Manage Back Pain

Upper Back Pain.

Causes and Treatment of Upper Back Muscle Pain.

Upper back pain is a common complaint that I treat in my physiotherapy clinic on a daily basis.


Your upper back is anatomically connected with your neck, mid-back and shoulders - which provides for lots of possible problems at such a busy intersection!

This is one of the reasons why upper back muscle pain is so common. It can be associated with pain in your shoulder and neck, or you may just have upper back alone.


What are the Causes of Upper Back Pain - you might be asking - and Why Me?!


While this is a frequently asked question in my clinic - the simple answer is that the causes of upper back pain are many. However, the most common underlying cause of upper back pain that I see is lack of good posture.

Upper Back Pain90% of upper back pain clients that I treat have pain arising from poor sitting posture which they maintain over long periods of time. A burning upper back pain results when your soft tissue becomes overstretched, and overstrained, over time - resulting in an intitial burning sensation and then pain.

This burning sensation results from the soft tissues in your upper back being overstretched over long periods of time. The tissues eventually become overstrained - and pain may develop either at the same time as the burning sensation or shortly after it.

The upper back is the most common area to experience this type of burning sensation. This is due to your head - which is a very heavy part of your body - hanging from your upper back with an incorrect alignment as you sit and work with poor posture.

Unloading your upper back usually eases this burning feeling. Examples of unloading would be to correct your sitting posture or to support your upper back with a pillow or neck roll when lying down.



If this does not eliminate your burning sensation then seek medical advice. Do not ignore burning upper back pain as further problems in your neck and back may develop.


upper back painAnother common cause of burning upper back pain is an impinged nerve in your neck or upper back. When nerves are compressed in any way, you will commonly experience various degrees of burning sensations. These symptoms will be constant if your nerve is badly trapped - or intermittent if your nerve is impinged only slightly.


Correcting your posture may help your symptoms, but it is very important that the cause of the trapped or impinged nerve is addressed and removed where possible. This may involve joint mobilisation, release techniques to soft tissues, or mobilisation of discs. Treatment of the cause from a physiotherapist is very important.


Other causes of upper back pain that I see include:
  • Poor lifting techniques.

  • Stress.

  • Poor baby-feeding techniques.

  • Poor mattresses.

  • Using a poor pillow or one that does not suit you.

  • Whiplash injuries following a road traffic accident or sports injury.

  • Poor schoolbag-carrying techniques - a real problem with the amount of books many schoolchildren are expected to carry.



Treatment needs to be directed to the primary cause along with posture correction - followed by a correction of the secondary effects of poor posture, such as muscle imbalances. This will ease your upper back pain and prevent further episodes in most cases.



Chronic Upper Back Pain.
Chronic upper back pain is a pain in your upper back that lasts longer than 6 weeks. It is a common presentation in my physiotherapy clinic - often because some people delay too long before they seek treatment and before they know it, over six weeks have passed! The most common causes that I see are:
  1. Long-term poor posture.

  2. Unresolved whiplash injuries.

  3. Overuse injuries.

  4. Genetic conditions.

As stated above, lack of a good posture will always lead to pain in your upper back in my opinion. If you sit, or stand, for long periods of time in a poor posture you will eventually end up with pain. This is due to your muscles, ligaments, nerves and discs being placed under undue stress due to poor posture.


When these structures are placed under stress they will eventually break down causing pain and dysfunction. The treatment for this condition requires posture correction and manual treatment to the structures that are strained.


upper back painUnresolved whiplash injuries also cause upper back pain both directly from the structures that you damaged at the time of the accident and from the poor posture which you develop to ease your pain. Over time this leads to strain and eventual pain. Treatment should be directed to the whiplash injury and the correction of posture where indicated.


Overuse injuries often cause upper back pain because of the strain your muscles and other soft tissues are put under over time. The treatment for this upper back pain is to stop the overuse movement where possible or else change the way that you do it.


Subsequently, you may need to have treatment on the structures that are strained. Your Physiotherapist or Physical Therapist will tell you what to do.


Genetic conditions include Osteoarthritis, rheumatoid arthritis, and scoliosis. Treatment is individual in each case. The important aspect of treatment relies on the cause of the problem being addressed primarily followed by back strengthening exercises and posture exercises.


Remember - you can always treat the symptoms of a condition, even where you cannot always cure the underlying condition. Seek the right advice.



Please read the following for more information on dealing with specific types of Upper Back Pain:







Neck and Upper Back Pain. This is commonly seen in sedentary workers with poor working postures. Treatment involves correcting your posture and immediate work environment as well as manual therapy and exercises as required.


Read more on Neck and Upper Back Pain.



Upper Right Vs. Upper Left Back Pain.
This can occur if we favour the right arm more than the left arm - or vice-versa - repetitively over time. However, there are many other causes of one-sided upper back pain. This can be caused by poor posture or overuse. However, left-sided upper back pain may sometimes also be related to heart problems. Treatment involves eliminating the cause through advice, manual therapy and exercises.


Read more on Upper Right Vs. Upper Left Back Pain.



Pregnancy and Upper Back Pain.
This can occur as a result of the postural changes associated with pregnancy, or as a result of the "ligamentus laxity" that pregnancy hormones can cause - which results in strain on your upper back.


Read more on Pregnancy and Upper Back Pain.



Upper Back Pain Lungs.
I sometimes see people with Upper Back pain and lung pain. Whenever somebody comes to me with upper back and chest pain and I suggest that they check with their doctor for a chest infection or potentially something more serious in their lungs.


Read more on Upper Back Pain Lungs.



Exercises for Back pain.
Although manual therapy from your physiotherapist is an important part of the treatment of your upper back pain, exercises that you will carry out yourself are a necessity for the management and long term resolution of your symptoms.


Read more on Exercises for Back pain.


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The information on this web site does not replace specific medical advice. It should only be used to complement advice from your doctor. Always seek in-person advice from a doctor or other qualified health provider for your particular condition.