medical history, and by examining your back. If a pinched nerve isn’t obvious, your doctor may recommend an imaging test, such as:

  • Magnetic resonance imaging (MRI). This painless, noninvasive test uses a powerful magnet and radio waves to create images of the inside your body. Unlike an X-ray, which primarily shows bones and large organs, an MRI can reveal more detailed images of soft tissue, such as the discs in your spinal column. An MRI can sometimes pick up signs of nerve compression.
  • CT scan. This painless and non-invasive test creates detailed pictures of your nerve roots. Ultrasound, which uses sound waves to create images, can also detect nerve compression in the upper back.
  • Nerve conduction study. This checks nerve pulses and how your nerves and muscles respond to them through a small electrical charge delivered through special electrodes placed on your skin.
  • Electromyography (EMG). In an EMG, your doctor will inject a needle into the muscles activated by the nerves they believe are injured. The way the muscles respond to the electrical charge delivered by the needle can indicate if there’s nerve damage in that area.

Rest

Rest is the most common treatment for a pinched nerve in the upper back. You should refrain from activities that could strain your upper back, such as lifting heavy objects over your head or any strenuous pushing or pulling.

Medication

Along with rest, you may find pain relief by taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve). Corticosteroid injections may also reduce inflammation and pain in the affected areas.

Physical therapy

Your doctor may recommend physical therapy to exercise and strengthen the muscles of your upper back. Toning these muscles may help relieve pressure on a nerve.

A physical therapist may also help you learn to modify the way you do certain tasks, such as yard work or lifting heavy items, to help ease the burden on your back muscles. Adjusting your standing and sitting posture may also be part of your physical therapy.

Surgery

If rest and physical therapy don’t help, surgery may help treat a painful pinched nerve in the upper back. This could involve removing part of a herniated disc or a bone spur.

While surgery can be quite effective, it’s usually a last resort. Other more conservative approaches should be tried first.

While resting your upper back muscles is important after a pinched nerve diagnosis, there are a few exercises you can do to help improve your flexibility and ease your pain.

Remember to talk with your doctor first before engaging in any stretching or exercise routine that could affect your pinched nerve.

Prone head lift

This stretch can help your upper back and neck muscles.

  1. Lie on your stomach. Raise your upper body by resting on your elbows.
  2. Tuck your chin down toward your chest.
  3. Slowly lift your head so your eyes are looking as high up as they can without straining your neck or back.
  4. Hold for 5 seconds, then slowly lower your head to the starting position.
  5. Hold in starting position for 5 seconds before repeating your head lift.
  6. Repeat up to 10 times a day.

Scapular retraction

This is a good exercise to help with posture.

  1. Stand with your arms at your side and your head in a neutral position.
  2. Slowly pull your shoulders back and down, as if trying to squeeze your shoulder blades together.
  3. Hold for 10 seconds, then return to your starting position.
  4. Repeat 5 times. Do 2 sets of 5 repetitions each day.

Add resistance by stretching a towel or resistance band in front of you while you move and squeeze your shoulders.

Mild upper back pain or tingling that fades after a few days may just be the result of temporary inflammation that put pressure on a nerve. These symptoms don’t require a doctor visit.

However, if upper back nerve pain is a recurring problem, explain your symptoms to your doctor.

If you have back pain or numbness that lasts for several days without relief, you should see a doctor soon. Also, if pain shoots down your spine or out across your torso, make an immediate appointment. Tingling or numbness in your arms or legs should also prompt a quick visit to your doctor.

In most cases, a full recovery from a pinched nerve occurs with little more than some rest. At the first sign of a pinched nerve in your upper back, find a comfortable position and rest. If you’re able to take an NSAID, do so, but always follow the label’s instructions or the guidance of your doctor.

If pain or numbness continue after rest, see your doctor and try to explain your symptoms in detail, including when they started and what, if anything, brings relief.

Some severely damaged nerves may not regenerate or recover to their previous full strength. If this is the case, physical therapy and other treatments may be able to help you manage any lingering effects of a pinched nerve in your upper back.