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Experts reveal why you have upper back pain (and what you can do about it)

Upper back pain can be relieved pretty simply in most cases

a man in a chambray shirt holding neck
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The euphemism “pain in the back (or neck)” is used to describe a challenging situation or person. However, literal pain in the upper back (and around the neck) is also a challenge — one experts say can affect mobility and quality of life.

“The upper back, or thoracic spine and lower neck, functions as the base of the pivot points for the head, is responsible for providing support to the upper body, protecting vital organs, and allowing for flexibility in movements like bending, twisting, and turning,” said  Dr. Rahul Shah, MD, a board-certified orthopedic spine surgeon. “Pain or discomfort in this area can restrict these movements and lead to discomfort, making daily activities and even sleep difficult.”

Upper back pain can occur in a variety of places. You may experience right upper back pain. The affected area may expand over time. For example, you may start out experiencing upper left back pain. Later, you may experience upper back pain between the shoulder blades. Sometimes, these issues can be solved with at-home remedies. Experts explained the causes of and treatments for upper back pain.

two men and a woman sitting around a table slouching
Pixabay/Pexels / Pexels

Primary upper back pain causes

A pair of experts mentioned poor posture as one of the biggest culprits of upper back pain.

“Prolonged slouching or sitting in an incorrect posture can strain and fatigue the muscles and joints in the upper back,” Shah said.

A physical therapist notes that our lifestyle and work environments don’t help matters.

“We are living in a digital world where we are constantly texting on our phones, answering the phones, or typing on the computer,” John Gallucci Jr., MS, ATC, PT, DPT, CEO of JAG-ONE Physical Therapy, said. “If an office is not set up ergonomically, that person will fall into a habit of having bad posture. This creates tight muscles on the front side of the body and weak muscles in the back as the poor posture, or slouching, ultimately stretches out those muscles too much.”

Slouching is one reason your upper back may bother you, but several others exist. Shah said other upper back pain causes include:

  • Muscle strain: This cause is sometimes a result of poor posture. However, Shah said overexertion and sudden movements can also “strain the muscles and ligaments in the upper back, leading to pain.”
  • Herniated disc: Shah explained that the cushioning discs between vertebrae can rupture or bulge. A person may experience upper back pain if these discs press on the surrounding nerves.
  • Osteoarthritis: Shah said our spinal joints may experience wear and tear. Though this issue sounds benign, wear and tear can cause significant upper back stiffness and pain.
  • Thoracic Outlet Syndrome: This condition occurs when the nerves or blood vessels between the collarbone and first rib compress. “Thoracic Outlet Syndrome can lead to pain in the upper back and arm,” Shah said.
  • Fracture. If the pain in your upper back is severe, there’s a chance you broke a bone. “A vertebral fracture due to injury or conditions like osteoporosis can cause severe upper back pain,” Shah said.

a black and white photo of a man stretching his back and shoulders

Treatments for upper back pain — including ones you can do at home

Upper back pain can range from pesky to life-altering. In either event, help is available. Shah and Gallucci shared at-home and medical treatments to help with upper back pain.

At-home solutions for upper back pain

Whether you’re experiencing upper left or upper right back pain (or both), you may benefit from simple solutions that don’t require leaving your home.

  • Gentle stretches. Gentle stretches can be soothing for upper back pain. “Cat-cow — a well-known yoga and stretching pose — can help improve flexibility and relieve tension in the body,” Gallucci said.
  • Isometric exercises. Shah explained that these exercises activate muscles without moving them through a range of motion. “One can improve the blood flow to the muscles and activate the synchrony of the muscles, which may be altered with minor injuries,” Shah said.
  • Improve posture. Since poor posture is such a common upper back pain cause, you may benefit from nixing this habit. “Being mindful of your posture, especially while sitting and standing, can alleviate strain on the upper back,” Shah said.
  • Ergonomics adjustment. Depending on where you work, this solution may not technically be “at home.” Still, the right workplace equipment can set you up for success, regardless of your office location. “Ensuring that an office and desk set up is adjusted to your specific needs will help support good posture and reduce strain to help manage upper back pain,” Gallucci said.
  • Hot/cold therapy. Gallucci said that a heating pad can help relax tense muscles. “If your body doesn’t respond well to heating pads or pain is increased with the use of a heating pad, try using a cold pack to see if the pain is minimized,” Gallucci said.

When to call a doctor for upper back pain (and what they might suggest)

Though you may think the pain in the upper back is a pesky tweak — perhaps due to arm day gone wrong — some situations require prompt medical attention.

Shah said a person should consult a doctor if the pain is:

  • Severe, persistent, or worsens over time.
  • Accompanied by other symptoms like weakness, numbness, tingling, or loss of bladder/bowel control.
  • Due to an injury, fall, or accident.

Dr. Shah said a doctor might recommend physical therapy or medications, such as pain relievers or muscle relaxants, if the issue is persistent or worsens.

You should always feel comfortable discussing issues with your provider, including upper back pain. If you’re unsure if you tweaked your shoulder or have a more severe problem, your best bet is to call your doctor.



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