Physiotherapy For Upper Back Pain

Physiotherapy For Upper Back Pain!

For Thoracic Pain, Physiotherapy is an Indispensable Treatment Modality among patients experiencing discomfort and stiffness. Different causes can cause a person to experience this pain, such as bad postures, straining of muscles, or underlying medical conditions. Specific exercises and manual therapies for alleviating the pain, maximizing mobility, and promoting the strengthening of specific supportive muscles are offered by focusing on physiotherapy that targets upper back pain. With stretching, strength training, and posture correction techniques, physiotherapy stands out as an exceptional noninvasive approach for managing and reducing upper back pain.

What Comprises Your Upper Back?

It’s comprised of twelve vertebrae known as T1 through T12, collectively referred to as the thoracic spine. These vertebrae are connected to your ribs, which form a strong framework around vital organs like the heart and lungs while also allowing flexibility of movement. Various muscles located in the upper part of the back, including the trapezius, rhomboids, and latissimus dorsi, play significant roles in shoulder movements and posture maintenance. Furthermore, ligaments and tendons also help stabilize the upper back, thereby ensuring the preservation of a straight line of the spine. For efficient physiotherapy treatments to be implemented, then, there is a need to understand the anatomy of the upper part of the back.

What Are The Symptoms/Effects Of Upper Back Pain?

Different symptoms characterize upper back pain; thus, recognizing them at early stages will enhance prompt treatment intervention since they are important in choosing appropriate remedies. Some common symptoms experienced during this kind of physical problem include;

  • Aching or Dull Pain: Persistent dull ache within the thoracic region.
  • Sharp Pain: Sudden acute pain that may be localized or radiate to other parts.
  • Muscle Stiffness: Tightness with difficulty moving either shoulders or upper back.
  • Tenderness: Sensitivity when touching or pressing on the affected area.
  • Headaches: A headache that starts from tight muscles at the top rear.
  • Limited Range Of Motion: There is difficulty in bending, twisting, or reaching due to pain.
  • Muscle Spasms: Involuntary contraction or twitching of upper back muscles.
  • Postural Issues: Noticeable changes in posture, such as slouching or rounded shoulders.
  • Pain With Movement: Pain increases with certain movements, including lifting and bending.

As such early identification of these signs assists an individual in seeking appropriate physiotherapy that helps manage and alleviate upper back pain accordingly.

Diagnosis Of Upper Back Pain

Diagnosing the cause of upper back pain involves a thorough process aimed at finding out its origin and coming up with effective remedies. The steps commonly followed are;

Review Of Medical History: An intensive scrutinization of patient’s medical background which comprises past injuries, existing health conditions, lifestyle factors and symptom patterns. This is done to find out any underlying causes and risk factors associated with it.

Physical Examination: Proper physical examination is performed to observe the posture, range of motion, and specific sites of pain on palpation that cause tenderness. During this time, physiotherapists may touch the upper back muscles as well as the spine to identify areas characterized by stiffness, cramps, or deformities.

Symptom Evaluation: Describing the character of pain, including its intensity, duration, and any activities that either worsen or relieve it, enables one to understand what could be causing this type of ache felt in the upper part of the back.

Functional Tests: Carrying out several functional tests for gauging strength, flexibility, plus stability, specifically among upper back musculature as well as vertebral column. These can sometimes involve shoulder movement tests, spinal alignment examinations, and muscle functioning check-ups.

Imaging Studies: Advanced imaging techniques such as X-rays, MRI (Magnetic Resonance Imaging), or CT (Computed Tomography) scans are sometimes carried out to get a detailed view of the thoracic spine and adjacent soft tissues when needed. They may reveal occurrences like herniated discs, fractures, or degenerative processes.

Neurological Examination: Evaluating the neurological function to assess any potential nerve involvement. This may involve tests of reflexes, sensation, and muscle power in order to determine whether there is nerve compression or damage contributing to the pain.

What Causes Upper Back Pain?

