Pain in the upper back spine can be caused by the following reasons: first, osteoporosis, when there is osteoporosis in the spine, there can also be pain in the spine, and when accompanied by compression fractures, the pain is more obvious, then the CT and X-ray of the thoracic spine should be examined for diagnosis and treatment, and blood tests should be done if necessary, and the patient should be seen by the endocrinology department. Second, tumor, when there is a tumor in the upper part of the spine of the chest, there can be pain in the upper part of the spine, often accompanied by low fever or wasting, and resting pain at night when sleeping, then the MRI, CT and blood tests of the thoracic spine should be examined to diagnose and treat. Third, supraspinous ligamentitis or interspinous ligamentitis, when there is chronic inflammation of the supraspinous ligament and interspinous ligament in the upper part of the thoracic spine, there can also be pain in the upper back spine, which should be diagnosed by early examination and examination to exclude other diseases. Fourth, the thoracic spine tuberculosis or bacterial infection, when the thoracic spine has septic spondylitis or tuberculous spondylitis, there can also be pain in the upper back, then to check the thoracic spine MRI, CT and blood tests to diagnose.