Understanding your pain
Neck and upper back pain symptoms
Your neck is the top part of your spine, called the cervical spine. Below it is the upper and middle back, called the thoracic spine, which sits between the base of your neck and the bottom of your rib cage. Pain can stay in one place or spread. An irritated structure in the neck may cause pain in the shoulder or upper back, and neck problems can be linked to headaches.
You may notice:
- Stiffness, or trouble turning your head
- Aching or tight muscles in the neck, shoulders and upper back
- Pain that spreads into your shoulder, arm or hand
- Numbness, tingling or weakness
- Headaches along with neck pain
What may be causing it
Common causes of neck and upper back pain
Joints, discs, muscles, tendons, ligaments and nerves surround the neck and upper back, and a problem in any one of them can cause pain. Common causes include:
- Poor posture, such as long hours at a desk or looking down at a phone
- Overused or strained muscles and joints
- Injury to the discs that cushion the spine
- Arthritis and age-related wear in the spine
- Pinched or irritated nerves
- Muscle spasms around the shoulders and upper back
- Stress, which often adds to muscle tension in the neck and shoulders
Middle back (thoracic) pain is less common than neck or low back pain because this part of the spine moves less. It deserves the same attention. Possible causes include muscle strain, a herniated disc, osteoporosis, fractures from an injury, scoliosis and poor posture.
When to book a visit
When to see a pain specialist for neck pain
Neck and back pain is one of the most common reasons people see a doctor.
Consider an appointment if your neck or back pain:
- lasts for weeks or keeps coming back;
- does not improve with rest and simple home care;
- spreads into your shoulder, arm or hand;
- comes with numbness, tingling or weakness;
- limits how well you can turn your head or move through your day.
When to seek urgent care
Get care right away if neck pain follows a serious fall or accident, if it comes with weakness in your arms or legs, trouble walking, or loss of bladder or bowel control, or if it comes with a fever and a stiff neck.
Your evaluation
How we evaluate neck and upper back pain
Your visit starts with a conversation and a focused examination.
We listen
Your provider asks about your symptoms, your activity and any past injuries, and what you have already tried.
We examine
Your provider examines your neck and back and may check your range of motion, strength and reflexes. Imaging such as an X-ray or MRI may be used when it will help find the cause. If the source is still unclear, a facet or medial branch block can help show whether a joint in the spine is causing the pain.
We explain
Your provider explains the findings and what your options are. If a procedure is recommended, the team explains the steps, the possible risks and what recovery looks like before you decide.
Your care options
Treatment options for neck and upper back pain
Your plan depends on what is causing your pain and how long you have had it.
- Medication management A careful plan for pain relievers and anti-inflammatory medicines.
- Trigger point injections Target tight, tender knots in muscle that can add to neck and upper back pain.
- Facet and medial branch blocks Used to diagnose and treat pain from the small joints in the spine.
Self-care can also play a part. Heat or cold packs and staying gently active, as your provider advises, help some people between visits. Good posture and regular breaks from sitting may also make a difference.
Common questions
Questions about neck and upper back pain
Your provider can answer questions about your own care at your visit.
What happens at my first visit?
You and your provider talk through your pain, your activity and any past injuries. Your provider examines your neck and back, then explains what may be causing your pain and which options might fit.
Will I need an MRI?
Not always. Imaging such as an X-ray or MRI may be used when it will help find the cause of your pain. Your provider decides with you after talking with you and examining your neck and back.
Can neck pain cause headaches?
Neck problems can be linked to headaches. If you have headaches along with neck pain, mention them at your visit so your provider can take them into account. For headache care, see our migraine treatment page.
What kind of doctor treats neck pain?
If your neck pain hasn’t let up, keeps returning or travels into your arm, a pain management doctor can help find out why. Common causes include a strained muscle, a worn or injured disc, arthritis or an irritated nerve. Once we know the source, we’ll talk through treatment that doesn’t involve surgery. You don’t need to see your primary care doctor first unless your plan requires a referral.
Why does my neck hurt when I turn my head?
Usually it’s a tight or strained muscle. It can also come from an irritated facet joint (one of the small joints along the back of the neck), a worn disc, arthritis or a pinched nerve. If it hasn’t eased after a few weeks, keeps coming back, or you notice arm pain, numbness or weakness, it’s worth getting checked.
What causes ongoing neck pain?
Ongoing neck pain can come from strained muscles, poor posture, worn or injured discs, arthritis or an irritated nerve. Stress can add to muscle tension in the neck and shoulders. An exam, and sometimes imaging, helps show which of these is behind your pain.
When should I see a doctor for neck pain?
Get care right away if neck pain follows a serious fall or accident, or if it comes with weakness in your arms or legs, trouble walking, or loss of bladder or bowel control. A fever with a stiff neck also needs prompt care. Neck pain that lasts for weeks or spreads into your arm is a reason to schedule a visit.
What nonsurgical treatments are there for neck pain?
Options may include medication management, trigger point injections and facet or medial branch blocks, along with self-care such as heat or cold packs and gentle activity. Your provider reviews which options may fit after your evaluation.
Related care
Clinical references
This page shares general information. It is not medical advice and does not replace a visit with a qualified clinician.