Upper right back pain can range from mild to debilitating. It can lead to less freedom of movement and make it hard for you to go about your day.

The upper right quadrant of your back starts at the base of your neck, and continues down your rib cage on the right-hand side. This area of the body includes the top of the thoracic spine, which ends at the small of your back.

Pain in the upper right back is often caused by problems with the spine, including:

  • Vertebrae. These small bones form your backbone, and are attached to your rib cage.
  • Spinal discs. Discs are located between each vertebra. They have spongy insides and a hard exterior. Your discs are designed to absorb shock when you walk, run, or jump.
  • Muscles, ligaments. and tendons. These are bands of fibrous connective tissue that hold the spine in place.
  • Nerves. Nerves are bundles of fibers that facilitate communication between the brain, spinal cord, muscles, and internal organs.

Sometimes, pain in this area of the body can be caused by serious and potentially fatal conditions, such as a spinal infection, lung cancer, pulmonary embolism, or cholecystitis (inflammation of the gallbladder).

Pain in the upper right back can be chronic or acute. The type of pain you feel can also vary from sharp and stabbing, to dull and throbbing. Upper right back pain is caused by a wide range of conditions. The cause will determine the type of pain you feel, as well as the best treatment for it.

Overuse, muscle strain, or injury

A muscle strain is a twist or tear in a muscle or tendon. Overexertion, or the repetitive movements involved with activities like shoveling snow, leaning over a computer, or playing sports can result in muscle strain.

Sudden twisting, or heavy lifting can also cause this condition. A fall, car collision, or sudden impact of any kind can cause injury ranging from mild to severe in the back.

Mild injuries can take the form of muscle strain, sprains, or spasms. A sprain is a stretch or tear in a ligament. A spasm is a sudden contraction in a muscle. Other symptoms include:

  • reduced range of motion in the arm or shoulder
  • increased pain with movement of the shoulder, arm, or back

Pressure on the spinal nerves

Herniated discs can be caused by lifting heavy objects or by injuries, such as whiplash. This condition is also referred to as a slipped or ruptured disc. When a disc in your back ruptures, pressure may be placed on the spinal nerves.

A herniated disc occurs if the soft inside of a spinal disc pushes out, bulging through a tear in its outer coating. Herniated discs are most common in the lower back, but can also occur in the neck, causing pain in the upper back. They may be more likely to occur in people who are overweight, or in older people.

Other symptoms of a herniated disc include:

  • arm or shoulder pain that may be made worse by coughing or sneezing
  • tingling sensation
  • numbness
  • muscle weakness in the arm or shoulder

Vertebrae fractures

Also called spinal fractures, this condition can be caused by an impact from a fall, sports collision, car crash, or other injury.

Vertebrae fractures cause the bones in the spine to break and possibly fragment, causing pinching or puncturing of the spinal cord or nerves. Vertebrae fractures range in severity from mild to catastrophic.

In addition to back pain, the symptoms you have will be determined by the severity of the injury. They may include:

  • neck pain
  • muscle spasms
  • weakness
  • tingling sensation
  • difficulty moving your arm or arms
  • paralysis

Osteoporosis

Osteoporosis is a bone disease that increases the risk of fractures. People with this disease often do not know they have it until they get a compression fracture in a spinal vertebra. Symptoms include:

  • sudden back pain onset
  • heightened pain when standing or walking
  • loss of height
  • receding gums
  • weak hand grip
  • brittle nails

Osteoarthritis

Osteoarthritis (OA) affects the joints of the body. Most of the spine’s vertebrae are connected to facet joints, making this area of the body susceptible to OA.

OA can cause upper right back pain, or pain anywhere along the spine. This condition is sometimes accompanied by scoliosis. Other symptoms include:

  • radiating pain into the neck, arms, or shoulders
  • weakness
  • numbness
  • muscle cramps
  • stiffness

Myofascial pain syndrome (MPS)

MPS causes chronic pain in the connective tissues (fascia) that cover muscle, and may occur within the intervertebral discs of the spine.

Myofascial pain is often caused by repetitive motion activities. It can generate pain deep within the muscle, or referred pain, causing you discomfort in other areas of your body. Symptoms include:

  • tender spot deep in a muscle
  • pain that continually worsens

Stress

Feelings like stress, nervousness, and anxiety can cause back pain. When you feel stress, your body prepares for a fight-or-flight response, bracing itself for a major challenge, even if one is not imminent. This causes your muscles to become tight.

