Learn how to treat, manage and prevent upper back pain.
Medically reviewed by Dr Roger Henderson and words by Claire Chamberlain
Struggling with a sore back and not sure what to do? 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. The good news is most cases of upper back pain are easily treatable.
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:
- Poor posture.
- A long time spent in front of a computer each day.
- Regularly carrying a heavy backpack or shoulder bag.
- A job or sport involving repetitive movements.
- Sustaining an injury, for example, whiplash.
- You have strained a muscle or ligament in your back.
- Lack of muscular strength in the back.
Upper back pain can also have more serious causes, including the following reasons:
- A slipped disc
- Spinal stenosis
- Spinal tumours
- Spinal infections
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.
‘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.
⚠️ 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.
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.’
Upper back pain home treatment tips
If you’re in acute pain and struggling to carry out normal day-to-day tasks then it is worth visiting your doctor to discuss treatment options. But in the meantime, try the following at-home self-management tips to ease upper back pain:
- Warm it up
Apply a hot water bottle or wheat bag to the area to warm tight muscles and ease the pain.
- Cool it down
Apply an ice pack to the area – never apply an ice pack directly to the skin – wrap it in a tea towel to ease inflammation.
- Try painkillers
Take over-the-counter painkillers, such as ibuprofen – always ask your pharmacist for advice if you’re not sure.
- Stretch it out
Try a few gentle stretches to ease the pain, listed below.
Rehab stretches for upper back pain
Try the following stretches to target upper back pain, recommended by Hirst:
- Lie on your side, with your knees bent and both arms stretched out in front of you. Inhale to prepare.
- 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.
- Return back on your next inhale.
- Repeat four to five times on each side.
- 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.
- 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).
- Continue slowly exhaling and inhaling, moving to the rhythm of your breath.
Upper back pain prevention tips
To help reduce your chance of developing upper back pain in the future, Hirst recommends the following simple lifestyle changes:
✔️ 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.
When should you seek medical advice?
Although the majority of cases of upper back pain are due to simple musculoskeletal problems that usually settle without treatment, there are a number of occasions when medical advice should be sought (pain in the thoracic spine is more likely to have a serious cause than pain in the neck or lower back).
If you are experiencing upper back pain for any of the following reasons, make an appointment with your GP:
- Pain that is not improving after 3-4 weeks.
- A recent injury, such as a fall or car accident.
- If you have osteoporosis(thinning of the bones).
- Worsening pain, or pain that is present all the time.
- Weight loss and/or generally feeling unwell.
- Any change to the shape of the spine.
- Pins and needles, weakness or numbness in the arms or legs.
- Worsening back stiffness.
- Any alteration to the normal functioning of the bladder and bowels.
- A history of cancer.
- Long-term (over 6 months) use of prescribed steroids.