What's causing your upper back muscle pain?
Causes, posture, stretches and exercises

If you've been suffering from upper back muscle pain then you are not alone, discomfort across the upper back, neck and shoulders is epidemic in our modern society of phones, computers and long commutes. But don't despair! Applying some simple principles of good posture alongside a little bit of awareness and some specific exercises can make a huge difference to your symptoms.

By Oliver Wakefield M.Ost and Louise Pratley M.Ost

upper neck muscle pain, louise in painUpper back muscle pain can be a uncomfortable but fortunately there is loads that can be done

So what is causing your upper back muscle pain?

If your upper back muscle pain is arising from your work or any hobbies or habits where you are static for long periods of time then the chances are you are suffering from something we call 'static postural muscle pain'.

Essentially when a muscle is over used for long periods of time it fatigues and builds up in lactic acid. This process causes pain in the muscle eventually leading to trigger points (or knots) and then shortening of the muscle. This dysfunction put excessive strain on joints, ligaments and disks leading to a generally uncomfortable and painful situation.

If you are not sure what's causing your pain then scroll to the bottom of the page to look at differentiating between mechanical and non-mechanical lower back pain.

The process of static postural muscle pain can look a little something like this: 

Restriction at the top of the upper back

Poor posture at the desk loads the upper back and neck muscles, eventually causing compression and irritation through the upper thoracic vertebra leading to a fixed, hunched posture through the base of the neck.

Pain and restriction in the neck

As the upper back hunches forwards, the head is pushed as well leading to tighten of the neck muscles especially at the base of the skull potentially causing headaches, pain and restriction in neck movement especially rotating left and right.

Pain along the top and the front of the shoulders

As the head is pushed forward the trapezius muscles across the top of your shoulders contract to stop your head from falling further forwards. This causes the shoulder to drop forward causing pain and dysfunction not only across the top of the shoulders and into the neck but also at the front of the shoulders.

Upper back and shoulder blade pain

As the shoulders drop forward, the upper back flexes forwards causing a loading of your postural muscles in the upper back. The muscles which brings your shoulder blades together and fix your shoulders back begin to weaken, causing further dysfunction, restriction and pain. 

Lower back pain

The final stage of static postural muscle pain is lower back pain, as the body slumps down, the curve in the lower back tends to decrease, causing an increased load through the intervertebral disks and ligaments at the back of the spine.

Fixing upper back muscle pain

Does any of this sound familiar? If yes then read on.

If you spend a lot of time sitting then the chances are you experience some form of the upper back muscle pain that is outlined above. But what can be done?

While we would never claim to 'fix' or 'heal' anybody's upper back muscle pain, there IS a tremendous amount that can be done to minimise it's affects with very little effort.

Here are the top five tips recommended by the OFC for dealing with your upper back muscle pain, stiffness and other symptoms.

Step 1: Find the cause

While it may sound obvious, the first step in any life changing intervention is to find out what is going wrong in the first place. As discussed already, the chances are it's your posture while at work which is causing it. 

Taking some simple steps can make a huge difference.

- If you work in an office try adjusting the height of you computer monitor and the distance it is way from you.

- Try a better chair more suited to working long hours. A chair with adequate lumbar support is a great start.

Step 2: Stretch your muscles

As previously discussed, upper back muscle pain can be caused by a lack of adequate nutrition and waste removal to and from the muscles. Stretching is a great way to improve this flow, ensuring that your muscles are not building up in lactic acid and are not starting to shorten.

The best stretches for upper back muscle pain include stretches to the trapezius, pectoral muscles, rhomboids, levator scapulae and the muscles at the back of the head and upper neck.

upper back muscle pain, stretching the chest and upper shoulders
upper back muscle pain, stretching the back of the neck
upper back muscle pain, stretching the trapezius
stretching the rhomboids, upper back muscle pain

Step 3: Strengthening

Ensuring that your muscles are strong enough to do their job is crucial for relieving any upper back muscle pain. 

Strengthening your rhomboids can help to stop your shoulders from rounding and strengthening the muscles at the back of your neck can help to reduce tension type headaches and feelings of fatigue and lethargy.

upper back muscle pain, strengthen
upper back muscle pain, strengthen rhomboids
upper back muscle pain, strengthen rotator cuff
upper back muscle pain, strengthen latissimus dorsi

Step 4: Addressing the spine

Over time, poor posture at work can begin to shape and compress the spine, slowly worsening your condition. Certain exercises including things like the bridge, or simply lying on you back on the floor for a few minutes at the end of the day can help to reset the bent forward position that occurs after being sat in a car or office all day.

Louise demonstrates the use of rolled up yoga matt to help correct posture and relieve symptoms of pain through the spine.

upper back muscle pain, lumbar support
upper back muscle pain, lying over a rolled up towel
upper back muscle pain, leaning against a rolled up towel

Step 5: Staying aware

Staying aware is the hardest of the five steps especially as your symptoms begin to improve. Try to ensure that your head is over the top of your neck and body, not out in front. Bring you shoulders backwards and your chest forwards might feel strange initially but over time these tiny chances can make a world of difference.

reminder for good posture, upper back muscle painAdding a post it note to your computer can help to remind you to sit tall and maintain good posture

Making sure your upper back muscle pain is just that, and nothing else

Before we start it is important that we ensure your upper back muscle pain is just muscle pain and nothing else - to do that we need to rule out any other more serious pathology.

When patients come to us we initially seek to categorise their pain into two catagories:

Mechanical and non-mechanical

Mechanical pain is pain arising from a mechanical dysfunction. This could be a torn muscle, an inflamed tendon, an arthritic joint and so on. 

Non-mechanical pain arises due to non-mechanical causes including any pathology such as cancer, infection, fever and so on. 

They present in different ways and to rule out a more serious pathology we check pain against the following criteria:

  • Persistent, unremitting pain which never goes away and is not affected by position, movement or palpation
  • Pain which is non-responsive to pain medication
  • Pain which is worse at night or only present at night
  • Pain which is accompanied by unexplained weight gain or loss and fatigue
  • Pain which is accompanied by any number of unexplained systemic signs or symptoms including blood in stools, heavy periods, headaches, nausea, swelling, persistent dry cough and many more. 

If there is any suspicion you pain is non-mechanical, we suggest you seek advice from a medical doctor before continuing with any of the advice or exercises on this page. 


This page was written and composed by experts in their fields;


Oliver is a registered Osteopath in the UK with a particular interest in sports and rehabilitation - he practises in Devon, Southwest England.


Louise is a registered Osteopath, fitness model and enthusiast as well as a business and social influencer. She also practises as an Osteopath in Devon, UK.

Oliver and Louise specialise in helping people get over their pain and get back to living the lives they want to be living - follow this link to find out more about us.

We welcome any one who wants to get in touch with us here at the OFC for any reason - please use the form on our contact us page.

All the information and advice in this website should be followed with common sense and expert help - follow this link for our full disclaimer.