Why does my upper back hurt?
Upper back pain is usually a stillness problem rather than an injury. The mid-back is built to rotate and extend, a desk asks it to do neither, and the muscles holding your shoulder blades in place end up working continuously without ever getting a rest.
Upper back pain, in plain terms
The thoracic spine is the least-discussed part of the back and one of the most consequential. It’s meant to be your main source of rotation, and when it stiffens both the neck above and the lower back below start covering for it.
Pick whichever of these sounds most like yours. The answer is different for each, and the fix follows the cause.
Find your version
A specific knot under my shoulder blade
One spot, deep and gnawing, relieved by pressure for an hour then back. Often referred from the neck, which is why massage never holds.
General ache from desk work
Diffuse tension across the whole area, worse late in the day. Sustained low-level muscular work with no break.
I can’t rotate — reversing the car hurts
A mobility restriction rather than a pain problem, and the root cause of a good deal of neck and lower back trouble.
Whichever version is yours, see a doctor first if
- The pain began after a fall, a crash, or a direct blow
- You have numbness, pins and needles, or weakness anywhere
- The area is hot, red, or swollen, or you have a fever
- The pain is worst at night and doesn’t ease in any position
- You have unexplained weight loss or a history of cancer
- Pain on taking a deep breath, breathlessness, nausea, sweating, or jaw and arm discomfort — treat as an emergency
These are uncommon, but they point to problems that movement work won’t touch and that get harder to treat the longer they wait.