Several sources contribute to upper back pain, which results in discomfort and limited mobility within the thoracic region. Some common triggers include:

Poor Posture: Prolonged hours sitting or standing in an incorrect manner exerts excessive pressure on thoracic spine. Slumping or curving over especially while working on a computer or looking down at your mobile phone results into muscle fatigue and strain thus causing upper back pain.

Muscle Strain: Excessive use of muscles located in the upper part of one’s body can lead to their straining. Such occurs from activities like lifting heavy items improperly repetitive motion injuries or sudden twists among others resulting in both immediate stiffness and pain.

Injury or Trauma: Injury from accidents, falls or sports can result into significant upper back pain Trauma may cause fractures sprains or muscle tears that disrupt normal functioning and architecture of thoracic spine plus its associated muscles.

Spinal Conditions: Various spinal conditions which result in upper back aches entail:

Herniated Discs: Pressing on nerves is done by bulging discs, leading to pain and discomfort.

Degenerative Disc Disease: Long-term wear and tear of spinal discs can bring about constant pain and reduced flexibility of the spine.

Osteoarthritis: Degeneration of cartilage in the spine results in pain and inflammation.

Sedentary Lifestyle: Lack of physical activity weakens muscles supporting the backbone thus causing poor posture thereby making one more susceptible to upper back ache. Further, a sedentary lifestyle leads to weight gain which puts more stress on the back.

Psychological Stress: Anxiety and stress tighten muscles at the top back. Prolonged muscle tension during stressful times often causes continued contraction hence pain and discomfort.

Underlying Medical Conditions: Upper back pain may be as a result of medical conditions like osteoporosis (weakening bones) or scoliosis (curvature of spine). Pain around thoracic region can also be caused by infections such as spinal infection or shingles.

Poor Ergonomics: Improper ergonomic setups at workplaces or in various activities can lead to repetitive strain injuries causing chronic upper back pains. To guard against this, it is important that there should be proper alignment and support while working both on desk or with physical tasks as well.

Types of Upper Back Pain

Classification of upper back pain can be based on its features, causes, and the period it lasts. Understanding the various types of upper back pain is important in diagnosing and treating them. Some are:

Acute Upper Back Pain: Acute pain is short-term and most commonly lasts more than six weeks. This could often come as a result of sudden injury such as improper lifting strains, sprains or falls and accidents. Symptoms include sharp, intense pain that may restrict movement that needs immediate attention.

Chronic Upper Back Pain: Chronic pain occurs for more than three months in a row and can be caused by underlying conditions like osteoarthritis or degenerative disc disease. It feels dull or burning and comes with stiffness as well as long-term mobility problems.

Mechanical Upper Back Pain: This results from musculoskeletal mechanical issues like poor posture, overuse syndrome, or ergonomics-related problems. Mechanical pain is mostly localized and gets worse when there are specific movements or prolonged static positions.

Referred Upper Back Pain: This starts somewhere else but is then felt in the upper back. Illnesses such as gallbladder diseases, heart problems, or gastrointestinal disorders contribute to this type of condition. The main health issue must be addressed to make an accurate diagnosis possible.

Myofascial Pain: Muscle tightness and tenderness in muscle fibers characterized by trigger points explain musculoskeletal myofascial upper back pain. The muscles become tense again due to repetitive strains during work activities, poor posture, and psychological pressures, which cause myofascial pains in the upper part of the body near the neck area.

Neuropathic Upper Back Pain: Nerve damage or compression could lead to neuropathic pain. It may involve tingling numbness, neck-shoulder limb weakness accompanying this kind of painful condition caused by herniated discs, which cause spinal stenosis, among other things;

How Does Physiotherapy Help with Upper Back Pain?

