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Upper Back Pain
The upper back is stiffer by design than the neck or lower back — it has ribs attached to it. That stiffness makes it prone to aching under sustained postures, and to sharp catching pain when a rib joint stops moving properly. It is rarely serious and generally settles quickly with hands-on treatment and some movement.
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Does this sound like you?
Most people have several of these, not all of them.
- Aching between or under the shoulder blades
- A sharp catch on deep breathing, coughing or twisting
- A feeling of needing to click or crack the upper back constantly
- Pain wrapping around the ribcage towards the front
- Symptoms clearly worse at the end of a working day
Why it happens
- Long periods at a desk with the upper back rounded
- Carrying heavy bags on one shoulder
- Overhead or repetitive lifting at work
- A stiff rib joint that has stopped moving with the breath
- Stress, which loads the upper back and shoulders first
What we would do about it
Roughly in this order — each step waits for the one before it.
- Joint and rib mobilisation, which is often immediately effective
- Dry needling and soft tissue work for the muscle guarding around it
- Thoracic mobility and rotation exercises to do daily
- Shoulder blade and postural strengthening
- Workstation review, since this is usually a loading problem
- Breathing pattern work where the ribs are involved
See a doctor first if
- Your pain followed a significant injury
- It is getting worse rather than settling
- It comes with numbness, weakness or unexplained weight loss
This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment.
The upper back responds quickly to hands-on treatment
This is one of the more satisfying things we treat — a stiff rib joint often changes within a session. Then we work out why it stiffened up. Ask a question first, or call us on 0403 907 587.
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Other back conditions we treat
Related reading: the neck version of the same problem, shoulder conditions and lower back pain.
General information only, not advice about your own problem — nothing here replaces an assessment. Source: Postural Syndrome on Physiopedia.
