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Upper back pain management


backpainWhile the lower back often takes up a large portion of the discourse surrounding chronic back pain, it’s counterpart, the upper back, or thoracic region of the spine, isn’t without its own array of issues. Upper back pain can manifest in the base of the neck all the way down to the bottom of the ribcage, and because of the location of critical vertebrae and nerve centers, upper back injuries can affect feeling in the shoulders and arms as well.

Don’t miss this quick guide to managing upper back pain:

Common causes of upper back pain

A mix of poor posture habits, bad lifting technique, and routine overexertion all contribute to chronic upper back pain. Common causes include:

  • Poor body mechanics – especially when lifting something heavy, improper form can lead to muscle strain, microscopic tendon tears, sprains, spinal stress, and ensuing pain and discomfort.

  • Bad posture habits – the body positions you take even when simply sitting at work can gravely affect the health of your back. Slumping, slouching, hunching your shoulders, and a more recent phenomenon of craning the head past the shoulders and tilting it down, also known as text neck, place undue stress on the neck and back muscles.

  • Joint problems – dysfunction in one or more joints where the vertebrae of the spine connect with your ribs can cause a unique type of upper back pain that is often hard to pinpoint.

  • Illness – conditions like osteoporosis (weakening of the bones) and even infections like a spinal epidural abscess can wreak havoc on the spine and adjoining tissues.

  • Repetitive movements – if your job or a sport you play require repetitive movement or heavy lifting which engages the upper back muscles, you may experience chronic inflammation and tension from overuse.

Diagnosing the source of upper back pain often comes down to a mix of clinical evaluations and imaging tests. Your doctor will discuss your medical history, assess your levels of mobility and pain, and potentially request tests like x-rays, bone scans, MRIs, blood tests, and even nerve studies to rule out more serious underlying conditions that could be causing your pain.

Upper back pain symptoms

Because the upper back is so intrinsically connected to the shoulders and neck, chronic pain symptoms can vary and present in multiple areas. Common upper back pain symptoms include:

  • Muscle tightness and stiffness

  • Headaches

  • Sharp pain in upper back when taking a breath

  • Muscle spasms

  • Tenderness and inflammation

  • Weakness, tingling, or numbness in one or more arms

  • Radiating pain up the neck and down the arms

  • Increase in dull aching or soreness at night

Treatment tips for managing upper back pain

When it comes to effectively managing upper back pain, sufferers often look for both a quick fix to attenuate painful symptoms as well as longer-lasting remedies to prevent future flare-ups. Common treatment techniques for upper back pain include:

Spinal Manipulation

Visiting a chiropractor might seem like a costly endeavour, however, more and more healthcare insurers are covering basic chiropractic services as rates of back injuries among adults continue to increase. Chiropractors target much of their care towards the manipulation of the spine and adjacent joints, muscles, and other soft tissues to help realign the spine, relieve pain, and remobilize joints.

Alternating Temperature Therapy

This accessible and medicine-free remedy of alternating applications of ice packs and heat pads to relieve back pain has withstood the test of time. Research has shown that icing a sore back helps to both constrict blood vessels to slow inflammation as well as numb spasming nerve endings and alleviate pain. Applying a heating pad afterwards is then believed to widen blood vessels to flush out waste by-products, soothe knotted muscle fibres, and speed up tissue repair.


Massage may come in the form of therapeutic manipulation of the body’s soft tissues by a professional massage therapist or as self-myofascial release through foam rolling or trigger point massage. Studies have found that massage can improve circulation to tense, jumbled muscle fibres as well as loosen tight fascia and increase endorphin and oxytocin levels. Similar to massage, the ancient Chinese practice of acupuncture has also been touted as a potential drug-free way of addressing back pain through the targeted insertion of ultra-thin needles into the body’s soft tissues.

Orthotic Aids

Most often utilized as a preventative measure to, orthotic aids for upper back pain may include posture braces that support good spine alignment and neck braces that stabilize vulnerable tissues and weak or fractured bones in the neck.


A variety of over-the-counter and prescription medication options are available for the treatment of acute and chronic back pain. They include anti-inflammatories like ibuprofen, muscle relaxants, topical pain relievers, anti-depressants, cortisone injections, and narcotics.

A report in the Annals of Internal Medicine which discusses updated clinical guidelines for treating chronic back pain indicate, however, that narcotics should be an absolute last resort for treatment and only in patients who did not respond to the myriad of non-pharmacological remedies available.

Additional upper back pain remedies include electrotherapy, stretching and strengthening upper back, arm, and neck muscles, as well as biofeedback and even mindfulness-based stress reduction (like you find with yoga).