Upper Back Pain – Symptoms, Causes, and Treatment Options

Overview of Upper Back Pain

Upper back pain is a common musculoskeletal condition that affects the thoracic spine—the part of your spine that runs from the base of your neck to just below your rib cage. While not as widely reported as lower back pain, research suggests that up to 19% of adults experience upper back pain at some point in their lives (Hoy et al., 2010, Best Practice & Research Clinical Rheumatology).

Unlike the lower back, which is built for flexibility and movement, the upper back is designed for stability and rib protection. This means upper back pain often develops due to muscle irritation, joint dysfunction, or poor posture, especially when sitting for long periods at a desk or leaning forward over a phone.

How upper back pain affects daily life

• Work: Sitting at a computer can worsen stiffness, making it hard to focus.
• Sports & exercise: Pain may limit your ability to lift weights, swim, or play racket sports.
• Sleep: Many people find it hard to get comfortable, waking up sore or restless.
• Relationships: Chronic pain can reduce patience, energy, and willingness to socialize.
• Mental health: Long-term discomfort is linked to stress, anxiety, and lower mood.

Is upper back pain different from lower back pain?

Yes. Lower back pain is more common and often linked to heavy lifting or disc injuries. Upper back pain usually relates to posture, muscle strain, or issues with the joints where ribs attach to the spine. Both can be disabling, but they often have different underlying causes.

Symptoms of Upper Back Pain

Upper back pain symptoms can range from mild stiffness to severe, debilitating pain. Understanding the types of symptoms helps you recognize when to seek medical care.

What are the main symptoms of upper back pain?

• Aching or stiffness between the shoulder blades.
• Sharp or burning pain that worsens with movement.
• Muscle tightness or spasms, especially after sitting or standing for hours.
• Limited range of motion, making it hard to lift, reach, or twist.
• Radiating pain that may spread to the neck, shoulders, or arms.

How does pain severity vary?

1. Mild: A dull ache after a long day of desk work.
2. Moderate: Pain that interrupts sleep or exercise.
3. Severe: Intense, stabbing pain that makes breathing or moving difficult.

Functional impacts of upper back pain

• Work performance: Constant discomfort can reduce productivity and increase sick days.
• Sports participation: Athletes may need to modify or stop training.
• Sleep quality: Tossing and turning, or waking up with stiffness, is common.
• Mood and mental health: Chronic pain is linked to frustration, fatigue, and even depression.

Red flag symptoms – when to seek help immediately

Upper back pain can sometimes signal a serious medical issue. See a doctor urgently if you have:

• Sudden, severe pain after trauma (e.g., car accident, fall).
• Numbness, weakness, or tingling in arms or legs.
• Chest pain or difficulty breathing, which may indicate a heart or lung problem.
• Unexplained weight loss or fever along with back pain.

Authoritative Reference: Hartvigsen J, Hancock MJ, Kongsted A, et al. (2018). What low back pain is and why we need to pay attention. Lancet. 391(10137): 2356–2367. doi:10.1016/S0140-6736(18)30480-X

Causes and Risk Factors for Upper Back Pain

Upper back pain causes are often a mix of mechanical strain, lifestyle habits, and health conditions. While most cases are not life-threatening, understanding the risk factors can help you prevent flare-ups.

What are the most common causes of upper back pain?

• Poor posture: Slouching at a desk or looking down at your phone for hours (sometimes called “tech neck”).
• Muscle strain: Overuse, sudden lifting, or repetitive motions can injure muscles and ligaments.
• Joint dysfunction: Irritation of the small joints where ribs meet the spine.
• Trauma or injury: Sports collisions, falls, or car accidents.
• Underlying conditions: Osteoarthritis, scoliosis, herniated discs (though less common in the upper spine).

Risk factors that increase your chances

• Age: Degeneration of spinal joints is more common after age 40.
• Occupation: Jobs with repetitive lifting, bending, or prolonged sitting raise risk.
• Obesity: Extra weight puts stress on muscles and joints.
• Pregnancy: Hormonal changes and shifting weight can increase thoracic strain.
• Sedentary lifestyle: Weak core and back muscles fail to support the spine.
• Stress: Emotional tension often shows up as muscle tightness in the shoulders and upper back.

Example: Desk jobs and upper back pain

If you work long hours at a computer without breaks, your upper back muscles tire out and stiffen. Over weeks or months, this can progress to chronic pain. Small adjustments—like adjusting chair height, using ergonomic supports, or stretching—can make a big difference.

Authoritative Reference: Maher C, Underwood M, Buchbinder R. (2017). Non-specific low back pain. Lancet. 389(10070): 736–747. doi:10.1016/S0140-6736(16)30970-9

Clinical Path for Upper Back Pain – Diagnosis, Recovery, and Management

Upper back pain can have many possible causes, so diagnosis and recovery depend on your individual situation. Doctors usually combine a physical exam, history, and sometimes imaging to identify the source of discomfort. Recovery often depends on the severity of symptoms and how quickly you begin self-care or professional treatment. Long-term management focuses on posture, movement, and lifestyle strategies that reduce recurrence.

