Pain in the right side of the upper back is usually caused by muscle or bone problems, but sometimes the cause is an internal organ. The body's pain network sends impulses from the pain's source through nerves to the brain, but pain from internal organs doesn't always occur over the organ itself, but instead is referred to another location, such as the upper right back. Monitoring your symptoms can assist your doctor toward making an accurate finding of the cause of this pain.
The muscles of the neck, shoulders and back support the head and work when we lift or type, but also carry stress from worry and poor posture. These muscles can cause pain in the right upper back after injuries, such as strain from a car wreck or fall, and with overuse from long stretches of work at a computer, especially when the ergonomics of the desk and chair aren't right or when a mouse or track pad is used frequently and only with the right hand.
Trigger points can cause pain, especially in the trapezius muscle at the top of the shoulder and in the muscles between the shoulder blades. These trigger points are small, localized "knots" in muscles that can cause pain in the upper right back.
The bones of the neck and shoulders include the vertebrae; the clavicle, or collar bone; the scapula, or shoulder blade; the ribs; and the humerus, or upper arm. Injuries to these bones that cause bruising or fracture can lead to upper right back pain, as can arthritis in the joints between these bones. Fractures from osteoporosis and cancers that have started in or spread to these bones, most commonly breast, lung, prostate, thyroid and kidney cancers, can also cause pain in this area.
Referred Pain From Internal Organs
Problems related to the gallbladder, liver, intestines, stomach, appendix, kidney, right fallopian tube and right ovary can all cause pain in the right upper back. Pain here can also result from irritation of the diaphragm due to liver disease, gallbladder disease, stomach and duodenal ulcers, and kidney infection and stones.
Appendicitis is usually felt in the right lower abdomen, but if the appendix is higher up in the abdomen, which occurs in some people, it can cause inflammation of the liver capsule, which then causes diaphragm irritation because the liver lies against the diaphragm, leading to upper right back pain. Ovarian cysts, infection of the fallopian tubes, and tubal pregnancy can also lead to liver capsule inflammation, which in turn can cause irritation of the diaphragm and pain referred to the right upper back.
Referred Pain From the Lungs
Problems in the lung such as pneumonia, cancer, infection of the pleura -- the thin layer of tissue that surrounds the lung and lines the chest cavity -- and fluid in the space between the two layers of the pleura from heart failure or infection can all cause pain referred to the right upper back. Ongoing or severe pain in the upper right back should be evaluated by a physician, so that problems can be diagnosed and treated.
- Clinically Oriented Anatomy; Keith L. Moore, Ph.D., et al.; 2009
- Brain: Patterns of Referred Pain in the Normal Subject
- University of Arkansas for Medical Sciences: Superficial Muscles of the Back, Intermediate Muscles of the Back, Deep muscles of the Back
- University of Maryland Medical Center: Gallstones and Gallbladder Disease
- TriggerPoints.net: The Trigger Point & Referred Pain Guide: Upper Back, Shoulder and Arm