Understanding upper back pain

What are the symptoms of upper back pain?

Common symptoms include:

• Persistent pain or stiffness between or around the shoulder blades
• Difficulty with everyday movements such as bending, lifting or twisting
• Sharp or shooting pain that spreads from the upper back into the shoulders or arms
• Muscle tightness, knots or spasms
• Reduced range of motion in the shoulders and neck

Some people also notice headaches or tingling in the arms. Tingling, numbness or weakness is worth mentioning to your doctor, as it can point to a nerve being involved.

What causes upper back pain?

Several factors can contribute:

• Posture. Long periods sitting or standing with the head forward and shoulders rounded, at a computer or on a phone, strain the muscles and ligaments of the upper back.
• Overuse. Repetitive movements or heavy lifting at work, at the gym or in sports can overload the upper back muscles.
• Injury. Falls, car accidents and sudden impacts can injure the muscles, joints or bones of the upper back.
• Medical conditions. Arthritis, osteoporosis and disc problems can all contribute to upper back pain.
• Stress. Many people hold tension in the shoulders and upper back, and stress often makes pain feel worse.

When should you see a doctor first?

Most upper back pain comes from muscles and joints. Some does not. Call 911 if upper back pain comes with chest pain or pressure, shortness of breath, sweating, nausea, or pain spreading into the arm or jaw. See your doctor promptly for pain after a fall or accident, pain with fever or unexplained weight loss, pain that wakes you at night and doesn't ease with position, or if you have osteoporosis and the pain came on suddenly.

Can acupuncture and Chinese herbs help?

They may help some people. We look at the whole picture: neck, shoulders, posture, stress and sleep.

Acupuncture

Acupuncture is a Traditional Chinese Medicine (TCM) technique that uses thin, sterile needles placed at specific points on the body. For upper back pain, points are chosen along the channels that run through the back, neck and shoulders, as well as points elsewhere that suit your overall pattern.

The aim is to release muscle tension, support circulation and engage the body's own pain-modulating responses. Some research suggests acupuncture may help some people with neck and upper back pain, and results vary. It can be combined with physiotherapy and exercise. Don't change any pain medication without your doctor's advice.

Herbal medicine

Chinese herbal medicine may be added for some people. Herbs traditionally used for pain and stiffness include Dang Gui (Angelica sinensis), Chuan Xiong (Ligusticum chuanxiong) and Shu Di Huang (prepared Rehmannia root). In TCM they are used to move and nourish the blood. They are always given as part of a formula chosen for the individual, not as a one-size-fits-all remedy.

Some herbs interact with medications, including blood thinners, so Dalibor needs to know everything you take.

What can you do at home?

• Set up your screen at eye level and take short movement breaks every 30 to 45 minutes.
• Gently roll the shoulders and stretch the chest to counter a rounded posture.
• Use heat on tight muscles if it feels good.
• Check your pillow and sleeping position if you wake up stiff.

What happens at a first visit?

Your first visit starts with questions about the pain, your work and activities, and your health history. Dalibor checks your movement and does a TCM assessment, including pulse diagnosis. You hear the plan and the cost before treatment. Your first visit is an initial examination ($110, about 60 minutes) followed by your first acupuncture treatment ($120). Acupuncture with sterile, single-use needles is generally low-risk; tell us about any medications and whether you are pregnant.

Next steps

Upper back pain often overlaps with the neck and shoulders. See our pages on neck pain acupuncture and shoulder pain acupuncture for more. The clinic is at 1550 Enterprise Rd in Mississauga, about 20 minutes from Etobicoke. When you are ready, book a first visit.

Common questions

Can upper back pain come from the heart?

Sometimes. Upper back pain with chest pain, shortness of breath, sweating, nausea or pain spreading to the arm or jaw needs emergency care. Call 911.

Is upper back pain usually from posture?

Posture and long hours at a desk or phone are common contributors, but not the only ones. Injury, overuse and conditions such as arthritis can also play a part.

How many acupuncture sessions will I need?

It depends on how long you have had the pain and what is behind it. Dalibor gives you an estimate after the first assessment and reviews it as you go.

This page is general information, not medical advice. Acupuncture works alongside the care you get from your family doctor. If your symptoms are new, severe or getting worse, see your doctor first.