Although upper back (thoracic spine) pain is not as common as lower back pain, it can cause significant discomfort and pain when it does occur. The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.The thoracic spine is designed to be very strong and stable to allow us to stand upright and to protect the vital internal organs in the chest. This section of the spinal column has a great deal of stability and only limited movement, therefore there is generally little risk of injury or degeneration over time in the upper back. Because there is little motion and a great deal of stability throughout the upper back (thoracic spine), this section of the spine does not tend to develop common spinal disorders, such as a herniated disc, degenerative disc disease, or spinal instability. These conditions can cause upper back pain but are exceedingly rare in the upper back.Upper Back Pain can occur as a result of trauma or sudden injury, or it can occur through strain or poor posture over time. As an example of the latter cause, in recent years, upper back pain has become a familiar complaint from people who work at computers most of the day. Often, upper back pain occurs along with neck pain and/or shoulder pain.The shoulder girdle attaches by large muscles to the scapula (the shoulder blade) and the back of the thoracic rib cage. These large upper back muscles are prone to developing irritation (myofascial pain) that can be painful and difficult to work out. Often, muscular irritation and upper back pain is due to either de-conditioning (lack of strength) or overuse injuries (such as repetitive motions). Muscle strains, sports injuries, other injuries can all result in pain from muscular irritation. This type of upper back pain is most amenable to osteopathic treatment.