Physiotherapy helps in relieving upper back pain significantly through a systematic and versatile approach. An initial physiotherapist examination of root causes is done for the purpose of thorough understanding. This assessment often involves an extensive clinical history and physical examination and may be supported by diagnostic imaging. Following this finding, a tailored treatment program encompassing both active and passive physiotherapy techniques to meet the patient’s specific requirements is formulated. Usually, this plan includes interventions such as manual therapy, targeted exercises, and modalities like heat, cold, or electrical stimulation, which are meant to reduce pain and inflammation.

The physiotherapist also leads the patient through various exercises aimed at strengthening back muscles, improving one’s posture, and increasing flexibility once the treatment plan has been outlined. For this phase to succeed, patients must actively participate by ensuring that they maintain their fitness schedule as well as stretching routines on a regular basis. Additionally, mobilization of stiff joints and soft tissues using manual therapy may be necessary, whereas other passive treatments such as ultrasound therapy hydrotherapy can facilitate the healing process. Furthermore, effective management of pain in the future requires educating the patient on ergonomic adjustments and lifestyle modifications essential to this program.

During this time period, ergonomically catering to someone’s pain while teaching them how to avoid any future recurrence will go a long way towards helping them manage their pain effectively without suffering from it again.

Benefits of Physiotherapy on Upper Back Pain

Physical therapy has different benefits for upper back pain, aimed at reducing the discomfort and improving overall appearance. These include:

Reduction of pain: Physiotherapy can be used to manage lower back pain through exercises and hands-on techniques, which leads to a significant reduction in pain. This enables people to carry out their daily activities without being uneasy.

Improved mobility and flexibility: physiotherapists develop plans that will help increase movement range and flexibility in the area between shoulders. This will enable patients to regain free movement with reduced effort.

Muscle strengthening: Through power training exercises for muscles supporting the spine, there is a lower chance of getting future injuries. Stronger muscles contribute to better posture and spinal alignment.

Posture correction: Physiotherapists advise patients on proper sitting position as well as providing exercises for rectifying abnormal postures that cause upper back pain in many people.

Reducing stress levels: Patients suffering from psychological stress-related muscular tension can benefit from physical relief provided by physiotherapy treatments for upper back pain, including education about how physical manifestations of stress influence these conditions.

Prevention of injuries: Proper body mechanics as well as strengthening exercises can help prevent future upper back problems especially among workers who engage in manual labor or athletes.

Personalized treatment programs: Any physiotherapy plan is made individually for each patient depending on his condition thus yielding higher efficacy and specificity achieved in management of this kind of ache.

Physiotherapy Treatments for Upper Back Pain

Physiotherapy not only treats immediate distress but also equips patients with the tools needed to keep their spines healthy and prevent a recurrence. To sum up, various techniques are used during physiotherapy for the treatment of this type of problem, like targeted exercise aimed at enhancing a comfortable life and manual therapies dealing with muscle relaxation and tension relieving, among others, while strength training is intended towards strengthening muscles supporting the vertebral column. Apart from teaching how to have proper sitting positions and doing exercises for straightening out the abnormal postures that mainly cause upper back pain, experts in this field also provide stress management techniques that aim at alleviating both physical and mental forms of this problem. Every patient receives the best possible treatment with regard to their unique conditions as well as individual needs through the use of individually developed plans for effective pain management and recovery.

Active physical therapy for your upper back

Active physiotherapy involves exercise and activity intended to strengthen back muscles, improve flexibility, and promote overall spinal health. Active physiotherapy requires patient involvement compared to passive treatments. Here are some active physiotherapy strategies for your upper back:

Stretching exercises

These will help in improving flexibility in the muscles of the upper part of the spinal cord. Common stretches include cat-cow stretch, thoracic extension, and doorway stretch among others. Regular performance of these stretches can relieve tension and increase mobility at the level above.

Strengthening exercises

Better support and stability can be provided by strengthening muscles around the shoulders and upper back. Scapular squeezes, resistance band rows, wall angles, etc., are exercises that target strong muscle tone within such areas; a physiotherapist will customize these according to individual fitness levels.

