20 July 2026
Upper Back Pain usually refers to any pain between your neck and your waist, including between your shoulder blades. Some people notice it as a tight, aching feeling across the shoulders. Others feel it more sharply between the shoulder blades, especially after sitting at a desk, driving for a long time, lifting awkwardly or sleeping in a position that has not supported them properly.
This part of the spine is known as the thoracic spine, and although upper back pain is often less talked about than lower back pain, it can still be frustrating for many people day to day. Understanding what may be irritating the area is a good first step towards knowing what to do next.
Common Causes of Upper Back Pain
Poor Posture and Desk-Based Work
Poor posture is one of the most common reasons people start to feel pain in the upper back, especially if they spend most, if not all, of the day at a desk. When you sit for long periods, it is easy for the shoulders to round, the head to creep forwards, and the upper back to become stiff. Over time, this can place extra strain on the muscles and joints around the neck, shoulders and shoulder blades.
You might notice it as a tight ache by the end of the working day, discomfort between the shoulder blades, or stiffness when you stand up after sitting for a while. Things like a poorly positioned screen, an unsupportive chair or working from a laptop on the sofa can all make this worse, meaning your body must work harder to hold you in that position.
Muscle Strain or Overuse
Muscle strain can happen when the muscles in the upper back are asked to do more than they are used to. This might be from lifting something awkwardly, carrying heavy bags, doing repetitive work, training at the gym, gardening, decorating, or even a sudden movement that catches the area off guard.
When these muscles become irritated, they can tighten up to protect the area, which may lead to aching, stiffness or pain between the shoulder blades. Sometimes it comes on straight away, but it can also build gradually over a few hours or days, especially if the same movement is repeated without enough rest.
Joint Irritation in the Upper Spine
The joints in the upper back can become irritated when they are not moving as well as they should, or when the area has been placed under repeated strain. This can happen after long periods of sitting, twisting awkwardly, lifting, or spending too much time in one position. The upper spine also works closely with the ribs and shoulder blades, so stiffness in this area can sometimes feel quite localised, almost like a “stuck” or pinching feeling between the shoulders.
For some people, it is not a dramatic injury that sets it off. It may be a few weeks of poor sleep, a change in workstation, more driving than usual, or simply doing a bit more than the body is used to. When the joints become irritated, the surrounding muscles often tighten too, which can make the pain feel sharper when turning, reaching or taking a deep breath.
Rib or Shoulder Blade-Related Pain
Pain around the shoulder blade can be awkward to pin down because it does not always come from one single place. The upper back, ribs, neck and shoulders all work together, so irritation in one area can easily be felt somewhere else.
Some people describe it as a sharp catch near the shoulder blade when they turn, reach across the body or take a deeper breath. Others feel a dull ache that sits under or between the shoulder blades, especially after driving, desk work, lifting or sleeping awkwardly.
This is one of the reasons upper back pain can feel a bit confusing. What feels like a “shoulder blade problem” may be linked to stiffness in the upper spine, muscle tension, rib movement, posture, or a mixture of these things.
Sports Injuries and Repetitive Movements
Sport can put a lot of demand through the upper back, especially activities that involve twisting, reaching, throwing, tackling or repeated overhead movement. Football, golf, tennis, swimming and gym training can all leave the muscles and joints around the upper spine working hard, even if the pain does not show up straight away.
Sometimes it is a clear injury, such as a fall, a heavy challenge or a sudden twist. Other times, it is more gradual. Repeating the same movement again and again can irritate the muscles around the shoulder blades, ribs and upper spine, particularly if the area is already stiff or tired. This can lead to aching, tightness or a sharp pulling sensation when turning, reaching or taking part in the same activity again.
It is also common for people to push through mild discomfort during sport, only to notice the pain properly later that day or the next morning. That does not always mean something serious has happened, but it is a sign the area may need a bit more attention rather than being ignored.
Sleeping Position or Unsupportive Pillows
A lot of people notice upper back pain first thing in the morning, and sleep position can be part of the reason. If your pillow is too high, too flat, or no longer giving much support, your neck and upper back can spend hours in a slightly strained position. You may not feel it while you are asleep, but by the time you wake up, the muscles around the shoulders and upper spine can feel tight, sore or difficult to move.
Sleeping curled up, lying with one arm tucked under the pillow, or spending the night twisted to one side can also put pressure on the upper back and shoulder blade area. It does not always cause a sharp pain. Sometimes it is more of a heavy stiffness that eases as you get moving, then returns again after another poor night’s sleep.
When Should You Get Upper Back Pain Checked?
Most upper back pain is not caused by anything serious, especially when it comes on after sitting for too long, lifting awkwardly, exercising, or sleeping in an uncomfortable position. In many cases, it settles with gentle movement, rest from the activity that triggered it, and a bit of attention to posture and daily habits.
That said, it is worth getting upper back pain checked if it is not improving, keeps coming back, or starts to affect normal things like working, driving, sleeping or exercising. You should also seek medical advice sooner if the pain came on after a fall or accident, feels severe, spreads into the chest, or is linked with symptoms such as numbness, tingling, weakness, breathlessness, dizziness, fever, or unexplained weight loss.
If something does not feel right, do not just push through it. A proper assessment can help identify whether the pain is likely to be coming from the muscles, joints, ribs, posture, or whether it needs to be looked at by another healthcare professional.
Can a Chiropractor Help with Upper Back Pain?
Chiropractic care can be helpful for some types of upper back pain, especially when the problem seems to be linked to stiffness, tension, posture, or how the upper back, neck and shoulders are moving.
At Lichfield Chiropractic Clinic, the aim is not to guess the cause from the symptoms alone. Upper back pain can feel similar from person to person, but the reason behind it can be different. One person may be struggling after weeks of desk work. Someone else may have irritated the area through lifting, sport, driving, poor sleep, or a mix of several small things building up over time.
A chiropractor would usually start by asking about how the pain began, where you feel it, what makes it better or worse, and how it is affecting normal day-to-day movement. They can then assess how the spine, ribs, shoulders and surrounding muscles are working together.
Where chiropractic care is suitable, treatment may include hands-on work to improve movement and ease tension, along with simple advice you can actually use at home or at work. That might include small changes to your desk set-up, stretches, strengthening exercises, or ways to stop the same problem being aggravated again.
Why not get booked in with one of our expert chiropractors today? We have extensive experience pinpointing the root cause of upper back pain and would love to help you with yours.
