Whether your upper back feels painful, stiff or restricted, or you're experiencing discomfort around your shoulder blades or ribs, I'll help identify what's contributing to your symptoms and find the right treatment to help you move more comfortably and get back to doing what matters.
Upper Back Pain Treatment in Hayes, West London
The upper and middle back known as the thoracic spine, sits between the neck and lower back and connects with the ribs to form an important part of the trunk and rib cage.
Pain in this area can be felt directly over the spine, to one side of the upper back, between or around the shoulder blades, or sometimes around the ribs and chest wall. Symptoms may appear suddenly after an awkward movement, lifting or exercise, or gradually build with prolonged sitting, work or changes in activity.
Because the thoracic spine works closely with the neck, shoulders and ribs, problems in one area can sometimes influence how the others move and feel. Upper-back symptoms can therefore present very differently from person to person.
Types of Upper Back Pain
Upper-back pain isn't always one specific condition. For some people, the main problem is pain or tenderness around the spine or shoulder blades; for others, it's stiffness, reduced rotation or discomfort associated with the ribs.
Symptoms can also become particularly noticeable during prolonged desk work, exercise, lifting or activities requiring repeated rotation or overhead movement.
Use the sections below to find the information that most closely matches what you're experiencing.
Upper Back Navigation
The Painful Lower Back
Upper-back pain may develop suddenly following lifting, exercise or an awkward movement, or gradually without one obvious injury. It may feel like a localised ache or sharper pain around the thoracic spine, or spread across the muscles and around the shoulder blades.
Movement of the upper back, neck, shoulders and ribs can all influence symptoms. Activities involving twisting, reaching, lifting or taking a deeper breath may sometimes make the area more noticeable, depending on which structures are involved.
You may notice:
Aching or pain between the shoulder blades
Pain predominantly on one side of the upper back
Tender or tight muscles around the thoracic spine
Pain when twisting or reaching
Discomfort with prolonged sitting
Pain with certain shoulder or arm movements
Discomfort around the ribs or with deeper breathing
Thoracic Joint & Facet Pain
The thoracic spine contains small facet joints between the vertebrae that help guide and control movement through the upper and middle back. The ribs also connect with the thoracic spine, meaning movement in this area involves several joints working together.
These joints can sometimes become painful or irritated, producing a relatively localised ache or sharper pain around the spine, often more noticeable on one side. Symptoms may be aggravated by rotation, extension, side bending or prolonged positions, and pain can sometimes be felt slightly away from the affected area.
Joint-related pain may develop after an awkward movement or increased activity, but it can also gradually appear without one obvious injury.
Muscular Upper Back Pain
The upper back contains numerous muscles involved in controlling the spine, shoulder blades, ribs and shoulders. These muscles work during everything from sitting and reaching to lifting, pulling and exercise.
A sudden movement, unfamiliar exercise or increase in physical load can sometimes result in a muscular strain, while prolonged positions or repeated activity may leave the area feeling aching, tight, tender or fatigued.
Pain may be felt beside the spine, across the upper back or around the shoulder blades and can sometimes be aggravated by reaching, lifting, twisting or particular movements of the arms and shoulders.
Thoracic Osteoarthritis & Degenerative Changes
Osteoarthritis and age-related changes can develop within the joints, discs and other structures of the thoracic spine over time. You may have seen terms such as thoracic spondylosis, spondyloarthrosis, degenerative disc disease or degenerative changes written on an X-ray or MRI report.
These findings become increasingly common as we get older and can be present in people who have no upper-back pain at all. Seeing them on a scan therefore doesn't automatically mean they're responsible for your symptoms or that your spine is damaged.
When these changes are associated with symptoms, they may contribute to aching, stiffness and reduced movement through the upper or middle back. Symptoms may be more noticeable after prolonged periods in one position or during activities requiring rotation or extension through the upper back.
Thoracic Disc Problems
The discs sit between the vertebrae and help distribute load while allowing movement through the spine. Disc bulges and herniations can occur in the thoracic spine, although symptomatic thoracic disc problems are considerably less common than those affecting the neck or lower back.
You may have seen terms such as disc bulge, disc protrusion, herniation or prolapse on an MRI report. As elsewhere in the spine, finding a disc change on imaging doesn't automatically mean it is responsible for your symptoms.
When a thoracic disc is symptomatic, pain may be felt around the middle or upper back and can occasionally travel around the rib cage or trunk. More significant neurological symptoms are much less common but would warrant appropriate medical assessment.