Core Strengthening

Keeping a good posture helps maintain a strong midriff hence reducing any strain on one’s upper back region. Some core stabilization exercises like planks, bridges, or Pilates-based moves can help build a strong core area, which in turn assists the upper section, which includes the neck.

Active Postural Training

This involves exercises and techniques that are designed to improve and maintain a good posture, which include activities such as seated and standing postural drills that encourage back muscles and shoulder muscles to hold an appropriate position.

Aerobic Conditioning

The incorporation of aerobic exercises such as walking, swimming, or cycling can enhance cardiovascular health in general and boost blood flow to the spinal muscles. Regular aerobic activity is helpful in reducing inflammation and pain in the upper back.

Functional Training

Focus on functional training exercises replicating everyday activities that enhance coordination and strength required for routine tasks involving lifting, carrying, reaching, etc., but with proper body mechanics.

Mind-Body Techniques

Yoga and Tai Chi are among some of the techniques that combine physical activity with mindfulness/breathing exercises aimed at improving flexibility/strength while at the same time helping relieve stress-related muscle tensions around upper back.

Passive Physiotherapy for Your Upper Back

A physiotherapist administers these techniques most often to alleviate your pain, reduce inflammation, and facilitate relaxation without requiring any activeness from you as a patient. Here are some passive physiotherapy methods for your upper back:

Massage therapy

Massage therapy refers to the manipulation of the soft tissues so as to release muscle tension and enhance circulation, thereby increasing overall relaxation. In this case, various approaches like deep tissue massage, myofascial release work, or trigger point therapy target specified areas where there is discomfort felt in your upper back, thus aiding recovery and easing off pain.

Heat & Cold Therapy

Relaxation of tight muscles, increased blood flow as well as reduced stiffness can be achieved by applying heat on the upper back unlike cold therapy (cryotherapy) which reduces inflammation around it numbing it down thereby relieving acute pains experienced here. Alternating between heat/cold works best for management of upper back pain.

Ultrasound Therapy

Ultrasound therapy utilizes sound waves to penetrate deep into your muscle tissues, promoting increased blood flow and decreased pain and inflammation. This procedure is usually employed in the treatment of soft tissue injuries and muscle spasms situated on the upper back.

Electrical Stimulation

This involves the use of equipment such as Transcutaneous Electrical Nerve Stimulation (TENS), which sends low-voltage electrical currents to the location being treated. It does this by minimizing pain signals reaching the brain while also enhancing natural pain relief mechanisms through relaxing muscles.

Manual Therapy

Manual therapy refers to hands-on techniques performed by a physiotherapist to mobilize and manipulate joints/soft tissues in your upper back. It helps restore mobility, alleviate pain, and improve function. Joint mobilization, manipulation, or soft tissue techniques can be used here.


Spinal traction means gently pulling or stretching the spine either using a mechanical device or a physiotherapist’s hand. This process helps relieve pressure from spinal nerves and discs, therefore reducing pain while adjusting alignment. Traction is specifically effective for conditions like herniated discs or pinched nerves.


Hydrotherapy creates a therapeutic environment in the upper back through water’s buoyancy, resistance as well as warmth. Muscles relax when exercise takes place in warm water, reduced pain & increased movement are attained without putting extra strain on your spine.

Taping of Kinesiology

They place a stretchy special tape on your back’s top. This tape gives the muscles and joints support, fights inflammation, and helps fix one’s posture. While eliminating discomfort and providing pain control, it facilitates complete freedom of motion.

5 Best Exercises for Upper Back Pain

Dealing with upper back pain is a tough nut to crack, but some specific exercises can provide relief and muscle strengthening. There are, however, five effective exercises for relieving pain in the upper part of your back.

Cat-Cow Stretch

This gentle stretch improves flexibility and relieves tension in the spine. Start on all fours, making sure that your wrists are under your shoulders and knees under your hips. On inhaling, arch your back, lifting up your head and tailbone towards the sky (Cow Pose). As you exhale, round your back and tuck in your chin and pelvis (Cat Pose). Repeat this process 10-15 times.

