Skip to main content
Musculoskeletal Symptom

Back pain (upper)

Upper back pain affects the thoracic spine, shoulders, and surrounding muscles and is often linked to posture, desk work, and muscle tension. Physiotherapy, osteopathy, massage, and the Alexander Technique are highly effective. Addressing the postural and lifestyle factors that contribute is key to lasting relief.

See therapies that may help

What is Back pain (upper)?

The upper back (thoracic spine) is less commonly affected by disc problems than the lower back, but is a common site of muscular tension, postural pain, and myofascial issues — particularly in people who work at desks or spend long hours at computers.

Poor posture, forward head carriage, rounded shoulders, and prolonged sitting all load the thoracic spine and surrounding muscles. Stress and tension are also significant contributors, with many people physically holding tension in the upper back and shoulders.

Signs and symptoms

Symptoms of upper back pain include:

  • Aching, stiffness, or sharp pain in the upper and mid back
  • Shoulder blade pain or pain between the shoulder blades
  • Muscle knots and tightness
  • Pain that worsens with sitting, computer work, or looking down
  • Associated neck or shoulder pain
  • Thoracic nerve irritation causing referred pain around the ribcage

Any chest pain should be medically assessed to rule out cardiac causes before attributing it to the upper back.

How therapy can help

A range of approaches effectively address upper back pain:

  • Physiotherapy and sports therapy — assessment, manual therapy, exercise prescription, and postural correction
  • Osteopathy and chiropractic — address spinal alignment and joint mobility
  • Massage therapy and myofascial release — target muscle tension and trigger points
  • Alexander Technique — strong evidence for spinal pain via postural re-education
  • Clinical Pilates and yoga therapy — build the core and postural muscles that support the thoracic spine
  • Bowen technique and acupuncture — commonly used for upper back pain

Seeking help

Upper back pain that is severe, persistent, associated with neurological symptoms (numbness, weakness, bladder or bowel changes), or accompanied by chest pain warrants medical assessment.

Most uncomplicated upper back pain responds well to physiotherapy and manual therapy, particularly when postural and lifestyle factors are also addressed.

Therapies that may help with Back pain (upper)

Showing 12 therapies linked to Back pain (upper).

Therapy Evidence Notes
Alexander Technique Practitioner
strong

Helps where posture and movement habits drive upper back pain.
Chiropractor
strong

Hands-on care for mechanical upper back pain; best combined with exercise.
Clinical Pilates Practitioner
strong

Builds the postural strength that supports the upper back and shoulders.
Massage Therapist
strong

Eases the muscular tension common in upper back and shoulder pain.
Myofascial Release Practitioner
strong

Releases the tight fascia behind upper back and shoulder tension.
Osteopath
strong

Hands-on treatment for mechanical upper back pain alongside movement advice.
Physiotherapist
strong

First-line care: assessment, exercise and posture advice for upper back pain.
Pilates Practitioner
strong

Strengthens posture and core to relieve upper back strain.
Sports Therapist
strong

Rehabilitation and conditioning for upper back strain, especially activity-related.
Acupuncturist
moderate

Used for upper back pain as part of broader management; outcomes vary.
Biofeedback Practitioner
moderate

Helps manage the muscle tension and stress involved in chronic upper back pain.
Yoga Therapist
moderate

Improves mobility and posture to ease upper back tension.

Frequently asked questions

Is upper back pain caused by poor posture?

Posture is a major contributor, particularly for desk workers. However, building strength and variability of movement is as important as correcting static posture.

Can stress cause upper back pain?

Yes. Emotional tension is frequently held in the upper back and shoulders. Addressing both the physical and stress dimensions often produces better outcomes.

Should I rest or keep moving with upper back pain?

Generally, keeping gently mobile is more beneficial than rest for most upper back pain. A physiotherapist can advise on appropriate activity for your specific presentation.