Upper and mid back pain — felt across the shoulder blades and along the middle of the spine — is very common, particularly among people who spend long hours at a desk. While it can be uncomfortable and persistent, it is usually mechanical and responds well to hands-on care, movement and practical changes. At Back in Action in Penwortham, we care for people across Preston and Lancashire with upper back pain.
Understanding upper back pain
The upper and mid back is formed by the thoracic spine, the twelve vertebrae between the neck and the lower back, each connected to a pair of ribs. This region is built more for stability than for the mobility of the neck or lower back, supporting the ribcage and providing an anchor for the muscles of the shoulders and shoulder blades. Pain here most often arises from the joints, muscles and rib connections of the area, and it is usually mechanical rather than a sign of serious disease.
One consequence of this design is that the thoracic spine can become stiff fairly readily, especially when held in one position for long stretches. The muscles spanning the shoulder blades then work overtime to hold you upright, and it is this combination of stiff joints and tired, tight muscles that produces so much everyday upper back discomfort.
Because the thoracic spine sits between the neck and the lower back and supports the shoulders, upper back pain is closely tied to neck and shoulder problems and to posture. Much of the upper back pain we see is linked to the sustained, slumped postures of modern desk-based life, which load the area and leave the supporting muscles tired and tight.
It is worth knowing that, although upper back pain can be persistent and wearing, serious causes are uncommon, and the great majority of cases are mechanical and very treatable. The combination of relatively stiff thoracic joints and muscles asked to hold a static posture for hours is a recipe for the familiar ache between the shoulder blades, rather than a sign of anything to worry about.
What upper back pain can feel like
Symptoms vary, but commonly include:
- Aching or tightness across the shoulder blades and mid back
- Stiffness, particularly after sitting for long periods or first thing in the morning
- A sense of fatigue across the upper back from holding yourself upright
- A sharp or catching pain with certain movements, twisting or deep breaths
- Tension that can spread up into the neck or out towards the shoulders
- Muscular tension that builds up through the course of the working day
- Discomfort that may be linked to the neck or shoulders
- Pain that eases with movement and a change of position, and builds with stillness
The pattern of what eases and what aggravates your pain — often better with movement and worse with sustained sitting — gives useful clues about what is involved.
Common causes and risk factors
Upper back pain often builds from a combination of everyday factors, including:
- Prolonged sitting and desk work, particularly with a slumped or hunched posture
- Sustained screen and device use, which pulls the upper back and neck forward
- Reduced activity and weakness in the muscles supporting the spine
- Stress and tension, which are often carried in the muscles of the upper back and shoulders
- Stiffness of the thoracic joints or rib connections, and sometimes a specific strain
Part of our assessment is working out which of these is most relevant for you, so that care and advice can be directed sensibly.
When to seek help
Most upper back pain settles with the right care, but some symptoms need medical attention. Please seek prompt advice if your upper back pain follows a significant injury, is severe and unrelenting, or comes with feeling generally unwell, a fever, or unexplained weight loss. Crucially, call 999 if upper back or chest pain comes with chest tightness, breathlessness, sweating or nausea, as this can signal a heart problem rather than a musculoskeletal one.
How chiropractic care can help
Mechanical upper back pain responds well to the kind of care chiropractors provide. The aim of our care is to ease the symptoms, free up stiff areas, and build the strength and endurance that help the upper back cope with daily demands. Following a thorough assessment — including the neck, shoulders and posture, which are so closely linked to the area — our hands-on, drug-free care may include manipulation and mobilisation of the thoracic spine and ribs where movement is restricted, soft-tissue work to ease the muscular tension that so often accompanies it, and a graded rehabilitation programme to build the strength and endurance of the supporting muscles.
Because we are a multi-practitioner clinic, we can also draw on physiotherapy and massage for muscular tension. We will always be honest about what care can realistically offer, and refer you on where appropriate.
What to expect at Back in Action
Your first visit is mostly about understanding your upper back pain. We will take a careful history and carry out a physical examination of the thoracic spine, neck, shoulders and posture, including how you move and the demands of your daily life and work. We will explain what we have found in plain language and discuss whether chiropractic care is appropriate, and what a sensible plan looks like.
You can read more on our new patients page, with current charges on the fees page. We will be realistic about the likely course of care and review your progress as we go.
Helping yourself: self-care and prevention
There is a great deal you can do to help upper back pain, much of it about countering the effects of sustained posture:
- Set up your workstation thoughtfully and avoid long unbroken periods at a screen
- Take regular movement breaks through the day to reset your posture and move the upper back
- Build strength and endurance in the upper back and shoulder-blade muscles over time
- Keep generally active, as overall fitness supports the whole spine
- Pay attention to stress and tension, which often settle in this area
If you would like guidance tailored to you, we can build a self-care and exercise plan around your particular problem so that progress in the clinic is supported by what you do at home. Because so much upper back pain is bound up with the demands of sitting and screen work, the everyday changes you make often matter as much as anything done in the treatment room.
Related conditions and treatments
Upper back pain is closely linked to neck pain, back pain, shoulder and arm pain, rib pain and posture and balance problems. The care we provide draws on approaches such as chiropractic manipulation, posture analysis and exercise and rehabilitation, and may form part of a wider plan alongside our chiropractic, physiotherapy and massage services.
Take the first step
If upper back pain is getting in the way of your life, you do not have to simply put up with it. We are happy to talk it through and help you understand your options. You can get in touch to book an appointment, or to ask any questions before your first visit.