Causes of Upper Back Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Upper Back Pain


Upper Back Pain Causes
What are the main causes of upper back pain?

What are the Causes of Upper Back Pain - and if you are suffering, you might be also asking - and Why Me?!

While this is a frequently asked question in my physiotherapy clinic - the simple answer is that upper back pain can be caused from a variety of reasons. However, the most common cause that I see and treat in my clinic is down to a lack of good posture.

Almost 90% of the upper back pain clients that I treat have pain arising from poor sitting posture which they maintain over long periods of time. I’ll explain a bit further, but first let’s briefly identify some of the other more regular causes of upper back pain.

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Other causes of upper back pain.

Some of the other causes of upper back pain that I see include:

  • Poor lifting technique, when lifting heavy loads, leading to injury. If you have to lift heavy loads, then using a correct lifting technique is vital to prevent such injuries.
  • Stress Tension in the shoulders and neck, which if severe enough over time can lead to upper back pain.
  • Poor baby-feeding techniques. Sometimes mothers can get upper back pain from the way they hold their baby while feeding them.
  • Poor mattresses or Pillow. If you find that you are getting upper back pain when sleeping, then this article on back pain while sleeping and my mattress buying guide or changing your Pillow will help.
  • Whiplash injuries following a road traffic accident or sports injury. A selection of articles on Whiplash is here
  • Poor schoolbag-carrying techniques - Schoolbags can be really heavy, and if carried incorrectly can lead to upper back pain problems in kids .
  • iPosture or Tech neck - this one I see more of - it is from kids and adults staring into their smartphones and tables. I have an article on it here

To summarise - the causes of upper back pain are many and varied. However, in my experience, they almost always come down to sticking with a poor posture over time in various positions. Let’s look at that in more detail.

The no. 1 cause of upper back pain - Poor posture!

Have you ever really looked at the way that you sit at a desk or a table? If you have a desk job and have upper back pain, this might become familiar to you.

Upper Back Pain from sitting
Upper Back Pain from Poor Computer Posture

So often I have clients with desk jobs telling referring to me with upper back pain, shoulder pain or neck pain - and when I assess them, it is often down to how they sit at their desks.

Then they tell me that they have had an ergonomic assessment of their work station and their set up is perfect. The truth is that no matter how wonderful your work station is ergonomically constructed, if you do not sit correctly while there you may develop upper back pain.

First, your station should ideally be assessed ergonomically by an expert in this field, or a chartered physiotherapist. If you work from home or spend a lot of time sitting at a desk, then I have guest article about the Top 5 tips on creating an Ergonomic Work Station here.

Then, the correct way to sit is to adopt what is called an “active sitting posture”. This involves lifting your tail bone upwards, pull your shoulder blades down and pull your tummy in! I like to use the description of a helium balloon coming out of the top of your head lifting you towards the ceiling!

Think about what normally happens - an “inactive sitting posture” - I find that clients with upper back pain work on their computers with their lower backs slumped, shoulder blades up and chin poked out towards the screen. The end result inevitably being - over time - mild to severe upper back or neck pain.

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Treating upper back pain

Treatment needs to be directed to the primary cause along with posture correction - followed by a correction of the secondary effects of poor posture, such as muscle imbalances. This will ease your upper back pain and prevent further episodes in most cases. If you have upper back pain for over 72 hours or have Chronic Upper Back Pain, I recommend that you see your physiotherapist for expert diagnosis, treatment and advice.


While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.

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