There are many causes of upper back pain, the common ones are pleurisy, ankylosing spondylitis, trauma and so on. 1. Pleurisy: it is an inflammation that occurs in the pleural cavity, mostly manifested as chest pain, chest tightness, dyspnea, and the symptoms of upper back pain can appear when the back pleura is involved. 2. Ankylosing spondylitis: chronic low back pain is a common symptom in the early stage, which is obvious at night, in the morning, or when getting up after sitting for a long time, and is relieved after activities, and most of them can develop to the chest and neck, with the appearance of soreness in the upper part of the back, activity limitation, or spinal deformity. 3. Trauma: Thoracic vertebrae fracture, dislocation or rib fracture can be caused by violent blows and impacts, resulting in back pain and swelling. There is mostly a clear history of trauma. There may be other reasons for upper back pain, such as muscle strain, acute myocardial infarction, cholecystitis, etc. You should go to the hospital in time, improve the examination to clarify the cause of the disease, and standardize the treatment under the guidance of the doctor.