What causes upper back pain?

Pain between the shoulder blades often follows lifting, reaching, coughing, or a sudden change in activity. A muscle strain may feel sore with movement or touch. Long periods looking down at a phone or laptop can overload the neck and upper-back muscles; this pattern is sometimes called Text Neck. A rounded upper spine, known as Kyphosis, can alter how the back carries load. A Vertebral Compression Fracture is another possibility, particularly after a fall or a forceful movement, and may cause sudden focal pain.

Pain can also be referred from the neck, shoulder, ribs, or chest. The location alone cannot identify the cause, so the timing, triggers, injury history, and other symptoms matter.

For a mild episode without warning signs, reduce the activity that triggered it while keeping gentle movement within comfort. Change position often, bring screens closer to eye level, and use brief walking or shoulder movements rather than staying still for long periods. Heat may soothe muscle tightness; protect the skin from burns. A clinician or physiotherapist can assess movement and work setup; a Workplace Ergonomic Assessment may help identify repeated strain. Depending on the findings, treatment may include exercise, hands-on care such as Myofascial Release, or another suitable approach.

Arrange prompt medical assessment after significant trauma, or when pain is severe, worsening, or limiting breathing or movement. Seek urgent help for chest pressure, breathlessness, faintness, new weakness, spreading numbness, loss of bladder or bowel control, fever, or unexplained weight loss. A new deformity or pain over one spinal bone also deserves timely review.

Could the pain be coming from a muscle, the spine, or another area? What examination findings would guide imaging? Which movements and exercises are appropriate now? How should I adjust my desk, phone, or lifting technique?