Upper back pain can be caused by trauma, muscle strain, heart disease and other factors. 1. Trauma: trauma to the upper back can lead to soft tissue injury, local bruising, swelling, pain and other symptoms. 2. Muscle strain: muscle strain can occur when the muscles of the upper back are strained or exhausted for a long time, and aseptic inflammation can occur locally, which can stimulate the local soft tissues to show pain after being active or cold. 3. Heart disease: when acute angina or even myocardial infarction occurs, pain in the precordial area can occur, and at the same time, it can be dispersed to the back, manifesting as pain in the upper part of the back. 4. Other diseases: In acute necrotizing pancreatitis, there is a lot of exudation and infection around the pancreas, which can invade the surrounding tissues and cause severe pain in the upper back. Acute cholecystitis can also cause radiating pain in the upper back. When unexplained pain in the upper back does not resolve quickly, it is important to consult a doctor for a definitive diagnosis and treatment.