The Stiff Upper Back
Upper-back stiffness can make turning, reaching and moving your shoulders feel restricted and may leave you feeling as though you constantly need to stretch or “loosen” the area.
The thoracic spine naturally has less movement than the neck or lower back because of its connection with the rib cage, but maintaining comfortable movement through this area remains important for everyday activity, exercise and overhead movement.
Stiffness often becomes noticeable after prolonged periods sitting or working at a screen and may also develop following an injury, a painful episode or periods of reduced activity.
You may notice:
Difficulty rotating comfortably from side to side
A stiff or restricted feeling between the shoulder blades
Stiffness after prolonged sitting or driving
Feeling the need to repeatedly stretch or move your upper back
Difficulty comfortably reaching overhead
Your upper back loosening once you start moving
Restrictions during gym exercises or sport
Reduced Thoracic Mobility & Joint Stiffness
The thoracic spine is made up of 12 vertebrae, with joints between each level and connections to the ribs. Together, these allow the upper and middle back to rotate, bend and extend while also providing a relatively stable base for movement of the neck, shoulders and rib cage.
Movement through this area can become restricted for a number of reasons, including prolonged periods in one position, changes in activity, pain or simply becoming less active over time. You may notice that turning, reaching or extending through your upper back doesn't feel as comfortable or as free as it used to.
Reduced thoracic movement can also become particularly noticeable during activities that require movement from several areas at once. Reaching overhead, rotating during sport, squatting or performing certain gym exercises may all feel different when the upper back isn't moving comfortably.
Muscular Tightness & Stiffness
The upper back contains several layers of muscles that help control the thoracic spine, ribs and shoulder blades. These muscles are working throughout the day during sitting, reaching, carrying, exercise and movement of the arms and shoulders.
After prolonged periods in one position, changes in activity, unfamiliar exercise or an episode of pain, the muscles around the upper back can sometimes feel tight, tired or guarded. This may create a feeling of stiffness even when there isn't significant pain.
Some people describe constantly wanting to stretch, move, crack or massage the area to get temporary relief. While this can feel helpful, recurring muscular tightness may also be worth looking at in the context of your overall movement, strength, workload and activity levels rather than simply treating the tight muscle itself.
The Shoulders, Neck & Upper Back
The upper back doesn't work in isolation. Movement of the thoracic spine, shoulder blades, shoulders and neck all work together during everyday activities such as reaching, lifting, turning and moving your arms overhead.
For example, comfortably reaching overhead requires movement not only from the shoulder joint but also from the shoulder blade and thoracic spine. Similarly, stiffness through the upper back may change how you move through the neck or shoulders during work, exercise or everyday activities.
This doesn't necessarily mean that stiffness in one area is causing pain somewhere else. However, looking at how these regions move and work together can help identify restrictions or areas that may benefit from improved mobility, strength or control.
Thoracic Osteoarthritis & Degenerative Changes
Osteoarthritis and age-related changes can develop within the joints, discs and other structures of the thoracic spine over time. You may have seen terms such as thoracic spondylosis, spondyloarthrosis, degenerative disc disease or degenerative changes written on an X-ray or MRI report.
These findings become increasingly common as we get older and can be present in people who have no upper-back pain or stiffness at all. Seeing them on a scan therefore doesn't automatically mean they're responsible for your symptoms or that your spine is damaged.
When these changes are associated with symptoms, they may contribute to aching, stiffness and reduced movement through the upper or middle back. You might notice difficulty rotating comfortably, stiffness after prolonged sitting or inactivity, or restriction during activities that require movement through the upper back and rib cage.
Staying active and maintaining movement and strength can remain important even when degenerative changes are present. Treatment and rehabilitation can focus on helping you move more comfortably and continue with the everyday activities, work or exercise that matter to you.
Rib & Costovertebral Joint Pain
The ribs connect with the thoracic spine through small joints at the back of the rib cage. Irritation around these joints or the surrounding tissues can produce pain beside the spine or around the shoulder blade and may sometimes spread around the side of the chest.
Symptoms can be aggravated by twisting, reaching, coughing or taking a deep breath. Rib-related pain is covered in more detail in the Rib & Chest Wall Pain section below.
Post Injury or Post Surgical Upper Back Stiffness
Following an injury to the upper back or rib cage, or after surgery involving the thoracic spine or chest, it's common for movement to feel restricted for a period of time. Pain, muscle guarding and temporarily reducing how much you move can all contribute to stiffness as the area recovers.
