The upper back, or thoracic spine, is the area between the neck and low back. Stiffness, muscle spasms, and pain are common upper back symptoms. Some patients feel pain when taking a deep breath, during movement, or when the tender area is touched. Poor posture, deconditioning, bending or twisting, sitting in a static position for a long time, hard coughing or sneezing, or carrying an overstuffed backpack can lead to upper back pain. Scoliosis, an abnormal curvature of the thoracic spine, sometimes causes upper back pain.

Jump to the upper back pain stretches section.

Rhomboid muscle strain is one cause of upper back pain. The rhomboid muscles originate in the upper back and attach to 3 vertebral spinous processes. There are 12 thoracic vertebrae numbered T1 through T12 (top to bottom). The spinous processes are small bones that can be felt on the back. The rhomboid muscles attach to T3, T4, T5, and the shoulder blades. The rhomboids help move the shoulder blades. Rhomboid muscle strain and spasm causes upper back pain between the shoulder blades. Some patients describe the muscle spasms and discomfort as knots in the back.

Upper Back Pain Treatment
First Response: Ice and Heat Therapy
Early treatment is important to speed healing and recovery. Ice therapy for the first few days followed by moist heat can help relieve symptoms. Store-bought ice products, ice cubes, or simply a bag of frozen peas wrapped in a towel can be applied 20 minutes every 4-6 hours. Moist heat therapy can begin after 2-3 days of icing. To prevent burns, wrap the heat source in a towel, and remove heat before sleeping. Punctured store-bought packs should be discarded because the chemical gel can burn skin.

3 Easy Upper Back Stretches
Under your health-care provider's guidance, these simple stretches and exercises may help relieve upper stiffness and pain. Start small (3 sets of 5) and gradually increase as your symptoms and body allow. Take it easy!

Arm Slides

• Stand against a wall and position your arms close against the wall, palms facing the wall.
• Keep your arms against the wall while slowly sliding them up above your head, if possible; if not, as high as is comfortably possible.
• Gently reverse and move your arms down; relax and repeat

Shoulder Blade Squeeze

• Sit or stand with your arms by your sides
• Squeeze and hold your shoulder blades together for 5 seconds
• Release the squeeze, relax and repeat

Upper Back Stretch

• Sit in a chair
• Cross both arms behind your head and bend gently forward
• Slowly arch backward; release and repeat

Learn more back pain exercises (and it's a video series, so it's easy to learn!).

When Symptoms Linger
When upper back pain results from injury, or home therapy fails, see your health-care provider. She/he may recommend medications such as an anti-inflammatory drug or muscle relaxant. Trigger point injections may help break the pattern of muscle irritability and spasm. Physical therapy and massage help to relax muscles and relieve pain while increasing mobility.