The patient states the upper back pain is constant, dull, achy, and exacerbated by physical tasks. It is worse during cooking and playing the guitar, any position where he is in a flexion posture for extended periods of time. This patient is a semi-professional musician, so the pain impacts his ability to work. The onset of pain was gradual over time, he describes it as “decades”. The pain has worsened more recently. There is no numbness or tingling. The only relief he had was with hot showers, but it was only temporary. The pain now keeps him from working as a musician as well as leaning over a desk for his primary profession as a real estate developer. This patient has sought relief from physical therapy but received no discernable benefit. This patient does not smoke. He consumes about 4-5 alcoholic drinks per week. He has no current history of trauma or illnesses at this time.

Question: Based on this clinical history, what are some of the differential diagnoses you are considering?