Upper Back Muscle Strain: Causes, Symptoms & Treatment
Manhattan Physical Therapy
What Is an Upper Back Muscle Strain?
An upper back muscle strain happens when the muscles in your thoracic spine (the area between your neck and rib cage) are overstretched or torn. This region includes important muscles like the trapezius, rhomboids, and erector spinae, which support your posture and help your shoulders and arms move properly.
Unlike your lower back, the upper back is more stable and less flexible. That’s why pain here is often linked to muscle irritation rather than major spinal instability. Still, when these muscles are strained, even simple movements like turning your head or lifting your arm can feel uncomfortable.
Most cases are mild and improve with the right care. But if ignored, a small strain can turn into ongoing stiffness, reduced mobility, and chronic discomfort that affects your daily routine.
What Does Upper Back Strain Feel Like?
The way it feels can vary depending on how the injury happened and how severe it is. Some people notice it suddenly after a movement, while others feel it build up over time. Common sensations include:
A dull ache between the shoulder blades
Sharp pain with certain movements
Muscle tightness or stiffness
Burning or pulling sensation in the upper back
Pain that spreads toward the neck or shoulders
Occasional tingling or “pins and needles” feeling
You might also notice:
Difficulty turning your neck or lifting your arms
Muscle spasms that come and go
Tenderness when you press on the area
Tracking when your pain starts, what makes it worse, and what helps can give useful clues about the cause and severity.
What Causes Upper Back Muscle Strain?
In most cases, upper back strain is mechanical. That means it comes from how you move, sit, or use your body rather than a serious underlying condition. Here are the most common triggers:
1. Poor posture
Spending hours hunched over a laptop or looking down at your phone puts constant stress on your upper back. Over time, this overloads the muscles and leads to strain.
2. Overuse or repetitive movements
Repeated actions like lifting, pulling, or even typing without breaks can fatigue the muscles. This is common in both desk jobs and physically demanding work.
3. Sudden movements
Quick twists, awkward reaches, or lifting something heavy without preparation can overstretch the muscle fibers.
4. Direct injury
Falls, sports injuries, or accidents can cause immediate strain along with stiffness and pain.
5. Muscle tension from stress
Mental stress often shows up physically. Many people carry tension in their upper back and shoulders, which can tighten muscles and lead to pain over time.
6. Exercise-related strain
Working out too intensely or skipping proper warm-ups can overload the upper back muscles, especially during pulling or overhead movements.
How Do You Know If It’s a Pulled Muscle or Something Else?
A muscle strain is the most common reason for upper back pain, but it’s not the only one. It’s important to recognize when your symptoms fit a simple strain and when they might point to something more serious.
Signs it’s likely a muscle strain:
Pain started after movement, lifting, or posture-related activity
Pain stays in one area and feels sore or tight
Symptoms improve with rest or gentle movement
No major neurological symptoms (like severe numbness or weakness)
Red flags to pay attention to:
Pain that comes without any clear physical cause
Pain along with chest discomfort or difficulty breathing
Unexplained weight loss or fever
Numbness, weakness, or loss of control in legs or bladder
Sometimes, upper back pain can come from internal organs (called referred pain), such as the heart, lungs, or digestive system. While this is less common, it’s important not to ignore unusual symptoms.
How Is Upper Back Muscle Strain Treated?
Treatment depends on how severe the strain is, but most cases improve with simple, conservative care. The goal is to reduce pain, allow healing, and gradually restore movement.
1. Rest (but not complete inactivity)
Avoid movements that trigger pain, especially lifting or twisting. That said, staying completely still for days can make stiffness worse. Light movement within a pain-free range helps recovery.
2. Ice and heat therapy
Use ice during the first 24–48 hours to reduce inflammation
After that, switch to heat to relax tight muscles and improve blood flow
Apply for about 15–20 minutes at a time, a few times a day.
3. Over-the-counter pain relief
Medications like ibuprofen or acetaminophen can help manage pain and inflammation. These should be used as needed, not relied on long term.
4. Gentle stretching and mobility work
Once the sharp pain settles, light stretching can help prevent stiffness. Movements should feel relieving, not painful.
5. Massage or manual therapy
Hands-on techniques can reduce muscle tension and improve circulation in the affected area.
6. Physical therapy
If pain lingers or keeps coming back, structured rehab is often the fastest way to recover. A physical therapist focuses on:
Improving posture
Strengthening weak muscles
Restoring proper movement patterns
How Long Does It Take to Heal?
Recovery time depends on how bad the strain is and how well you manage it early on.
Mild strain: a few days to 1–2 weeks
Moderate strain: 2–6 weeks
Severe strain: several weeks to a few months
Ignoring the problem or returning to activity too soon can delay healing. Many people feel better quickly but still have underlying tightness or weakness, which increases the risk of reinjury.
What Exercises Help Upper Back Muscle Strain?
The right exercises can speed up recovery and prevent future issues. The key is to start simple and progress gradually.
1. Shoulder blade squeezes
Pull your shoulder blades back and hold for a few seconds. This helps activate the muscles that support posture.
2. Chest stretch
Open up tight chest muscles that often contribute to poor posture and upper back strain.
3. Thoracic extension (upper back stretch)
Gentle backward bending over a chair or foam roller helps restore mobility in the thoracic spine.
4. Neck and upper trap stretches
Slow, controlled stretches can relieve tension built up from stress or long sitting hours.
5. Strengthening exercises
As pain improves, adding resistance exercises for the upper back and shoulders helps prevent recurrence.
The most important thing is consistency. Small daily movements are more effective than occasional intense sessions.
How Can You Prevent Upper Back Strain?
Prevention usually comes down to habits. Small adjustments in your daily routine can make a big difference.
Fix your posture
Keep your head aligned over your shoulders, especially when using a phone or computer. Avoid prolonged slouching.
Set up your workspace properly
Your screen should be at eye level, and your chair should support your upper and lower back.
Take regular breaks
If you sit for long hours, stand up, stretch, and reset your posture every 30–60 minutes.
Lift smart
Use your legs and avoid twisting your upper body when carrying heavy objects.
Stay active
Strong, flexible muscles are less likely to get injured. Regular movement keeps your back healthy.
Manage stress
Tension often builds in the upper back. Simple breathing exercises or short walks can help release it.
When Should You See a Professional?
Most upper back strains improve on their own, but some situations need medical attention. You should get checked if:
Pain lasts longer than a week without improvement
It keeps coming back
You notice numbness, tingling, or weakness
Pain is severe or getting worse
Seek urgent care if you experience:
Chest pain or trouble breathing
Loss of bladder or bowel control
Sudden weakness in your legs
If your upper back pain isn’t improving or keeps coming back, professional guidance can make a big difference. For expert evaluation and personalized treatment, call (212)-213-3480 to schedule a visit with Manhattan Physical Therapy and get back to moving comfortably.
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Alexander Liu
"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."
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Manhattan Physical Therapy
✆ Phone (appointments):
(212) 213-3480
Address: 385 5th Ave, Suite 503, New York, NY 10016
