EPISODE 54: Upper Back Strain- Why It Happens & How to Fix It for Good!
- Dr. Ja'nae Brown
- Mar 19
- 4 min read
Upper Back Strain: Why It Happens & How to Fix It
One of the most common complaints we hear in physical therapy is upper back pain—that nagging discomfort between the shoulder blades. It’s sore, tight, tender, and often feels like if someone could just dig into it with their fist, the pain would go away.
The culprit? An upper back strain. In this blog, we’ll break down the symptoms, causes, and most importantly, how we fix this problem and get you back to feeling your best.
What Causes Upper Back Pain?
If you’ve ever had pain between your shoulder blades, you know it can make simple tasks miserable. Sitting comfortably, getting a good night’s sleep, or even lifting objects can be a challenge.
Let’s break down the anatomy to understand why this happens.
A muscle strain, also known as a pulled muscle, happens when muscle fibers are overstretched or torn due to excessive force, overuse, or improper movement. In the upper back (thoracic region), strains typically involve muscles responsible for posture, scapular movement, and spinal stabilization.
The most commonly affected muscles include:
Trapezius – A large, superficial muscle covering the upper back and neck. It helps with scapular elevation, retraction, and rotation. Poor posture, excessive lifting, or repetitive movements often strain this muscle.
Rhomboids (Major & Minor) – Located between the scapulae and spine, these muscles retract and stabilize the shoulder blades. Prolonged slouching or excessive pulling motions can lead to strain.
Levator Scapulae – Running from the neck to the top of the scapula, this muscle assists with scapular elevation and neck movement. It’s commonly affected by stress, overuse, or excessive forward head posture.
Symptoms of an Upper Back Strain
Not sure if you have a muscle strain? Here’s what to look out for:
✔ Pain in the Upper Back – Aching, burning, or sharp discomfort between the shoulder blades that worsens with movement, lifting, or prolonged poor posture. ✔ Muscle Tightness or Stiffness – Difficulty moving your upper back, shoulders, or neck, often worse in the morning or after inactivity. ✔ Tenderness to Touch – Soreness when pressing on affected muscles. ✔ Swelling or Mild Inflammation – Some localized swelling or warmth in the affected area. ✔ Muscle Spasms – Involuntary muscle contractions that cause discomfort. ✔ Pain with Specific Movements – Increased discomfort when reaching, pulling, twisting, or sitting for extended periods with poor posture. ✔ Limited Range of Motion – Difficulty rotating the upper back or freely moving the arms. ✔ Radiating Discomfort – In some cases, pain may extend into the shoulders or neck but should not cause numbness, tingling, or weakness in the arms (which could indicate a nerve issue).
How to Treat an Upper Back Strain from Home!
If you think you’ve strained your upper back, follow these steps to manage pain, promote healing, and prevent further injury:
1. Pain Management
💊 Medication – Over-the-counter NSAIDs (ibuprofen, naproxen) or acetaminophen can help reduce pain and inflammation (if approved for you).
🛌 Modify Your Sleeping Position – Sleep on your back or side with proper pillow support.
📉 Reduce Back Stress – Maintain good posture while sitting and standing. Avoid slouching or hunching forward, especially when using your phone or computer. Avoid activities that aggravate the pain.
2. Gentle Stretching & Movement
Once initial pain subsides, gentle movement helps prevent stiffness and promotes healing:
🟢 Child’s Pose Stretch – Sit back on your heels, extend your arms forward, and lower your chest toward the floor.
🟢 Thoracic Extension Stretch – Sit on a chair, place your hands behind your head, and gently lean back. 🟢 Scapular Retraction – Squeeze your shoulder blades together and hold for 5 seconds, then release. Repeat 10-15 times.
When to See a Physical Therapist
🚩 If pain lasts more than 1-2 weeks despite self-care. 🚩 If you experience numbness, tingling, or weakness in your arms (could indicate a nerve issue). 🚩 If pain is severe, worsening, or affecting daily activities. 🚩 If you have difficulty breathing, chest pain, or fever (seek immediate medical care).
How Physical Therapy Can Help
Seeing a physical therapist (PT) for an upper back strain can speed up recovery, restore mobility, and prevent future issues.
Here’s what to expect:
Initial Evaluation – Your PT will assess pain levels, range of motion, muscle strength, and posture.
Pain Management & Early Treatment – Hands-on manual therapy, soft tissue massage, joint mobilization, and modalities like cupping, KTape, and dry needling as needed.
Mobility & Gentle Activation Work – Guided activation and movement drills to restore function and movement.
Strengthening & Functional Training – Exercises to build back endurance and improve postural stability.
Return to Activity & Prevention – Sport-specific drills, ergonomic adjustments, and a home exercise program to maintain progress.
How Long Does Recovery Take?
🟢 Mild strain (Grade 1): 1-2 weeks 🟡 Moderate strain (Grade 2): 3-6 weeks 🔴 Severe strain (Grade 3): 2+ months (may require additional rehab)
If your upper back pain is lingering, don’t ignore it! Physical therapy can help you recover faster, move better, and prevent this from happening again.
Need Help with Upper Back Pain?
If you’re struggling with pain and stiffness in your upper back, our team is here to help. Schedule an appointment today to start feeling better and get back to doing what you love!
📅 Book an in-person or virtual physical therapy session today!
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Keep Moving ❤️,
Dr. Brown & The PTSP Team
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