Many cases of upper back pain are caused by muscle or soft tissue problems, such as sprain, strain, or tension. Many symptoms, then, relate to the muscles:

• stiffness
• spasm
• pain
• tightness
• tenderness when the injured area is touched

Sometimes, you can also feel upper back pain when you take a deep breath because the vertebrae (the spinal bones) in your thoracic spine are connected to the ribs. Sneezing or coughing may also be painful.

With upper back pain (or mid-back pain), you may also have pain in your shoulders and neck (cervical spine). That's because all your muscles are connected, so if it's a muscle problem causing your upper back pain, the other muscles in your shoulders and neck can be affected.