Upper back pain can make ordinary movements difficult. Turning to check traffic, reaching into a cabinet, sitting through a workday, or taking a deep breath may suddenly feel uncomfortable.
The pain may develop after lifting, beginning a new workout, or spending hours at a computer. In other cases, it appears gradually as repeated movement, an old injury, or limited mobility places stress on the area.
Discomfort between the shoulder blades may come from a strained muscle, an irritated joint, the neck, a rib-related issue, or, less commonly, a thoracic disc problem. An evaluation may help when symptoms persist.
Where Does Upper Back Pain Occur?
The upper and middle back is supported by the thoracic spine, which begins below the neck and extends through the area where the ribs attach.
The thoracic spine provides stability while still allowing rotation, reaching, posture changes, and breathing.
Upper back pain may be felt:
- Between the shoulder blades
- Along one side of the spine
- Across the shoulders
- Near the inner edge of a shoulder blade
- Around the side of the rib cage
- Where the neck meets the upper back
Pain near the lower edge of the shoulder blades may overlap with middle back symptoms. ACR’s guide to middle back pain causes and chiropractic care explains other problems that may affect the thoracic region.
What Upper Back Pain Can Feel Like
Symptoms may change depending on the position of the body and the tissue involved.
A muscle strain may become more noticeable while lifting, reaching, or pulling. A restricted spinal or rib joint may cause sharper discomfort during rotation or deep breathing. Irritated nerves may produce burning, tingling, numbness, or pain that spreads away from the spine.
Common symptoms include:
- Aching between the shoulder blades
- Tightness across the upper back
- Sharp pain during twisting or reaching
- Burning near one shoulder blade
- Tenderness when the area is pressed
- Stiffness after waking or sitting
- Pain that increases during the workday
- Reduced upper-body movement
Activities That Can Strain the Upper Back
Desk and Computer Work
Computer work can keep the upper body in one position for long periods. As the head moves toward the screen and the arms reach toward the keyboard, muscles around the shoulder blades may work continuously.
Strain may be more likely when the monitor is too low, the keyboard is too far away, or the shoulders stay raised while typing. Even a well-arranged workstation can become uncomfortable without regular movement.
People who frequently look down at phones, tablets, or laptops may also experience neck and upper-back symptoms. ACR discusses this pattern in its article about tech neck symptoms and chiropractic care.
Lifting, Carrying, and Exercise
Reaching while holding weight, twisting during a lift, or carrying an object away from the body can strain the upper back.
Exercise may also trigger symptoms when intensity increases too quickly or form begins to break down.
Sharp pain, sudden weakness, or symptoms that keep worsening should not be treated as ordinary post-workout soreness.
Common Causes of Upper Back Pain
Muscle Strain
A strain may follow one forceful movement or build through repeated activity. It often causes tenderness, soreness, and pain when the affected muscle is used.
Limited Thoracic Movement
When part of the thoracic spine becomes restricted, nearby joints and muscles may take on more work.
A person may notice difficulty turning in one direction, stiffness while sitting upright, or discomfort when reaching overhead.
Neck or Shoulder Problems
Pain between the shoulder blades does not always begin in the upper back.
Restricted neck movement or shoulder irritation may alter reaching and lifting patterns, placing more demand on muscles near the spine.
ACR’s article about neck and shoulder pain explains how these connected areas may affect one another.
Rib Joint Irritation
The ribs connect to the thoracic spine through small joints that move during rotation and breathing.
Irritation near a rib joint may cause pain beside the spine or discomfort that wraps partially around the chest. Coughing, twisting, reaching, or taking a deep breath may make it more noticeable.
Because rib and chest pain can have causes unrelated to the spine, it should not automatically be assumed to be musculoskeletal.
Injuries
Auto accidents, falls, sports collisions, workplace injuries, and sudden lifting can affect the upper back.
Symptoms may begin immediately or become more noticeable later as stiffness develops.
