If a woman has pain in the middle of her back to the right, it may be caused by the following problems: 1. It may be caused by muscle strain in the back or fasciitis in the back, commonly seen in people who often do heavy physical labor or sports on the back of the shoulder. 2. The pain may be caused by degenerative changes in the cervical spine caused by cervical spondylosis, which may compress the nerve roots in the back of the right shoulder and cause pulling pain in the nerves in the back of the right shoulder. The nerve in the right side of the back of the shoulder may also cause pulling pain.