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What causes upper back pain?

Do you have a stabbing, sharp pain in the upper back?

Is there a pinched nerve in your upper back?

Do you have upper back pain between the shoulder blades?


Upper back pain is an odd condition in that there is rarely a good origin story. It's likely that there was no trauma or specific accident that caused the pain; rather, patients will often tell me they do not know how it started. One day it was just there. Basically, the upper back pain starts out of nowhere, but it often stays for these 3 reasons.

what causes upper back pain?
Sharp pain in the upper back

1- LOSS of STRENGTH (weakness)

2- LOSS of STRETCH (tense)

3- LOSS of POSITION (poor posture)

HOW IT STARTS is tricky because it is well known that the most common reason for pain is a previous injury. Upper back pain commonly reoccurs in patients. It's not uncommon to experience a few rounds of pain that slowly becomes more intense and more frequent with each new round of pain.

THE FIRST TIME you noticed the pain in your upper back is likely to be a very small and not memorable, but over time the intensity of the can pain increase. Not only does the pain level increase, but typically the duration of the pain in your upper back also increases. It's obviously easier to correct things earlier one, but even if you have had this for a long time there are still ways to find relief.

Upper back pain
Upper back pain between the shoulder blades

NOTHING HAPPENED! (inactivity)

Over these last 2 years many of us have got in the habit of doing nothing where we used to do something. Inactivity is the first step to losing strength, stretch and ultimately a good position. It's not that everyone must be a triathlete, but lifestyle changes are a very common trigger for conditions like upper back pain.

Sitting at our desk, sitting in our car, sitting on the bus, sitting on our couch and repeating all play into what causes upper back pain. If you sit for 6 hours a day you are considered to be living a sedentary lifestyle. Which is often okay if we find ways to offset this inactivity with some extra movement. This does not have to be strictly time in the gym. It can be as simple a daily walk.


Perhaps there is a pinched nerve in the upper back, but it's important to put it into context. The nerves that would be impacted in the upper back are nerves that are a fraction of the size of one of your hairs. So, while they can be very sensitive it's rarely considered a to be primarily a nerve problem; rather, it's a muscular problem that impacts the nerve. What's the muscular problem?

upper back pain
Pinched nerve in the upper back

THE MUSCULAR PROBLEM | The recipe for upper back pain

Which came first? The loss of strength? The tightness? Or, is our poor positioning what causes upper back pain? The answer is yes. This is the recipe for upper back pain.

Sit poorly. Reduce activity. Repeat.


There are a lot of fancy stretches, exercises and postural recommendations that may help, but the one step that people often forget is repetition. Research shows that consistent general exercise is actually better than pain meds. In fact, improving your cardio may actually be better than strength training. The best exercise for your upper back pain is the one you do consistently. We offer a number of focused exercise and rehab plans, but as long as you begin to move more you'll begin to notice changes.

I recommend daily walks (10k steps a day) or push-ups (20+ a day) as an easy way to start.

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