Thoracic Disc Problems
Disc problems are less common in the thoracic spine than in the neck or lower back, but they can occur.
A thoracic disc issue may cause pain near the spine, discomfort around the ribs, or neurological symptoms when a nerve is affected. ACR provides more information in its guide to thoracic herniated disc treatment options.
When Upper Back Pain May Involve a Nerve
Possible signs of nerve irritation include:
- Burning pain
- Numbness or tingling
- Electric or shooting sensations
- Weakness
- Changes in coordination
- Pain that travels into an arm or around the ribs
Pain extending into an arm may originate in the neck even when discomfort is also felt near a shoulder blade.
An examination may be needed to identify where the irritation is occurring and whether a referral is appropriate.
How Upper Back Pain Is Evaluated
A chiropractor may ask when the pain began, whether an injury occurred, which movements reproduce it, and whether the symptoms change during breathing.
The examination may assess:
- Thoracic and neck movement
- Shoulder function
- Posture
- Muscle strength
- Sensation and reflexes
- Areas of tenderness
- Spinal and rib movement
Imaging or referral may be considered after a significant injury, when neurological changes are present, or when the examination suggests a problem that requires further investigation.
Chiropractic Treatment Options for Upper Back Pain
Chiropractic care may be considered when the examination identifies a mechanical problem involving spinal movement, muscle function, posture, or related joints.
Thoracic and Spinal Adjustments
An adjustment may be used when a spinal joint is not moving comfortably.
Care may focus on the thoracic spine, neck, ribs, or other connected areas. The technique should match the patient’s condition and comfort.
Muscle and Movement Care
Soft-tissue methods, mobility work, or strengthening exercises may be recommended when they match the examination findings.
Practical changes may include repositioning a monitor, reducing repeated overhead work temporarily, modifying a workout, or returning to lifting gradually.
Upper Back Pain Care at Advanced Chiropractic Relief
At Advanced Chiropractic Relief, Dr. Tristan Wendt D.C. evaluates how the thoracic spine, neck, shoulders, ribs, and surrounding muscles may be contributing to upper back pain.
The examination may include movement, posture, orthopedic, and neurological testing.
When appropriate, care may include chiropractic adjustments and Johnson BioPhysics® methods. Some eligible patients may also be evaluated for the Ring Dinger® manual spinal decompression adjustment.
The Ring Dinger® is not automatically recommended for every person with upper back pain. An examination is required to determine whether decompression may be appropriate.
Treatment recommendations and responses vary from patient to patient.
What to Do When Upper Back Pain First Appears
Mild discomfort that develops after sitting or unfamiliar activity may improve with temporary changes.
It may help to:
- Avoid activities that sharply increase the pain
- Continue gentle movement when comfortable
- Change positions more frequently
- Reduce heavy lifting temporarily
- Review desk and screen placement
- Return to exercise gradually
Avoid forcefully twisting the spine or trying to adjust your own neck or back. Stop an exercise or stretch when it produces numbness, tingling, weakness, or traveling pain.
Warning Signs That Need Medical Attention
Seek prompt medical care when upper back pain occurs with:
- Chest pressure or chest pain
- Difficulty breathing
- Sudden severe pain
- Fever
- Fainting or dizziness
- Severe weakness
- Loss of bladder or bowel control
- Symptoms following a major accident
Medical evaluation is also important when pain continues to worsen, interferes with sleep, or occurs with unexplained weight loss.
Schedule an Upper Back Pain Evaluation in Houston
Upper back pain may come from strained muscles, restricted thoracic movement, a neck or shoulder problem, a rib joint, an injury, or disc and nerve irritation.
Because these conditions can produce similar symptoms, an examination may help identify contributing factors.
Advanced Chiropractic Relief evaluates upper back pain for patients in Houston and those traveling from outside the area. Dr. Tristan Wendt can review the symptoms, examine upper-body movement, and discuss whether chiropractic care may be appropriate.
Request an appointment with Advanced Chiropractic Relief to have your upper back pain evaluated.
