Upper Back, Shoulder, and Chest Pain

Over time, repetitive motions can cause micro-tears in muscles and tendons in the neck. These may lead to herniated disks, spinal stenosis or misalignments in the neck vertebrae.

Generally, neck pain is not serious and usually heals on its own. Your doctor will recommend rest, ice and heat and over-the-counter pain relievers.
Poor Posture

People often develop poor posture without even realizing it, especially if they spend most of their day sitting at a desk. This sedentary lifestyle causes muscles to become tight and short over time. The tightness can lead to a rounded upper back and forward head posture, which can cause pain in the neck, shoulder, and chest area.

Long-term poor posture can wear down the ligaments, tendons, and muscles that support the neck. It also forces the body to use muscle fibers that contribute to movement (called phasic fibers) to support the spine, instead of muscles that typically support posture (called static fibers). This extra pressure over long periods of time can increase the risk for spinal disc pathology, bulging, and herniation.

The good news is that posture can be changed by incorporating changes into daily activities and exercise. This can be done by focusing on stretches and exercises that are specific to the area that is being affected. Foam rolling and trigger point therapy can help loosen the muscles of the upper back and shoulders, however if the initial imbalance is not addressed then these techniques will not provide lasting results.
Stress

Stress isn’t as common a cause of upper back pain as it is lower back pain, but it can still occur. Frequently sitting all day at work or craning your neck to look at screens all evening can lead to structural changes that increase stress on the muscles and ligaments in the upper back.

Accidents and collisions can also cause upper back pain by injuring spinal bones, discs, muscles, ligaments and nerves. Injuries to the thoracic spine, which runs from the base of your neck to the bottom of your rib cage, can also cause pain, and can be felt as tightness, throbbing or sharp, especially when taking deep breaths.

Rarely, upper back pain can be caused by an infection of the spinal cord, which is known as a spinal epidural abscess. This is a collection of germs that can cause back pain, and if not treated quickly, can become life-threatening. This is usually accompanied by other symptoms, such as numbness or tingling in your arms or chest pain, and shortness of breath.
Muscle Irritation

The neck has a number of muscles that support its posture and movement, and irritation of these muscles or their connective tissue — known as fascia — can cause pain. Irritation can be caused by overuse, as in slouching in a chair or sleeping with your head elevated, or by injury, such as whiplash from a rear-end car accident.

Infections in the neck can also lead to pain. For example, a spinal epidural abscess (a collection of germs and pus that builds up between the bones of the spine and the spinal cord) can cause pain and weakness in one arm or leg, depending on which nerves are affected.

Most of the causes of upper back neck pain are reversible. Treatment typically starts with ice to numb early, intense pain and reduce inflammation; over-the-counter pain relievers like acetaminophen (Tylenol) and NSAIDs, such as ibuprofen (Advil, Motrin), are used for mild to moderate pain. Over time, your doctor may suggest exercises to strengthen and stretch your neck and spine.
Arthritis

The bones that make up your spine are stacked on top of each other and connected by small joints. The top seven bones of your neck, called cervical vertebrae, link to your head through small joints in the front of your spine called facet joints. Nerves pass through these joints and carry messages to and from your brain.

Over time, these neck joints may become worn or damaged. This is known as osteoarthritis. In the cervical spine, arthritis often causes small lumps to grow at the edges of the bones or joints in the neck. This is called spondylosis and it can cause pain, stiffness, and loss of mobility.

Over-the-counter NSAIDs like aspirin and naproxen can help reduce pain and inflammation. Your doctor can also prescribe stronger NSAIDs or a muscle relaxant to address your symptoms. If your symptoms are severe or persistent, your doctor may inject steroid-based medicine into the space around the pinched nerve to reduce pain and inflammation.pain in back shoulder blade