As healing progresses, gradually restoring comfortable movement and rebuilding strength can help you return to normal everyday activities, work and exercise. Following surgery or a significant injury, this should be guided by your stage of recovery and any advice or restrictions provided by your medical team.
Rib & Chest Wall Pain
The ribs connect to the thoracic spine through small joints at the back of the chest and move alongside the spine and surrounding muscles during breathing, twisting and everyday movement.
Pain arising from the ribs, rib joints or surrounding muscles can sometimes be felt around the back of the rib cage, alongside the spine or shoulder blade, or travel around towards the side of the chest.
Symptoms may follow coughing, exercise, lifting or an awkward movement, but can also develop gradually. Depending on the structures involved, twisting, reaching or taking a deep breath may aggravate the area.
You may notice:
Localised pain around a rib or beside the thoracic spine
Pain wrapping around the side of the rib cage
Discomfort when twisting or reaching
Pain with coughing or sneezing
Discomfort when taking a deeper breath
Tenderness around the ribs or muscles between them
Pain following exercise, lifting or an awkward movement
Costovertebral & Rib Joint Pain
Each rib connects with the thoracic spine through small joints at the back of the rib cage. These costovertebral and costotransverse joints help the ribs move alongside the thoracic spine during breathing, twisting and movement of the trunk.
Pain around these joints may be felt as a localised ache or sharper pain beside the spine or around the shoulder blade, and can sometimes spread around the side of the rib cage. Symptoms may develop after an awkward movement, lifting, exercise or prolonged coughing, but can also appear without one obvious trigger.
Because the ribs move every time you breathe, symptoms can sometimes become more noticeable with deep breathing, coughing, sneezing, twisting or reaching. Certain arm and shoulder movements may also aggravate the area because of the way the shoulder blade and rib cage work together.
Intercostal & Chest Wall Muscle Pain
The intercostal muscles sit between the ribs and help move and stabilise the rib cage during breathing and movement. Other muscles around the chest wall, upper back and shoulders also attach onto the ribs and can contribute to pain in this area.
These muscles can become painful or strained following exercise, repetitive twisting, lifting, prolonged coughing or a sudden increase in activity. Pain may be relatively localised or spread along part of the rib cage and can sometimes feel sharp with particular movements.
Symptoms may be reproduced by twisting, reaching, coughing, sneezing or taking a deeper breath, and the affected area may feel tender when touched or when the surrounding muscles are used.
When Chest or Upper Back Pain Needs Medical Attention
Most upper-back and rib pain is musculoskeletal, but pain around the chest or upper back can sometimes have other causes.
Seek urgent medical attention for new or severe chest pain, particularly if it feels like pressure, heaviness or tightness, or occurs alongside shortness of breath, sweating, nausea, faintness, or pain spreading into the arm, jaw or back.
Sudden unexplained difficulty breathing, coughing up blood, severe symptoms following significant trauma, or feeling acutely unwell also require urgent medical assessment.
Scoliosis & Upper Back Pain
Scoliosis describes a sideways curvature of the spine accompanied by rotation of the vertebrae. It can affect the thoracic spine, lumbar spine or both, and the size and shape of the curve can vary considerably from person to person.
Some scoliosis is structural, meaning there is a persistent three-dimensional change in the shape and rotation of the spine. This includes idiopathic scoliosis, which commonly develops during adolescence, as well as curves associated with other underlying conditions.
You may also hear the term “functional” or “non-structural scoliosis.” This is generally used to describe a spinal curve that occurs in response to another factor; for example, differences in leg length, positioning or muscular factors , rather than a fixed structural change within the spine itself.
Scoliosis is often first identified during childhood or adolescence, although some people only become aware of a curve later in life or develop changes associated with ageing. If a new or progressing spinal curvature is suspected, particularly in a child or young person, appropriate medical assessment may be recommended.
Having scoliosis doesn't automatically mean you will experience pain. Many people with scoliosis remain active and experience few or no symptoms. For others, differences in how the spine, rib cage and surrounding muscles move and manage load may be associated with back pain, stiffness or muscular fatigue.
You may notice:
Aching or stiffness through the upper or lower back
One shoulder sitting higher than the other
One shoulder blade or side of the rib cage appearing more prominent
Differences in the shape of the waist or trunk
Muscular aching or fatigue after prolonged sitting or standing
Differences in movement from one side to the other
Discomfort during certain activities, exercise or sport
Managing Scoliosis-Related Pain & Stiffness
Treatment isn't about trying to “straighten”, “realign” or correct your spine with hands-on treatment. Where scoliosis is associated with symptoms, the focus is instead on understanding what is affecting you and helping you manage those symptoms.