Thoracic Extension

It targets the thoracic spine, thus aiding in improving mobility and reducing stiffness. Sit on a chair with both feet flat on the floor. Place hands behind head with elbows pointing outwards. Gradually arch over the chair’s backrest while maintaining a neutral lower back. Maintain extension for several seconds before returning to the starting position (sit upright). Do it again 8-10 times.

Thread the Needle

It is a stretching exercise that opens up tightness within the shoulders and upper back; it feels good, too! Begin in the Tabletop position, which is formed by kneeling while placing palms flat on the ground/mat, fingertips forward so that they form right angles to the mat/floor beneath them; from there, slide my right arm underneath the left one by putting weight onto right shoulder as well as ear; keep left hand grounded below my shoulder during this process. Hold for twenty-thirty seconds, then switch sides and perform two or three reps per side.

Child’s Pose

This yoga posture helps to stretch out the upper backs along with the shoulders too gently. Start hands down/knees bent until reaching arms forward at once while sitting hips toward heels, simultaneously extending arms ahead of you, fold over at waistline, forehead touching ground/relaxing neck (the floor is a good place to put my forehead and relax my shoulders). Stay in this position for about 30 seconds–1 minute, inhaling deeply.

Prone Cobra

This exercise will strengthen the muscles in your upper back while working on your posture. Lay flat on the mat with legs outstretched and hands by sides, palms facing down towards the floor. Engage core and lift chest off the ground, pulling shoulder blades together. In order to prevent neck strain, continue gazing down throughout the exercise. Hold for some seconds, then lower down. Repeat ten-twelve times

How often should you stretch your upper back for back pain?

Stretching of the upper back regularly can help reduce pain significantly as well as enhance mobility. Stretching exercises are recommended to be done two to three times a week for better results. However, some professionals suggest that stretching every day may bring more consistent relief and improve flexibility in general better.

A six-week observation of people who did daily stretches on their upper back, as written in the Journal of Physical Therapy Science, showed decreased levels of pain and increased functional ability. Furthermore, the American College of Sports Medicine (ACSM) recommends most days involve stretching, where regularity becomes important when trying to keep musculoskeletal health going.

Final Words

In conclusion, both active and passive physiotherapy methods provide valuable strategies for managing upper back pain. Active physiotherapy treatments involve exercise, which makes patients strong enough to cope with treatment, improving flexibility and enhancing postures, whereas passive physiotherapy involves hands-on techniques that alleviate pain without requiring any participation from the patient. On top of maintaining its functionality throughout one’s entire life, with a few stretches being done consistently every day, along with combined therapies included in a normal routine, is the best way to get long-term relief from this illness. Visiting healthcare professionals will assist an individual in coming up with an appropriate plan that takes into account particular requirements, which in turn guarantees a holistic approach towards disease management, especially regarding rear neck pains.


Q: What typically causes upper back pain?

A: Upper back pain may result from various sources including bad body posturing, muscular strain due to overuse or trauma injuries among others; herniated discs; osteoarthritis; scoliosis or kyphosis, and even sedentary lifestyles and weight-lifting or repetitive movement based activities.

Q: How can physiotherapy help in relieving upper back pain?

A: Physiotherapy is highly effective in relieving upper back pain through a combination of active and passive techniques. Active physiotherapy involves exercises to strengthen and stretch the muscles, improving posture and flexibility. In turn, passive physiotherapy encompasses massage, heat therapy, cryotherapy, ultrasound treatments as well and TENS, which are useful for reducing pain intensity plus inflammation while ensuring recovery rates rise.


"Hasan", I am a physiotherapy Doctor. I have completed my B.S.c course (4 years) under Rajshahi University, Faculty of Medicine, Rajshahi. Currently I am working as a clinical physiotherapist at a renowned physiotherapy center and I am continuing my MPT (Master's of physiotherapy) degree at CRP, Savar.

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