Various problems or conditions can develop in the heart or lungs, which may send pain to both the chest and upper back. Similarly, degeneration within the costovertebral joint (where the rib meets the thoracic spine) could pinch an intercostal nerve and cause pain along the rib. When a spinal nerve in the thoracic spine (upper back) becomes compressed or inflamed, such as by a bone spur (abnormal bone growth) or thoracic herniated disc, pain may travel along the nerve from the upper back to the chest. See Upper Back Pain from Intercostal Muscle Strain Additionally, tendons, ligaments, or the muscle’s connective tissues (fascia) may become overstretched or inflamed and refer pain to the chest and upper back. When one muscle becomes painful or stiff, other nearby muscles may also become painful in response, such as if they need to work harder. Muscle inflammation or strain in the chest and/or upper back region can cause muscle tightness and/or spasms. Some of the underlying biomechanics that can contribute to both upper back and chest pain include: The chest and upper back are in close proximity to each other with both sharing many ribs that help protect the same vital internal organs. Some people may experience increased pain when sitting or lying down. Sometimes upper back and chest pain alleviates with rest or avoiding specific activities, but not always.
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