How physiotherapy can treat upper back pain

Studies have shown that about 1 in 10 men and 1 in 5 women will suffer from upper back pain at some point in their lives.[1] Thoracic spine and upper back pain is a complex issue with many biological, muscular, joint and lifestyle factors contributing to the overall problem.

In between the neck and lower back lies the thoracic spine region, containing 12 vertebral segments and 12 pairs of ribs that attach to the spine at the back and front, forming the rib cage that protects your heart and lungs and provides the mechanics that are essential for breathing.

So you could say it’s a pretty important area.

What causes upper back pain?

Unfortunately for our thoracic spine, our modern lifestyles include long periods of time sitting, slouching, and looking at our mobile phones and computers. This leads to stiffness and reduced movement, increasing the natural kyphosis (rounding curve) of your thoracic spine which can lead to injury and long term pain.

Pain in the thoracic spine is the ugly cousin of lower back pain. Upper back pain can range from a dull ache to borderline debilitating pain that can spread to the shoulders, neck and down to the lower back.[2]

The root cause of your upper back pain may be quite complicated, it is essential that a thorough body assessment is undertaken by your physiotherapist to ensure any underlying issues are identified.

The most common causes of upper back pain include:

  • Poor posture while using technology for long periods of time[3]
  • Myofascial pain
  • Osteoarthritis
  • Injury or overuse of muscles and ligaments
  • A herniated disc (rare) or degenerative joint disease (DJD)
  • Repetitive strain injury (RSI)

How can I prevent upper back pain?

Preventing every single cause of upper back pain may not be possible, but there are some basic steps you can take that may avoid some of the more common causes.

These include:

  • Spending less time on your mobile phone looking down
  • Taking regular breaks from sitting
  • Stretching any stiff or sore areas
  • Warming up the body before any strenuous activities or sports
  • Avoiding excessive unaccustomed twisting or lifting with your back
  • Have regular massage or physio to help work out the tension and reduce spasms
  • Work with a musculoskeletal physio to strengthen weak muscles
  • Being conscious of your posture at all times including walking upright and sitting correctly

By undertaking an in depth physical assessment, utilising techniques such as mobilisation, deep tissue massage, dry needling and patient education we aim to restore normal function and improve your quality of life and mobility.

At Fixio, we are experts in assessing all vertebral movements and analysing postural conditions. Your physio will undertake an assessment that will involve thoracic spine movements such as extensions, rotations, side bending and rib expansion.

Other areas of assessment may include shoulder movements such as serving for volleyballers and stroke analysis for swimmers, neck movements and lumbar spine movements as well. Sitting and standing posture will also be assessed by your musculoskeletal physio to watch for kyphosis.

Always remember prevention is much better than a cure.

If you live on the Northern Beaches and would like to know more about our Personal Training or Thoracic Mobility programs



[1] N. Fouquet, J. Bodin, A. Descatha, A. Petit, A. Ramond, C. Ha, Y. Roquelaure, Prevalence of thoracic spine pain in a surveillance network, Occupational Medicine, Volume 65, Issue 2, March 2015, Pages 122–125,

[2] Theisen, Christina & Wagensveld, Ad & Timmesfeld, Nina & Efe, Turgay & J Heyse, Thomas & fuchs-winkelmann, Susanne & D Schofer, Markus. (2010). Co-occurence of outlet impimgement syndrome of the shoulder and restricted range of motion in the thoracic spine – a prospective study with ultrasound-based motion analysis. BMC musculoskeletal disorders. 11. 135. 10.1186/1471-2474-11-135.

[3] Heneghan NR, Baker G, Thomas K, et al What is the effect of prolonged sitting and physical activity on thoracic spine mobility? An observational study of young adults in a UK university setting BMJ Open 2018;8:e019371. doi: 10.1136/bmjopen-2017-019371

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