You may also have:

Uncommon causes

Lung conditions. Since your lungs are located near your upper back, conditions like pneumonia or respiratory infections can cause pain in the upper right back. Lung cancer can also cause pain in this area, especially if it’s metastasized to the spine or chest. You may also feel pain if a tumor in your lung is pushing against your back. A pulmonary embolism (blood clot in the lung) can also cause pain in your upper right back.

Gallbladder ailments. Even though your gallbladder is not located near your upper back, conditions affecting it, such as gallstones, can make your upper right back hurt. This is known as referred pain. Cholecystitis (inflammation of the gallbladder), is a potentially serious condition that can also cause pain in this area. When not treated, cholecystitis may make your gallbladder rupture.

Spinal infection. Infections in the spine can be caused by bacteria, viruses, or fungi. They may be more likely to occur in people who have a weakened immune system. They can also occur as the result of a surgical procedure. Spinal infections can affect the discs, bones, or spinal cord. These types of infections may be accompanied by other symptoms, such as numbness, chills, fever, or tingling.

Upper right back pain under shoulder blade

Muscle strain, sprains, and spasms can affect the rhomboid muscles, which are located in the middle of the shoulder blades. This pain is mostly felt in the middle of the upper back, but may radiate out to one or both sides.

Pain under or near your shoulder blade can make it hard to rotate your shoulder fully, or move your arm with full range of motion. This type of pain is often caused by muscle strain, resulting from overuse. It can also happen if you sleep in an odd position, or have poor posture.

If pain in or under the shoulder blade does not dissipate with home treatment within a few days, it may also signal more serious conditions in the lungs or gallbladder.

Upper right back pain when breathing

Pain in the back can sometimes feel worse when you take a deep breath. This is because the vertebrae of the spine are connected to your rib cage. Usually, this is nothing to worry about. But sometimes, this type of pain can signal a pulmonary embolism (blood clot in the lung).

Medical emergency

If the pain is severe or accompanied by the following symptoms, seek medical help immediately:

  • sudden onset of shortness of breath
  • fainting or sudden onset of dizziness or weakness
  • sudden spike in temperature above 100°F (37°C).
  • sudden onset of severe chest pain
  • rapid heartbeat or sudden onset of irregular heartbeat
  • coughing up of blood

Back pain often resolves with at-home treatment, over the course of a few days. You may need to combine several treatments to get the best effect. These include:

  • OTC pain medication. Pain medications like NSAIDS or acetaminophen (Tylenol) can help reduce pain and inflammation.
  • Heat and ice. Heat and cold therapy can help calm down back spasms and relieve tightness. Try using a hot water bottle on your back, or sit in a whirlpool bath. Ice packs can be beneficial for inflammation, swelling, and pain from injury, sprains, and muscle strain.
  • Exercise. Gentle exercise, such as stretching or shoulder rolls, can help relieve pain and stiffness.
  • Massage. Massage around the lower neck and shoulder blades can help reduce muscle knots.
  • Rest. Bed rest can help with acute back pain, but should be limited. Try resting for a few hours at a time, for one to two days only.

Back pain is a common occurrence that can happen to anyone. There are, however, several risk factors that might cause you to experience upper right back pain, or chronic back pain, more often. These include:

  • obesity or access weight can put more pressure on your back
  • not exercising can cause poor muscle tone or weak muscles in the back and abdomen
  • age (back pain increases with age)
  • chronic stress or depression
  • improper lifting, repetitive motion, and poor posture (desk jobs can also be a risk factor)
  • smoking cigarettes reduces blood flow throughout the spine and healing time from injury

Upper right back pain often resolves with at-home treatment, within a few days. If it does not start to improve within a week, see a doctor.

You should also seek medical treatment for back pain resulting from an injury, or pain associated with other symptoms, such as new bowel or bladder problems, muscle weakness, tingling, numbness, or fever.

Right upper back pain can be caused by a wide range of conditions. Usually, these are treatable at home.

Back pain often resolves with self-care within a week. If yours does not improve or dissipate within that time frame, see a doctor to rule out more serious underlying conditions.