Upper back pain may be caused by the following reasons: First, there may be muscle strain here, often seen in patients doing extensive activities involving the lower back, which in turn leads to muscle strain in the lateral lumbar region, such as the external abdominal oblique muscle or the erector spinae muscle, which may lead to symptoms of pain in the upper lumbar region. Second, it may be caused by muscle spasm in the lumbar region, for example, if the breathing suddenly accelerates during the patient’s strenuous activities, it may cause muscle spasm in the muscles related to breathing, which in turn may cause pain here. Third, it may be caused by lesions related to the urinary system, such as acute glomerulonephritis or stones in the urinary system, which may have this symptom. Fourth, it may be caused by the third lumbar transverse process syndrome. The third lumbar transverse process is relatively long, and if the patient irritates the soft tissues around the third lumbar process due to bad posture or cold, it may also produce similar symptoms. In addition to this, fractures of the lumbar transverse process also have similar symptoms.