Hands-on treatment can play an important role, particularly when there are painful, stiff or tight areas around the spine, rib cage, shoulders or pelvis. Sometimes these are not directly at the curve itself, but in areas that may be working differently or compensating for the way your body moves. Treatment may include joint mobilisation or manipulation, soft tissue techniques and other approaches depending on what is appropriate for you.
Alongside this, exercise and rehabilitation can help improve movement, strength and physical capacity. This may involve working on the back itself as well as the shoulders, trunk, hips or other areas depending on your individual presentation and what you need your body to do.
The wider picture matters too. Your activity levels, work, exercise, general conditioning and the particular demands placed on your body can all influence how you feel, so management should be adapted to you rather than simply treating the appearance of the spinal curve.
The aim is to help you remain active, confident and able to do the things that matter to you, whether that's everyday activity, work, the gym or sport.
Posture & Upper Back Pain
Upper-back pain and stiffness are commonly associated with desk work, prolonged sitting and spending long periods using laptops, phones or other screens. You may notice aching between the shoulder blades, tension across the upper back or a feeling that you're becoming increasingly stiff or “hunched” as the day progresses.
However, posture is rarely as simple as being told that you “sit badly” or need to sit up straight. There isn't one perfect posture that everyone needs to maintain, and even a supposedly good position can become uncomfortable if you stay there for long enough.
Often, what matters is how long you spend in one position, how frequently you move, your workstation setup, your activity levels and how well your body is currently able to tolerate the demands placed on it.
The upper back also works closely with the neck, shoulder blades, shoulders and rib cage. If the thoracic spine feels particularly stiff or you're spending long periods in one position, you may notice symptoms developing across several of these areas rather than in one isolated spot.
You may notice:
Aching or stiffness between the shoulder blades
Upper-back discomfort that builds throughout the working day
Feeling increasingly stiff or “rounded” after prolonged sitting
Neck and shoulder tension alongside upper-back symptoms
Discomfort after prolonged laptop, phone or screen use
Feeling the need to repeatedly stretch, move or “crack” your upper back
Symptoms that improve when you get up and move around
It's Not About Having “Perfect” Posture
Rather than trying to hold yourself upright all day, management may involve finding comfortable working positions, improving your workstation setup and regularly changing position so your body isn't spending hours loaded in exactly the same way.
Where appropriate, hands-on treatment can help with pain, muscular tension and areas that feel particularly stiff or restricted, while exercise and rehabilitation can work on movement, strength and your ability to comfortably tolerate longer periods of sitting, working or other activities.
And because posture involves much more than just the upper back, we may also look at how the neck, shoulders, hips and the rest of your body are moving and working together.
For a more detailed look at desk posture, forward-head and rounded-shoulder patterns, ergonomics, driving and how posture can relate to neck, back and headache symptoms, see our Posture-Related Pain page.
Upper Back Pain at the Gym
The upper back plays an important role in many gym movements, particularly exercises involving pulling, pressing, rotation and reaching overhead. The thoracic spine, ribs, shoulder blades and shoulders all need to work together to manage load during training.
Upper-back pain may develop after a sudden increase in training, heavier lifting, unfamiliar exercises or simply doing more than your body is currently accustomed to. Sometimes pain is more muscular, while at other times stiffness or irritation around the thoracic or rib joints may make particular movements uncomfortable.
Thoracic stiffness can also become noticeable during exercises such as overhead pressing, squatting, rowing, pull-ups or Olympic lifts. These movements don't rely on the upper back alone, shoulder mobility and the movement and control of the shoulder blades (scapulae) are also important. Restrictions or differences in one area may change how you perform the movement or where you feel the load.
Pain during training doesn't automatically mean you've damaged something or need to stop exercising completely. In many cases, training can be modified rather than stopped, allowing you to stay active while symptoms settle and gradually rebuild your tolerance to the movements and loads you want to return to.
You may notice:
Pain or stiffness during rows or pulling exercises
Discomfort during overhead pressing
Difficulty comfortably getting your arms overhead
Upper-back restriction when positioning a bar for squats
Pain during pull-ups or other overhead movements
Feeling restricted around the shoulder blades or shoulders
Symptoms with twisting or rotational exercises
Aching or stiffness following a training session
Pain after increasing weight, volume or training frequency
Upper Back Pain at Work
Upper-back pain can become increasingly noticeable during the working day, whether you spend hours at a desk, drive for long periods or have a more physically demanding job.
