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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.

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.

  1. Joint and rib mobilisation, which is often immediately effective
  2. Dry needling and soft tissue work for the muscle guarding around it
  3. Thoracic mobility and rotation exercises to do daily
  4. Shoulder blade and postural strengthening
  5. Workstation review, since this is usually a loading problem
  6. 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.

Or call us on 0403 907 587 — we see patients across Seaton.

General information only, not advice about your own problem — nothing here replaces an assessment. Source: Postural Syndrome on Physiopedia.