Neck and Upper Back Pain

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

Published: 12 November 2015

Neck and upper back pain is becoming more common, upper back pain that I see is due to poor neck posture, particularly in people who spend too much time looking into their phones, tablets and laptops!

In my experience it is more common to have neck and upper back pain than to have neck pain alone. This is down to their close proximity and connection to each other, and the fact that the upper back also supports the head and neck.

As I mentioned earlier, the most common presentation of neck and upper back pain that I see in my physiotherapy clinic is down to poor posture. Poor posture of the neck is where the chin is poked out forwards increasing the depth of the curve in the neck. Remember that the head is one of the heaviest parts of the body, and the further you poke your head forward, the more strain the neck and upper back have to take to support it.

This “chin-poked” posture increases strain and the muscles of the upper back have to work excessively hard to hold the head. Frequently, patients tell me that their head is too heavy for their neck - this is due to the excess work the upper back muscles have to do to hold the neck in this poor posture. You will see what I mean the next time you see someone looking down into their phone or tablet. In these cases posture correction is required with physiotherapy to successfully treat neck pain in the long term.

The same applies to people who have a poor sitting posture - again resulting in chin poke. I see this mainly in clients with office jobs - posture correction and work station redesign are the main considerations that I address in these situations. Ergonomic assessments and the use of back pain support products such as “back friends” may also be of use.

Another common clinical presentation is neck pain due to stiffness in the upper back. If the upper back is not moving as freely as it should, the neck has to compensate by moving beyond its normal range. As you turn your head the upper back is required to turn with it and if the stiffness is in your upper back and it does not move with the neck - neck strain will occur. This can also result in neck and upper back pain. Treatment of the cause is the most important thing here so a diagnosis of what is causing the stiffness in the upper back is important.