For desk-based work, symptoms often build after spending prolonged periods in one position. You may experience aching between the shoulder blades, stiffness through the middle of the back or tension extending into the neck and shoulders, particularly towards the end of the day.
Your workstation setup and ergonomics may be relevant, but there isn't one perfect sitting position that needs to be maintained for eight hours. Screen height, chair setup and desk position can all be considered, alongside something equally important — regularly changing position and moving throughout the day.
You may notice:
Aching or stiffness that builds throughout the working day
Pain between the shoulder blades during desk work
Neck and shoulder tension alongside upper-back symptoms
Discomfort after prolonged sitting or driving
Pain with repeated lifting, carrying or twisting
Symptoms during reaching or overhead work
Feeling better when you're able to move or change position
Flare-ups during particularly busy or physically demanding periods
Physical jobs create different demands. Repeated lifting, carrying, reaching, twisting, pushing, pulling or working overhead may aggravate symptoms when the upper back and surrounding areas aren't currently coping well with the workload.
Driving and commuting can also contribute, particularly when you're sitting for long periods or repeatedly turning, reaching and getting in and out of a vehicle. The aim is to understand what your job actually requires from your body and find realistic ways to help you stay working comfortably rather than simply telling you to avoid the movements or positions that aggravate you.
What Patient Say
Upper Back Pain FAQs
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Pain between the shoulder blades can come from several areas, including the muscles, joints of the thoracic spine, ribs, neck and shoulders. Prolonged positions, changes in activity, exercise and irritation of local muscles or joints can all contribute.
The location of your pain can give us useful information, but it doesn't always tell us exactly which structure is responsible. Looking at what movements or activities aggravate your symptoms and how the surrounding areas are moving can help build a clearer picture.
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Posture can influence how your upper back feels, particularly if you spend long periods sitting or working at a screen, but there isn't one universally “bad” posture that causes upper-back pain.
Often, how long you stay in one position, how frequently you move, your workstation setup, activity levels and physical capacity are more useful things to consider than trying to sit perfectly upright all day.
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Yes. The ribs connect to the thoracic spine through small joints and are surrounded by muscles and other tissues that can become painful or irritated.
Rib-related pain may be felt beside the spine, around the shoulder blade or further around the side of the chest and can sometimes be aggravated by twisting, coughing, sneezing or taking a deep breath.
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Yes, although symptomatic thoracic disc bulges and herniations are much less common than disc problems affecting the neck or lower back.
Disc changes can also be found on MRI scans in people without symptoms, so seeing a disc bulge on a scan doesn't automatically mean it is responsible for your pain.
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Yes. The shoulder, shoulder blade and upper back work closely together, so some shoulder problems can be experienced as discomfort around the shoulder blade or upper-back region.
Equally, pain around the shoulder blade doesn't automatically mean there is a problem with the shoulder itself. Looking at the neck, thoracic spine, shoulder and scapular movement can help determine which areas may be contributing.
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Moving or stretching a stiff upper back can feel helpful, and some people find that cracking the area provides temporary relief. However, feeling as though you constantly need to stretch or crack your back doesn't necessarily mean that something is “out of place.”
If stiffness repeatedly returns, it may be more useful to look at movement, strength, activity levels, prolonged positions and the demands you're placing on the area, rather than relying on repeatedly stretching or cracking it.
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IMost upper-back pain is musculoskeletal and isn't caused by anything serious. However, pain around the upper back and chest can occasionally come from other areas of the body.
New or severe chest pain, unexplained shortness of breath, significant trauma, rapidly worsening weakness or neurological symptoms, or feeling acutely unwell alongside your pain should be medically assessed rather than assumed to be a musculoskeletal problem.
Not Sure What's Causing Your Upper Back Pain?
Every Upper back problem is different, so treatment starts with understanding what's causing your symptoms. Once we've identified the source of your symptoms, I'll explain what's most likely causing them and recommend the treatment that's most appropriate for you.
You don't need to know exactly what's wrong before booking an appointment , that's what the assessment is for.
👉 Learn more about what to expect from treatment
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Whether you’re dealing with pain, stiffness, injury, or simply want to move better, we’re here to help. Get in touch and we’ll guide you in the right direction.
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