Upper back pain: what causes it and what helps
Based on NHS guidance and NHS physiotherapy service advice, checked September 2026.
Reviewed by Harvir Ubhi, HCPC-registered physiotherapist. Last reviewed 25 September 2026.
The short version: upper back pain is pain anywhere between your neck and your lower back, often around the shoulder blades. Most of it comes from muscles and joints and eases with time and gentle exercise, usually within about six weeks. The NHS does suggest seeing a GP more readily than for lower back pain. And if it comes with chest pain, call 999.
Why upper back pain is treated differently
Upper back pain is less common than lower back pain. Your upper spine (the thoracic spine) is joined to your ribs, so it moves less. Because pain here can occasionally come from somewhere other than the back, the NHS advises seeing a GP if your pain is between your shoulders, rather than just waiting it out.
For pain lower down, see lower back pain.
Common causes
- muscle strain, often after lifting, sport or an awkward movement
- long periods sitting in one position, at a desk or driving
- carrying heavy bags on one shoulder
- stiffness in the joints of the upper spine
What helps
- Keep moving. Stay active and carry on with daily activities as much as you can.
- Change what aggravates it. Take regular breaks if sitting makes it worse, and spread shopping or work bags across both sides.
- Heat or ice. Either can help. Wrap the pack in a towel.
- Painkillers. Anti-inflammatories such as ibuprofen, if they're suitable for you. Ask a pharmacist.
- Don't stay in bed for long periods. The NHS advises against it for back pain.
5 upper back exercises from NHS physios
From Cambridge University Hospitals' physiotherapy guide. Do these movements a few times a day. They should feel like a gentle stretch: if an exercise makes your pain clearly worse, stop it and ask a physio.
- 1
Seated forward bend
Sit on a chair, back straight, feet flat on the floor. Bring your chin to your chest and gently round your upper back. Return slowly.
- 2
Seated backward lean
Sit on a chair with a high back, feet flat. Lean gently backwards so the part of your spine above the chair back extends over it. Return slowly.
- 3
Seated twist
Sit with your arms crossed over your chest, hands on opposite shoulders. Turn your upper body to one side, back to the middle, then to the other side.
- 4
Cat and cow
On all fours, arch your back up towards the ceiling, then let it drop down so your mid-back hollows. Move slowly between the two.
- 5
Chest opener
Lie on your back with a rolled towel along your upper back. Put your hands behind your neck, elbows pointing up, and let your elbows gently fall out to the sides.
Not better after six weeks?
That's when NHS physio services suggest getting it assessed. You can see a private physio in London without a GP referral, usually for £70 to £130 for a first appointment. Tell us what's going on and a HCPC-registered physiotherapist on our team will match you with the right one.
It's free, and most people hear back within 24 hours.
When to see a GP
- the pain is between your shoulder blades
- it hasn't improved after a few weeks of home treatment
- it's stopping you doing normal activities
- you have a high temperature or feel generally unwell
- you've lost weight without trying
- it started after a fall or accident
- it came on suddenly and you have osteoporosis
Upper back pain questions
Is upper back pain serious?
Usually not. NHS physio services describe most upper back pain as nothing sinister, caused by muscles and joints, and say it tends to get better with time and gentle exercise. The NHS does suggest seeing a GP more readily for pain between your shoulders than for lower back pain, to rule out other causes.
When should I worry about pain between my shoulder blades?
Call 999 if it comes with chest pain. See a GP if you also have a high temperature, feel unwell, have lost weight without trying, the pain started after a fall or accident, or it came on suddenly and you have osteoporosis.
How long does upper back pain last?
Norfolk and Waveney's NHS physio service says you should expect it to be noticeably better within about six weeks if you keep up the exercises and adjust what aggravates it. If it isn't, that's the point to see a physio.
Can sitting at a desk cause upper back pain?
Long stretches in one position often make it worse. NHS physio advice is to take breaks if sitting aggravates it, and to spread weight across more than one bag rather than carrying everything on one shoulder.
Related: back pain · private physio costs · NHS physio waiting times
Call 999 or go to A&E if you have back pain and:
- chest pain
- numbness, tingling or weakness in one or both legs
- numbness around your genitals or bottom
- you can't pee, or can't control your bladder or bowels
Sources
- NHS, Back pain (last reviewed 5 March 2026). nhs.uk/conditions/back-pain
- Norfolk and Waveney Community MSK Services, Upper back. norfolkandwaveneycommunityhealth.nhs.uk
- Cambridge University Hospitals, Thoracic spine exercises (16 July 2024). cuh.nhs.uk
This page is general information, not medical advice. If you're worried about your symptoms, speak to a GP, call NHS 111, or in an emergency call 999.