Upper back pain often shows up as tightness, burning, or sharp pain between your shoulder blades, especially after long days at a desk, driving, or lifting. Whether your pain is mild and nagging or sharp and limiting your daily activities, the specialists at Mountain View Pain Center can help.
Upper back pain usually comes from a combination of posture, muscle strain, and joint irritation in the thoracic spine (the upper and mid-back). Our team looks beyond the pain spot to find out what’s really driving the problem.
Seek urgent evaluation if you have upper back pain with chest pressure, shortness of breath, fainting, unexplained fever, severe unrelenting pain, recent major trauma, new weakness, loss of balance, or numbness/tingling that is rapidly worsening. If symptoms feel severe or unusual for you, it’s always appropriate to get checked promptly.
The upper back is the thoracic spine, the twelve vertebrae between the base of the neck and the bottom of the ribs. Every one of them attaches to a rib, which makes this stretch of spine stiffer and more stable than the neck or the low back. Layered over it are the muscles that hold the shoulder blades in place: the trapezius, the rhomboids, the levator scapulae, and the erector spinae running either side of the spine. Where the pain sits is usually the first clue about which of those is involved.
How the pain behaves tells us as much as where it is. None of this is a diagnosis on its own, but it shapes what we look for first.
Pain is generally called chronic once it has been there longer than about three months. By that point the original strain has usually healed. What keeps it going is a combination of movement habits, muscle that has lost conditioning, joints that have stiffened, and a nervous system that has become more sensitive to signals from the area.
That changes the plan. Passive treatment on its own tends to do less at this stage. What does more is restoring movement through the thoracic spine, rebuilding strength across the mid-back and shoulder blades, and changing the daily positions that keep reloading it. Where an interventional procedure is appropriate, its job is usually to bring the pain down far enough that the rehabilitation can actually happen, which is why Pain Management, Physical Therapy and Chiropractic care are planned together here instead of tried one after another.
Upper back pain can come from posture, muscle strain, joint irritation, rib/thoracic stiffness, or referred pain from the neck or shoulder. Your visit may include a review of your symptoms and activities, movement and posture assessment, and evaluation of the thoracic spine, ribs, shoulders, and surrounding muscles. If symptoms include radiating pain, numbness, or tingling, we may also perform a basic neurologic screen. We also check for red flags to determine whether imaging or referral is appropriate.
At Mountain View Pain Center, we use a team-based approach to treat upper back pain. Pain Management providers, chiropractors, physical therapists, and acupuncturists work together to reduce pain, restore mobility, and prevent future flare-ups.
Targeted diagnostic injections and image-guided procedures when appropriate to reduce inflammation and calm irritated nerves or joints.
Upper back and shoulder blade strengthening, postural retraining, and corrective exercises.
Gentle spinal adjustments and joint mobilization to improve thoracic mobility and reduce pressure on irritated joints.
Helps relax tight muscles, improve circulation, and calm chronic mid-back tension.
Home care can calm symptoms, but if your upper back pain keeps coming back, it’s time to get it evaluated.
Most upper back pain that gets worse when you breathe comes from the joints and muscles of the rib cage, not from the lungs. Each rib meets the spine at a small joint, and every one of those joints has to glide a little with each breath. When one becomes irritated or restricted, every breath loads it, which is why the pain feels like a sharp catch mid-breath, sits to one side of the spine, and settles to a dull ache in between.
How to tell it apart from something urgent. Mechanical rib and spine pain is positional. It changes when you move, there is a spot you can find with a finger, and it does not come with breathlessness at rest. Pain with breathing that arrives alongside chest pressure, new shortness of breath, coughing up blood, fever with a productive cough, a fast heartbeat with light-headedness, or one-sided calf swelling is a different problem and needs emergency assessment instead of an appointment.
Keep breathing normally. It is tempting to take shallow breaths to avoid the catch, but a rib cage that stops moving stiffens further, and shallow breathing makes the problem more persistent, not less. Gentle rotation and extension of the mid-back, done several times a day, not once and hard, is usually more useful than rest.
Most upper back pain comes from muscles and joints, but some symptoms require urgent medical care.
Call 911 or seek emergency care if:
For non-emergency pain that’s limiting your work, sleep, or daily activities, our team can help you get a clear diagnosis and a plan.
No referral is needed for Chiropractic, Physical Therapy, Acupuncture or Pain Management, and our goal is to get you in within the same week.
The examination works outward from the spot you point to. We check movement through the mid-back and ribcage, the individual segments, how the shoulder blades sit and control on the ribs, and the neck, because the neck refers into the area between the shoulder blades often enough that skipping it is how an upper back gets treated for months without improving. If the pain is worse on a deep breath we test the rib joints specifically. Imaging is used when it would change the plan, not routinely.
Chiropractic here uses Diversified, drop-table and Activator techniques, with spinal decompression and dry needling available as modalities and a decompression table at every clinic. Bring a photo ID and your insurance card, any previous imaging, and a clear sense of what your working day physically looks like: how long you sit, what you lift, where the screen is. That last one shapes the plan more than people expect. Where an interventional step is appropriate it is performed in office at Northglenn, north Colorado Springs, Mesa and Glendale. Spine injections are also performed at Lowry on specific days.
