Back pain: causes, upper back pain and when to see a GP
Medically reviewed by Harvir Ubhi, Chartered HCPC Physiotherapist
Last reviewed: 17 September 2026
Back pain isn't one thing. Where it sits matters: the NHS gives different advice depending on whether it's in your lower back or higher up, between your shoulder blades. This page covers what causes back pain generally, what's different about upper and middle back pain specifically, and when it's worth seeing a GP rather than waiting it out.
If your pain is mainly in the lower back, our lower back pain guide covers that in more depth, including self-help exercises. If it runs down your leg, that's more likely sciatica. If self-help isn't cutting it, our London back pain physiotherapists page covers what to look for in a specialist.
When to see a GP
See a GP if your back pain came on after a fall or injury, started suddenly and you have osteoporosis, or you feel generally unwell with it, such as a fever or losing weight without trying.
The NHS is also specific about location: if the pain is coming from the top of your back, between your shoulders, rather than your lower back, that's worth a GP visit rather than just waiting to see if it settles.
What usually causes it
Most back pain doesn't have an obvious single cause, and it often gets better on its own. A pulled muscle from an awkward movement or lifting something the wrong way is common. A slipped disc can cause pain too, and if it presses on a nerve, the pain travels down the leg as sciatica rather than staying in the back.
Very rarely, back pain signals something more serious, such as a broken bone, an infection, or cancer, which is part of why the warning signs further down this page matter.
Upper and middle back pain specifically
Pain between your neck and lower back, around the shoulder blades or the top of your shoulders, is the least common type of back pain, and it's often harder to pin down to one exact cause. Poor posture held for long periods, whether that's a desk job or a stressful few weeks, can play into it, alongside straightforward muscle and joint strain.
Most upper back pain settles within about six weeks with some simple changes: notice what makes it worse and adjust it, whether that's taking regular breaks from sitting or not carrying everything in one bag over one shoulder. If it hasn't improved after six weeks of that, it's worth asking a physiotherapist for a proper assessment rather than continuing to wait.
The general approach that helps
Across the back, the same principle applies more often than not: staying active tends to help more than resting does. Keep up your normal activities where you can, and avoid long stretches sitting or lying still. A heat pack can ease stiffness, and a pharmacist can advise on suitable painkillers.
If your pain sits mainly in the lower back, our lower back pain guide has specific self-help stretches with step-by-step instructions, all sourced from NHS guidance.
When it's an emergency
Call 999 or go to A&E if you have back pain and any of the following:
- Numbness around your genitals or bottom
- Loss of bladder or bowel control
- Chest pain alongside the back pain
These can point to something more serious than ordinary back pain and need same-day assessment, not a routine appointment.
Frequently asked questions
What's the difference between upper and lower back pain?
Location changes the likely cause and the advice. Lower back pain is far more common and usually settles with self-care and staying active. Upper back pain, between your shoulder blades, is less common, and the NHS recommends seeing a GP more readily for it, rather than just waiting it out.
How long does back pain usually last?
Most back pain improves within a few weeks. Upper back pain specifically tends to respond to self-help changes within about six weeks. If pain persists well beyond that or keeps coming back, it's worth a proper assessment rather than continuing to self-manage.
Is back pain ever an emergency?
Rarely, but yes. Numbness around your genitals or bottom, losing control of your bladder or bowels, or chest pain alongside back pain all need urgent attention, not a routine GP appointment.
Should I rest or stay active?
Stay active where you can. Across almost all types of back pain, prolonged rest tends to slow recovery rather than help it.
Not sure who to see?
If self-care isn't enough, or you'd rather have a physiotherapist assess what's actually going on, tell us your symptoms and we'll match you with the right London physio. Free, no obligation.
Get matched free →Sources: NHS (nhs.uk), Norfolk & Waveney Community Health. Fetched and checked 16 September 2026.