Diagnosis of Upper Back Pain

Diagnosis of upper back pain begins with a detailed medical history and physical examination. The goal is to understand what’s causing your discomfort and rule out serious conditions.

How do doctors test for upper back pain?

Healthcare providers typically:

• Ask about your symptoms: When did the pain start? What makes it better or worse?
• Check posture and movement: Your ability to bend, twist, and lift helps identify functional limits.
• Perform a physical exam: This may include pressing on tender spots, testing muscle strength, and checking flexibility.

These steps help identify whether pain comes from muscles, joints, nerves, or a combination.

What imaging tests are used for upper back pain?

While most cases do not require scans, imaging may be ordered if pain is severe, unexplained, or persistent:

1. X-rays show bone changes, fractures, or scoliosis.
2. MRI (Magnetic Resonance Imaging) detects soft tissue issues such as herniated discs or nerve compression.
3. CT scans provide detailed cross-sectional images for complex cases.

Doctors typically use imaging only if symptoms suggest a serious problem, such as spinal cord compression, infection, or tumor.

How do doctors find the root cause of upper back pain?

Diagnosis involves piecing together your history, risk factors, and physical findings. For example:

1. If pain worsens after long hours at a desk, posture may be the main driver.
2. If pain radiates into the arms with numbness, nerve involvement may be suspected.
3. If pain follows trauma, fracture or soft-tissue injury is more likely.

This step-by-step approach helps rule out urgent conditions while guiding safe treatment.

Authoritative Reference: Qaseem A, Wilt TJ, McLean RM, Forciea MA. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 166(7): 514–530. doi:10.7326/M16-2367

Recovery Timeline for Upper Back Pain

Recovery from upper back pain varies depending on whether the condition is mild, moderate, or severe. Most cases improve with self-care and conservative treatment, but some may persist if underlying causes aren’t addressed.

How long does upper back pain usually take to heal?

1. Mild pain: Often improves within a few days to 2 weeks with rest, stretching, and posture changes.
2. Moderate pain: May take 4–6 weeks, especially if related to muscle strain or poor ergonomics.
3. Severe or chronic pain: Can last for months and may require physical therapy, medical care, or lifestyle adjustments.

What factors influence recovery?

• Positive factors: Early movement, good posture habits, regular stretching, strong core muscles.
• Negative factors: Sedentary lifestyle, smoking, obesity, untreated stress, or repetitive strain.

If/then decision pathway for recovery

1. If pain is mild and improves with simple stretches, posture correction, and activity modification, then you may not need medical imaging or intensive therapy.
2. If pain is moderate and lingers beyond 2 weeks, then seeking physiotherapy, exercise programs, or ergonomic changes is recommended.
3. If pain is severe, persistent, or linked to red flag symptoms (such as numbness, weakness, fever, or trauma), then urgent medical evaluation and imaging are required.

Return-to-work, sport, and lifestyle outcomes

• Work: Many people return within a few days if tasks are light, but heavy labor may require 4–6 weeks of graded return.
• Sports: Gentle activities like walking may resume quickly; high-impact sports may require weeks to months depending on healing.
• Lifestyle: Long-term improvements depend on ongoing posture care, regular exercise, and stress management to avoid recurrence.

Authoritative Reference: Henschke N, Maher CG, Refshauge KM, et al. (2009). Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 339:b3829. doi:10.1136/bmj.b3829

Management of Upper Back Pain

Management of upper back pain focuses on reducing symptoms, restoring movement, and preventing future flare-ups. Treatment usually starts with conservative measures before considering more advanced options.

What’s the best way to manage upper back pain at home?

Self-care is the first line of defense:

• Posture check: Sit upright with shoulders relaxed, and avoid slouching.
• Stretching: Gentle stretches for the chest, shoulders, and spine relieve tension.
• Movement breaks: Stand up and move every 30–60 minutes.
• Heat or cold therapy: Heat relaxes tight muscles, while cold reduces inflammation.

Step-by-step self-help & relief tips

1. Pause and reset your posture: Notice if you’re leaning forward; roll shoulders back.
2. Do a simple stretch: Reach arms overhead and gently arch the back.
3. Apply heat or ice: Use a heating pad for stiffness or ice pack for acute strain.
4. Stay active: Gentle walking or yoga helps circulation and healing.
5. Check ergonomics: Adjust chair, desk, and screen height to reduce stress.

Each of these steps works best when practiced daily, not just during pain flare-ups.

What therapies help manage upper back pain?

• Physical therapy: Builds strength, improves flexibility, and corrects posture.
• Manual therapy (e.g., chiropractic, massage): Relieves tension and restores movement.
• Exercise programs: Core strengthening, yoga, and Pilates improve long-term outcomes.
• Lifestyle strategies: Stress management, sleep hygiene, and weight management reduce recurrence risk.

Community support: Group exercise, coaching, or support groups help with accountability and resilience.

