Living with upper back pain
Upper back pain can affect how you sit, sleep, breathe, or carry things. People often describe tightness or aching between the shoulder blades that worsens after long hours at a desk or on their feet. While it’s less common than neck or lower back pain, research shows that up to one in three adults experience it each year1. The good news is that most cases improve with active recovery and consistent movement, not rest.
Did you know?
Most people with upper back pain recover without surgery or imaging. Staying active and learning how to move confidently can reduce pain and prevent recurrence3.
What are the symptoms of upper back pain?
- Aching, stiffness, or burning between the shoulder blades
- Sharp or pulling pain when twisting, reaching, or taking a deep breath
- Pain that wraps around the chest or ribs
- Posture-related pain after sitting or standing for long periods
- Morning stiffness or end-of-day fatigue
- Trouble sleeping comfortably
- Occasionally, numbness or tingling around the trunk if a nerve is involved
What causes upper back pain?
Upper back pain usually comes from muscle strain, stiff joints, or irritation of the small joints and discs that connect the ribs and spine. These issues can develop from poor posture, repetitive lifting, or sitting still for too long. Common contributors include:
- Prolonged desk or screen time
- Heavy backpacks or awkward lifting
- Weak postural or shoulder blade muscles
- Stress or tension-related muscle tightness
- Osteoporosis (disease that weakens your bones, making them thinner and less dense) or broken vertebra in older adults
- Rarely, infection, cancer, or spinal cord pressure (serious but uncommon)
These causes are supported by imaging and rehabilitation guidelines, which emphasize posture variation, movement, and exercise over bed rest2 3.
When should I see a doctor for upper back pain?
Most back pain improves in a few weeks with self-care and exercise. However, you should seek medical help if you experience:
- Pain after trauma or a fall
- Numbness, tingling, or weakness in your legs
- Difficulty walking or changes in bladder/bowel control
- Unexplained fever, weight loss, or night pain
- History of cancer, osteoporosis, or immune suppression (reduction of the immune system's ability to fight off infections and diseases)
- Chest pain, shortness of breath, or rash along one side of the body
These signs may point to a more serious condition that needs prompt evaluation.
How is upper back pain treated?
Most people recover without surgery. Active care and exercise are the cornerstones of treatment:
- Education & activity: Keep moving and avoid long periods of rest. Adjust posture often instead of trying to hold a “perfect” one.
- Exercise-based rehab: Stretch and strengthen your upper back, shoulders, and core muscles (hip, abdominal, pelvic and back muscles). Focus on thoracic mobility, scapular control, and general fitness.
- Medications: Short courses of nonsteroidal anti-inflammatory drugs (NSAIDs) may ease pain.
- Manual therapy: Hands-on treatments like mobilization or massage can provide short-term relief when combined with exercise.
- Injections or surgery: Reserved for severe or specific causes such as nerve compression, fractures, or tumors.
Most uncomplicated cases improve within 6–12 weeks of consistent active care3 4.
Sword's approach
Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.
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