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Upper Back Muscle Pain

Upper back pain is not as common as neck pain or lower back pain but in many cases the upper back pain and shoulder blade pain is referred from the neck anyhow so a physiotherapist will assess and treat the neck in these cases.

Further information about upper back pain can be seen at Wikipedia's upper back pain page and more general information about back pain at NHS Choices.


There are three proposed causes for the majority of upper back pain:

  1. Neck pain referred downwards, secondary to joint problems or disc protrusions.

  2. Joint dysfunction in the small spinal joints such as facet joints and the rib joints of the upper thoracic spine.

  3. Muscular irritation, although the evidence for this existing is not good even though much of this pain feels like it is in the muscles.

Upper back pain symptoms can vary from a sharp, stinging pain on getting to a particular position or posture to a persistent and aggravating ache which worsens on activity or holding a posture for too long. This can include upper back pain between shoulder blades and could spread downwards and be classed as middle back pain or mid back pain.

Lung pain from medical problems such as pleurisy, pneumonia, lung collapse and blood clots (pulmonary emboli) can also refer as upper back pain and medical advice should be promptly sought if there is any suspicion that the pain does not have a joint or muscular cause.

Muscular pain is assumed to be due to tight muscles, persistent holding of poor postures such as over a desk or at a computer or overuse syndromes such a repeating activities many times. Treatments include trigger point injections and trigger point manual therapy which some physiotherapists use, deep tissue massage, acupuncture, mobilisation techniques, manipulation, postural advice and correction, fitness programmes and specific exercises.

Upper back pain during pregnancy can be a problem but is much less common than low back and sacroiliac joint pains. A physiotherapist can help here and typically will assess a one-sided problem such as upper back pain left side as most pain syndromes like this are not symmetrical in presentation.

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