Every Mountain View Pain Center clinic has Pain Management, Physical Therapy, Chiropractic care and Acupuncture in the same building, so if upper back pain needs more than one kind of care, you do not get handed off to another practice.
Colorado: Denver, Aurora, Colorado Springs, Lakewood, Littleton, Highlands Ranch, Lone Tree, Northglenn, Lafayette, Greeley, Fort Collins.
Arizona: Phoenix, Mesa, Chandler, Glendale, Peoria.
No referral is needed in either state. Find your nearest clinic on the full clinic map, or call Colorado (720) 749-5599 or Arizona (602) 325-2024.
Pain between the shoulder blades is often caused by muscle strain, poor posture, or irritated joints in the thoracic spine. Sometimes it’s related to neck, shoulder, or rib problems that overload the upper back. An exam with our providers helps confirm the exact cause and rule out more serious issues.
Most pain between the shoulder blades is mechanical and settles with care. Get it examined instead of waiting if it wakes you at night, doesn’t ease in any position, or comes with fever, unexplained weight loss, or arm or leg weakness or numbness that is getting worse. Pain between the shoulder blades that comes with chest pain or pressure, shortness of breath, sweating, nausea, or pain spreading to the jaw or arm is a different problem: go to the ER or call 911. Our chiropractors screen for these warning signs at your first exam, and if something needs medical care, our Pain Management providers or your own doctor can see you first.
Yes, posture is one of the most common drivers of upper back pain. Long hours at a computer, driving, or looking down at a phone can overload the muscles between your shoulder blades and stiffen the joints in your upper back. Improving posture plus strengthening key muscles typically leads to lasting relief.
Mild upper back strains may improve in a few days with rest and home care. If pain lasts more than a couple of weeks, keeps coming back, or interferes with sleep or work, it’s best to be evaluated so you don’t miss an underlying issue.
Yes. Physical Therapy and Chiropractic care work well together for upper back pain. Therapy focuses on posture, mobility, and strength, while Chiropractic adjustments help restore motion in stiff joints. Our team coordinates your care so treatments support each other.
Most upper back pain comes from posture, muscle strain and joint irritation in the thoracic spine instead of from a single injury. Long hours at a desk, repetitive lifting, carrying a load on one side, and sleeping in an awkward position are the usual starting points. Less often it comes from a thoracic disc, a rib joint, arthritis in the spinal joints, or a compression fracture, which is why pain that will not settle gets examined instead of stretched.
Aching or burning between the shoulder blades, tightness or knots across the mid-back, stiffness that is worse after sitting, and pain that spreads into the neck or shoulder. Some people notice it most when taking a deep breath, reaching overhead, or turning to look behind them. Numbness, weakness, or pain that wraps tightly around the ribs is a different picture and should be assessed.
Move sooner than feels natural. Short walks and gentle thoracic extensions over a rolled towel usually do more than rest. Ice helps a recent strain; heat helps ongoing stiffness. Break up sitting every half hour, drop the screen to eye level, and breathe deeply enough to move the ribs. If it is no better after two weeks of that, the problem is usually a joint or a movement pattern instead of a tight muscle, and it is worth having someone look at it.
Women report upper back and neck pain more often than men, and a few reasons come up repeatedly: less muscle mass supporting the same daily loads, posture changes during and after pregnancy, breast size in some cases, and a higher risk of osteoporosis after menopause, which makes thoracic compression fractures more likely with age. None of those is a diagnosis on its own. They are reasons the same desk or the same job can produce different symptoms.
Muscle and rib-joint pain in the upper back can make a deep breath hurt, and people often describe that as not being able to breathe fully. Genuine shortness of breath is different. Upper back or chest pain together with real breathlessness, sweating, nausea, or pain spreading to the jaw or arm needs emergency care, not a clinic appointment. Those can point to a heart or lung problem, not a back problem.
Usually because a rib joint or the muscles around it have become restricted. Each rib meets the spine at a small joint that has to move with every breath, so when one stops gliding properly, breathing loads it and produces a sharp catch. It is mechanical, positional and treatable. Pain with breathing that comes with chest pressure, breathlessness at rest, coughing up blood or fever is different and needs emergency assessment.
Most upper back pain is mechanical and settles with care. A few patterns are not, and they are worth knowing. Pain that wakes you at the same hour every night. Pain that does not change whatever position you put yourself in. Fever or unexplained weight loss alongside the pain. Weakness or numbness in an arm or leg that is getting worse, not better. Any change in bladder or bowel control. Those are reasons to be examined, not to wait and see. Upper back pain that arrives suddenly with chest pressure, breathlessness or sweating is a different problem and belongs in emergency care.
Pain that never fully clears usually means whatever is driving it has not been identified and taken out of the daily loop. Thoracic joints that have stopped moving well, ribs that no longer glide, and the muscles guarding around both will keep producing the same ache for as long as the pattern repeats. Constant pain is also a reason to look wider than the sore spot, because the neck, the shoulder and the way you load your back at work all feed it. An examination that reproduces your pain on demand is what separates a working diagnosis from a guess, and it is where Physical Therapy and Chiropractic start.
Upper Back Pain is treated at every Mountain View Pain Center clinic in Colorado and Arizona. See the full clinic map, Colorado or Arizona.
