Upper right back pain can stem from many causes. According to the Spine Health website, upper back pain, including upper right back pain, can be caused by trauma or sudden injury, or it can be caused by excessive strain or poor posture over time. Some causes of upper right back pain are more common than others, and upper right back pain is often accompanied by neck and shoulder pain.
Scapular Fracture
Right-sided scapular fractures or a fracture of the right shoulder blade can cause upper right back pain. According to the American Academy of Orthopaedic Surgeons, although it's rare--representing less than 1 percent of all broken bones--scapular fractures can be painful and can affect a person's daily activities. The scapula is a roughly triangular, paired bone that overlies the ribs in the upper back. The AAOS notes that most scapular fractures affect the body or mid-portion of the scapula, and are caused by high-energy, blunt force trauma. Scapular fractures can occur during motorcycle or motor vehicle accidents or during a fall from a roof of other significant height, and may occur in conjunction with other injuries, such as head, lungs and spinal cord damage. Common symptoms associated with a scapular fracture include extreme pain with arm movement on the involved side, swelling behind the shoulder and skin abrasions.
Rib Fractures
Right-sided posterior rib fractures can cause upper right back pain. The Merck Manuals website states that rib fractures, which can cause severe pain, typically are caused by strong forces acting on the body, including falls, motor vehicle accidents or being struck on the upper right back by a blunt object such as a baseball bat. However, some elderly individuals, especially those with extremely low bone mineral density, can sustain a rib fracture from a minor fall or from a violent bout of coughing. Fortunately, apart from the accompanying pain, most rib fractures are benign, unless organs such as the lungs, liver or spleen are damaged by the fracture-inducing force. Most rib fractures, including those in the upper right back, cause significant pain with deep breathing that lasts for several weeks. X-rays of suspected fractures are often negative, meaning that although a rib fracture may be present, it cannot be seen on the X-ray film.
Myofascial Trigger Points
Myofascial trigger points or MFTPs are a common cause of upper right back pain. According to the Spine Health website, if a person is experiencing focal tenderness in the upper right back, an active MFTP may be the source of the pain. MFTPs--hyperirritable nodules or knots within a tight band of muscle--are often located in the parascapular muscles or the muscles that lie between the shoulder blades and the spine. MFTPs that cause upper right back pain may be found in the following right-sided muscles: rhomboids, levator scapula, upper trapezius, serratus posterior superior and the intercostal muscles or the muscles between the ribs. The Spine Health website notes that massage therapy, acupuncture and MFTP injection therapy using lidocaine may be effective in reducing or eliminating MFTPs and the associated pain or discomfort. Other conservative care methods, such as osteopathy or chiropractic can also help alleviate MFTP-related upper right back pain.