Prevention strategies

• Strengthen core and upper back muscles to support the spine.
• Use ergonomic setups for workstations.
• Practice mindful movement during daily tasks like lifting or bending.
• Build long-term habits such as daily stretching and regular activity.

Authoritative Reference: Chou R, Deyo R, Friedly J, et al. (2016). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 166(7): 493–505. doi:10.7326/M16-2459

Multidisciplinary Care for Upper Back Pain at CARESPACE

At CARESPACE, upper back pain is treated through a coordinated, team-based approach that combines multiple health disciplines. Instead of relying on a single treatment, you receive a personalized plan that addresses physical, mental, and lifestyle factors together—helping you recover faster and reduce the risk of recurrence.

How does CARESPACE treat upper back pain differently?

CARESPACE takes a multidisciplinary approach that integrates chiropractic, physiotherapy, massage therapy, kinesiology, fitness training, psychotherapy, nutrition, naturopathic medicine, acupuncture, and more. This is different from standard single-discipline care, where you may only receive treatment for symptoms without addressing the root causes or contributing lifestyle factors.

• Chiropractors can restore mobility and improve joint alignment.
• Physiotherapists design corrective exercises for posture, strength, and flexibility.
• Massage therapists relieve muscle tension and improve circulation.
• Kinesiologists and fitness trainers help build long-term movement strategies.
• Psychotherapists and mental performance coaches provide coping tools for stress, anxiety, or insomnia linked to pain.
• Nutritionists and naturopathic doctors address inflammation, weight, and overall health factors.

By coordinating care across these services, CARESPACE ensures you are supported on every front—physical, emotional, and lifestyle.

Why does a team approach help upper back pain recover faster?

Team-based care works better because pain rarely has just one cause. For example, your discomfort might start with poor posture, but stress at work may be causing muscle tension, and weak core strength may be making the problem worse. A single treatment can help temporarily, but without addressing all contributors, the pain often comes back.

At CARESPACE, your recovery plan may look like this:

1. Acute phase (first few weeks): Pain is managed with chiropractic adjustments, gentle physiotherapy, and massage for immediate relief.
2. Subacute phase (weeks 2–6): You begin structured exercise with a physiotherapist or kinesiologist, while psychotherapy supports stress reduction.
3. Maintenance phase (long-term): Fitness training, nutrition coaching, and ergonomic education prevent recurrence and build resilience.

This layered approach means you are not just treating the pain—you are rebuilding strength, balance, and confidence for the long term.

What role does mental health play in upper back pain care?

Chronic pain is not only physical—it can affect your mood, sleep, and coping abilities. CARESPACE integrates psychotherapy, coaching, and stress management into care plans so you are supported both mentally and physically.

For example:

• If you struggle with pain-related insomnia, a psychotherapist may use cognitive strategies to help reset your sleep routine.
• If stress is causing muscle tightness in your shoulders and upper back, counseling and relaxation strategies can reduce tension.
• If pain has affected your motivation to exercise, mental performance coaching can help rebuild focus and consistency.

By addressing both body and mind, CARESPACE provides a more complete path to recovery compared to isolated treatments.

How is coordinated care personalized at CARESPACE?

Every plan at CARESPACE is tailored to your unique needs. Here’s how it works:

• Assessment: You begin with a thorough evaluation, which may involve a physiotherapist, chiropractor, or other specialists.
• Team collaboration: Based on findings, you may be referred to massage therapy, kinesiology, or psychotherapy for additional support.
• Integrated treatment plan: All providers share information, ensuring your care is seamless and goals are aligned.
• Ongoing adjustments: As you progress, your plan evolves—shifting from pain relief to strengthening and long-term prevention.

This integration helps you recover faster, avoid conflicting advice, and feel supported by a team that understands your whole health picture.

Why is CARESPACE’s approach better than standard care?

Most people with upper back pain see one provider at a time—maybe a chiropractor, or just a massage therapist. While these treatments can help, they don’t always address the multiple layers of pain (posture, stress, weakness, lifestyle). CARESPACE’s coordinated care ensures that:

1. You save time by receiving referrals within the same clinic.
2. Your providers communicate, preventing gaps or overlaps in treatment.
3. Your plan evolves from immediate pain relief to long-term prevention.
4. Your mental health is supported alongside physical recovery.

This is why multidisciplinary care often leads to faster results, lower recurrence rates, and greater overall wellbeing.

Related Conditions for Upper Back Pain

Upper back pain often overlaps with other spinal or musculoskeletal conditions. Understanding these related issues can help you recognize patterns and seek the right care.

• Neck pain (cervical spine pain): Pain in the neck may spread into the upper back and shoulders.
• Shoulder pain: Muscle or joint problems in the shoulders can mimic upper back pain.
• Lower back pain (lumbar spine pain): Sometimes discomfort in the upper spine is linked to poor posture or compensation for lower spine issues.
• Herniated discs or degenerative disc disease: Though less common in the thoracic spine, disc issues can still trigger pain.
• Scoliosis and spinal curvature disorders: Abnormal curves in the spine may cause uneven muscle strain and persistent pain.

Looking for information on a different condition? Visit our full Conditions List.