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Upper back pain

An ache or stiffness between the shoulder blades or across the middle of the back, often after long spells at a desk, driving or looking down at a phone. It usually comes from stiff joints and tired muscles rather than damage, and gentle movement and strengthening help it settle. The upper back sits next to the heart and lungs, so a few warning signs matter more here than elsewhere in the spine: check them first.

Also called pain between the shoulder blades, mid-back pain, thoracic back pain, stiff upper back.

Does this sound like you?

  • An ache or tightness between the shoulder blades
  • It builds through a day at a desk or behind the wheel, and eases when you move about
  • Stiffness twisting round, for example to look over your shoulder
  • A spot that is tender to press, with tight muscles around it

This is not a diagnosis. Several things cause pain in the same place, which is why the list below matters.

Check these first: when it is not upper back pain

If any of these apply, get checked before you start the exercises. The ones marked in red can't wait.

  • Upper back pain with chest pain, breathlessness, sweating or feeling sick. Call 999
  • Sudden, severe, tearing pain between the shoulder blades. Call 999
  • Numbness, tingling or weakness in both legs, or unsteadiness when you walk. Get seen the same day
  • Pain after a fall or an accident, especially if you have osteoporosis
  • Fever, feeling unwell, unexplained weight loss, or a history of cancer
  • Constant pain that is worse at night and does not change with position

The exercises, in the order you would build them up

Step 1 · Week 1 onwardsCat–Cow StretchMoves the whole spine, the upper back included, through a comfortable range. A good first thing in the morning and a good break from the desk.How to do it Step 2 · Week 1 onwardsThread the NeedleTwisting is usually the first movement a stiff mid-back loses. Slow, and only as far as is comfortable.How to do it Step 3 · Week 1–4Doorway Chest StretchEases the tightness across the front of the chest that builds up in long spells of sitting hunched forward. Gentle, never forced.How to do it Step 4 · Week 2+Scapular SqueezeBuilds endurance in the muscles between the shoulder blades, the ones that ache by the end of the day.How to do it Step 5 · Week 3+, if you have a rollerFoam Roll Thoracic ExtensionBends the upper back the opposite way to a day at a desk. Leave it out if you have osteoporosis or rib pain.How to do it

How long it takes

Most upper back pain eases within a few weeks with regular movement and breaks from sitting. Stiffness that has built up over months can take six to eight weeks of steady work to shift, and the strengthening is what stops it coming back.

What the NHS says

The NHS's own pages on this, to check what you have read here against.

Waiting for an appointment?

Kinehub turns this into a daily plan, adjusts it as you improve or struggle, and keeps the record you hand over when you are finally seen.

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More for the back

A daily plan for upper back pain

Kinehub turns these exercises into a short daily session with a demo for each one, and tracks your pain before and after so you can see whether it is working. Free to start.

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