How to treat upper back pain


Learn how to treat, manage and prevent upper back pain.

By Claire Chamberlain

Upper back pain (also known as thoracic back pain) refers to pain felt anywhere in the area between your neck and waist. It is often felt between the shoulder blades and, while it’s less common than lower back pain, it’s still highly prevalent throughout the population.

We speak to Lyndsay Hirst, chartered physiotherapist at Your Pilates Physio, about the common causes of upper back pain, as well as treatment options, self-management and preventative measures:

Common causes of upper back pain

There are a number of reasons why you might experience upper back pain. ‘The most common causes of upper back pain tend to be muscular and postural,’ says Hirst.

‘There can also be some joint involvement too, particularly in the area we refer to as the CT junction, which is the area where the lower cervical spine meets the upper thoracic spine (the lower part of neck). Stress and tension can also play a part in upper back pain.’

You may begin to experience upper back pain for the following reasons:

  • You have poor posture.
  • You spend a long time in front of a computer each day.
  • You regularly carry a heavy backpack or shoulder bag.
  • You do a job or sport involving repetitive movements.
  • You have had an injury, for example, whiplash.
  • You have strained a muscle or ligament in your back, for example, while playing sports.

Serious causes of upper back pain

Upper back pain can also have more serious causes, including the following reasons:

Symptoms of upper back pain

Upper back pain symptoms vary from person to person, depending on both the severity and cause of the pain.

‘Muscular pain tends to feel like a soreness, which might radiate across a larger area,’ explains Hirst. ‘It could be just on one side, but often in the upper back people will feel muscular pain across both sides. Joint pain would be more specific to the spine, and would be described more as an ache.’

If you experience sudden onset of upper back pain following trauma, seek medical attention.

As long as your upper back pain does not have a serious cause, it will likely ease within a couple of weeks. If, however, the cause is more serious, it’s important to see your doctor as soon as possible.

‘If you experience sudden onset of upper back pain following trauma, or find it difficult to lay on your back, or if you have a history of cancer, then you need to seek medical attention,’ advises Hirst.

Upper back pain treatment

The good news is that most upper back pain is easily treatable. ‘Upper back pain responds really well to physiotherapy treatment, especially manual therapy, such as joint mobilisation, massage/trigger point release and acupuncture,’ says Hirst.

‘However, addressing the root cause of the pain is also essential to make sure it doesn’t return,’ she adds. ‘Think about improving your posture, having an ergonomic assessment at work to check your workstation set-up, and doing some exercise.’

Self-management treatments

You can ease your upper back pain using self-management treatments including the following:

✔️ Applying a hot water bottle or wheat bag to the area.

✔️ Applying an ice pack to the area – never apply an ice pack directly to the skin – wrap it in a tea towel.

✔️ Taking over-the-counter painkillers, such as ibuprofen – always ask your pharmacist for advice.

✔️ Trying a few gentle stretches to ease the pain.

Rehab stretches for upper back pain

Hirst recommends the following stretches to target upper back pain:

Arm openings

  1. Lie on your side, with your knees bent and both arms stretched out in front of you. Inhale to prepare.
  2. As you exhale, reach the arm up above your head and continue to move it all the way behind you, so your chest faces the ceiling, your spine is rotated and your arm reaches the floor behind you.
  3. Return back on your next inhale.
  4. Repeat four to five times on each side.

Cat/cow stretch

  1. On all fours, inhale to prepare, then as you exhale, tuck your tailbone under as you lift your spine to the ceiling and drop your head between your shoulders.
  2. As you inhale, begin to lift the tailbone, drop your spine to the floor (allowing your back to arch) and lift your head (this should be the reverse of the first movement).
  3. Continue slowly exhaling and inhaling, moving to the rhythm of your breath.

Upper back pain prevention tips

Hirst recommends the following lifestyle changes, to help reduce your chance of developing upper back pain in the future:

✔️ Take measures to improve your posture.

✔️ Perform the above stretches, to keep your upper back flexible and help maintain the health of your joints.

✔️ Request an ergonomic desk assessment at work.

✔️ Address any stress you may be feeling with mindfulness and exercise, if this is a factor for you.


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