Upper back pain

Physio for upper back pain

See a GP first about pain at the top of your back, between your shoulders: the NHS lists it as a reason to get checked rather than treat it at home. Once you have been checked, a physio can help with exercise and hands-on treatment, which the NHS lists among the treatments for back pain.

Back pain often gets better on its own and usually improves within a few weeks. Stay as active as you can while you wait, and check the other warning signs on this page.

Check the warning signs first

Written from NHS guidanceLast checked Clinical review pending
When to get it looked at
The NHS suggests seeing a GP for pain at the top of your back, between the shoulders.
How long it tends to take
The NHS says back pain usually improves within a few weeks, but can sometimes last longer or keep coming back.
Getting a physio
In many areas you can refer yourself to NHS physiotherapy without seeing a GP, or you can pay privately.

Does this sound familiar?

  • An ache between your shoulder blades after a long day at a desk.
  • Stiffness across the top of your back when you twist or turn.
  • It started after lifting, carrying or reaching awkwardly.
  • It comes with a stiff neck or sore shoulders.

These are common ways people describe upper back pain. They are not a diagnosis. If you recognise them, check where it hurts to see a suggested next step.

Common causes of upper back pain

The NHS says back pain can have many causes, and it is not always obvious what they are. Upper back pain has no separate NHS page, so these come from its back pain page.

What people noticeWhat the NHS lists as a possible cause
Came on after lifting or a sudden movementAn injury such as a pulled muscle (strain), a common cause of back pain
No clear reasonOften none that can be found: back pain often gets better on its own
Less oftenSometimes a medical condition such as ankylosing spondylitis
Less oftenVery rarely, a serious problem such as a broken bone, cancer or an infection
From the NHS: Back pain

When to get help first

If you have upper back pain and any of these, do not wait to see a physio. This is the same list our check asks, taken from the NHS pages below. If you are not sure, call 111.

999

Call 999 or go to A&E

If you have upper back pain and:

  • Sudden pain, pressure or tightness in your chest that does not go awayIncluding chest pain that spreads to your arm, neck, jaw or back, or comes with sweating, feeling sick, light-headed or short of breath.
  • The back pain started after a serious accident, such as a car crash
Do not drive yourself to A&E. Ask someone to take you, or call 999 for an ambulance.
111

Get help from NHS 111, or ask for an urgent GP appointment

If you have upper back pain and:

  • You feel hot, cold or shivery, or generally unwell, as well as the pain
  • Severe back pain that started suddenly, or is getting worse quickly
GP

See a GP

If you have upper back pain and:

  • You have lost weight without trying to
  • A lump or swelling in your back, or your back has changed shape
  • Back pain that does not ease when you rest, or is worse at night
  • Back pain that is worse when you sneeze, cough or poo
  • Pain at the top of the back, between the shoulders

What you can do now

If none of the warning signs apply, the NHS suggests:

  • Stay active and keep up your daily activities as far as you can.
  • Use a heat pack or hot water bottle wrapped in a tea towel for stiffness or muscle spasm.
  • Try exercises and stretches for back pain, and stop if the pain gets worse.
  • Do not stay in bed for long periods.

The NHS suggests seeing a GP for pain at the top of your back, between the shoulders.

From the NHS: Back pain

What a physio usually does

Treatment can include exercise and physiotherapy, and manual therapy, where a trained therapist massages and moves the muscles and joints in your back.

  • At a first appointment, a physio asks about your symptoms, your health and your daily life, and may check how you move, your strength and your balance.
  • Treatment may include exercises to improve movement and build strength, and manual therapy, where the physio uses their hands to massage and move the area.
  • You usually get advice on managing your symptoms and exercises to do at home between sessions.

In many areas of England you can refer yourself to NHS physiotherapy through community musculoskeletal (MSK) services, without seeing a GP first. Waiting times can be long. You can also pay to see a physio privately. The NHS says to check they are registered with the Health and Care Professions Council (HCPC).

How long upper back pain tends to take

The NHS says back pain usually improves within a few weeks, but can sometimes last longer or keep coming back. Everyone is different, and a physio or GP can tell you more once they have assessed you.

From the NHS: Back pain

Questions people ask about upper back pain

Should I see a GP or a physio for upper back pain?

See a GP first. The NHS lists back pain that comes from the top of your back, between your shoulders, as a reason to see a GP rather than treat it at home. Once you have been checked, a physio can help. If you have any of the urgent warning signs on this page, follow that advice instead.

Can a physio help with pain between the shoulder blades?

Once a GP has checked it, a physio can assess how your back moves and help. The NHS lists physiotherapy, group exercise and manual therapy, where a trained therapist massages and moves the muscles and joints in your back, among the treatments for back pain that is not getting better after a few weeks.

Should I keep active with upper back pain?

Yes, as far as you can. The NHS says to stay active and carry on with your daily activities, and not to stay in bed for long periods. A heat pack or hot water bottle wrapped in a tea towel can ease stiffness and muscle spasms. Try exercises and stretches for back pain, and stop if the pain gets worse.

Is upper back pain serious?

Back pain often gets better on its own, and only very rarely is it a sign of a serious problem, the NHS says. Pain at the top of your back, between your shoulders, is still one the NHS asks you to get checked by a GP, and this page lists the signs that need help sooner.

Sources

Written from NHS guidanceLast checked Clinical review pending

This is general information, not medical advice or a diagnosis. A physio or GP can assess your own situation.