High back pain, also sometimes called upper back pain, isn’t as common as lower back pain or neck pain. But it can still disrupt your life and make exercise and everyday actions more difficult or uncomfortable, especially as you age.

Keep reading for everything you should know about the causes of higher back pain and exercises and other treatments that might bring you relief.

What is high back pain?

High back pain is any pain that occurs between the bottom of your neck and the bottom of your rib cage. This area of your back is called your thoracic spine, so discomfort there is also called thoracic spine pain. Your thoracic spine also includes the middle of your back, so you might experience symptoms there, too.

Common causes of high back pains

There are a number of different causes of higher back pain. The most common are muscle strains and poor posture. The good news is there are steps you can take to address these root causes and alleviate or prevent pain.

Prolonged sitting

"Prolonged sitting, in any position, can strain the muscles and joints of the upper back,” says Bold physical therapist and trainer Dylan Peterson. “Moving regularly, taking breaks, varying how you sit, or adjusting your workspace are simple ways to manage that."

Muscle strain and overuse

If you lift something heavier than you’re used to or increase physical activity too quickly, you might feel upper back pain from a strain or overuse. This type of back pain often goes away after a few days and can be avoided in the future with safe activity and strength training.

Medical conditions

Some medical conditions that lead to high back pains can be a little more complicated to address. Your upper back might hurt due to:

• Disk degeneration: There are small cushions of tissue called disks between each of the vertebrae (or small bones) in your spine. Over time, this tissue can dry out or shrink, making the disks less able to absorb everyday stress and leading to pain and stiffness, Peterson says.
• Osteoarthritis: The small joints along the spine can also wear down over time, leading to pain, stiffness, and sometimes swelling called osteoarthritis.
• Herniated disk: If any of the disks in your thoracic spine bulge or slip out of place, you may also feel pain in your mid back, ribcage or abdomen.
• Compression fracture: People with osteoporosis, or weak bones, may develop a fracture in a vertebra from pressure on the spine due to a car crash or fall, leading to pain. 
• Pinched nerve: A pinched nerve in your middle or upper back means a nerve is squeezed or irritated where it separates from your spinal cord. This can cause mid back, chest, and abdominal pain. 
• Spine conditions: Scoliosis, and kyphosis are conditions that affect the development or shape of the spine and may cause pain. 
• Inflammatory conditions: High back pain can also be caused by rheumatoid arthritis and ankylosing spondylitis, conditions related to whole-body inflammation that might require specialized anti-inflammatory treatments.
• Cancer: In rare cases, back pain may be due to a cancerous growth pressing on the spine or nerves.

If you recently injured your back, the cause of your pain might be relatively obvious. In other cases, it may take a thorough examination for a healthcare provider to identify the cause of your pain. They might also send you for imaging tests such as X-rays or MRIs to get a better look at your thoracic spine.

When to seek professional help

Most upper back pain isn’t serious and will resolve on its own. But you should see a healthcare provider about upper back pain if:

• You have high back pain following a fall
• You have pain that wraps around your chest or abdomen
• You have muscle weakness in one or both of your legs
• You have any changes to your urinary or bowel habits
• Your pain doesn't get better over time
• You develop numbness or tingling in your lower body
• You have a fever or are losing weight for no known reason

Symptoms of high back pain

Pain in your higher back can come on suddenly or build up over time. The pain might feel:

• Sharp or burning pain in one spot or that radiates to other areas
• Aching
• Stiffness
• Weakness, numbness, or tingling

Pain between the shoulder blades

Some people also experience pain between their shoulder blades, which falls in the area considered the thoracic spine. This discomfort can feel like tension or soreness, and it’s typically caused by your posture, stress, or lifting something heavier than you’re used to. 

"The shoulder blade area is a common destination for pain traveling from somewhere else,” Peterson says. “The neck and thoracic spine are frequent sources of pain between the shoulder blades. That's why treating above and below where it hurts can matter as much as treating the painful spot itself."

Exercise for high back pain

Immediately after upper back pain begins, you may need to modify or take a short break from any exercises that worsen your pain. But generally speaking, physical activity can help ease many types of middle or high back pain, and it may even prevent some types from ever starting.

That said, it’s still a good idea to speak with a healthcare provider before starting any new exercise routine, including exercise for high back pain.

Once you are approved to exercise on your own, you can experiment with some of the following movements and see how they make you feel.

Stretching exercises for upper back pain relief

Stretching exercises for upper back pain relief​ primarily help by alleviating muscle tension. “When muscles in the upper back — or anywhere in the body — become tight, they place extra tension on the spine and or surrounding joints,” says Bold head trainer Alicia Estrada. “A consistent stretching routine helps reduce that stiffness, improve range of motion, and create relief. Over time, this leads to better function, easier movement, and ultimately an improvement in how we feel.”

The movements below stretch your back, neck, and shoulders to loosen up the muscles there.

Seated trunk extension

• Start sitting on a sturdy chair with your feet on the floor, hip-width apart.
• Lean backward over the back of the chair until you feel a stretch through your back and shoulders.
• Hold briefly, then return to start.
• Continue for several rounds.

Seated cat cow

• Start sitting on the front edge of a sturdy chair with your feet on the floor, hip-width apart, and your hands on your thighs.
• Drop your chin and press your navel back as you round your back for cat pose.
• Sit up tall.
• Press your chest forward and your shoulder blades together behind you as you arch your back for cow pose.
• Sit up tall.
• Continue alternating between cat and cow pose for a few rounds.

Wall angel

• Stand with your back and head against a wall and your feet a small step away. Bend your arms and place the backs of your hands and your elbows on the wall, with your hands around shoulder height.
• Keeping the backs of your hands on the wall, slowly slide your arms up the wall as far as comfortable.
• Slowly slide your arms back down.
• Continue for several rounds. 

Thread the needle

• Start on your hands and knees, wrists under your shoulders, knees under your hips. 
• Slide one hand along the floor under your body, reaching toward the opposite side. Let that shoulder and the side of your head rest on the floor.
• Hold briefly and breathe.
• Slowly slide back to the starting position.
• Continue for several rounds, then repeat for the same number of rounds on the other side.

Strength exercises for high back pain

Strengthening exercises for upper back pain help support the muscles and bones in your back and may prevent or ease pain. “Strength training helps relieve upper back pain by activating underused muscles and improving stability and support,” Estrada says. “Strengthening the upper back reengages the muscles that support the spine, improving posture and alignment. Over time, stronger muscles reduce strain, enhance spinal stability, and help prevent recurring pain.”

The movements below help build strength in the larger muscles in your back and shoulders and improve stability in your shoulders, back, and neck.

Band pull apart

• Sit or stand tall holding a resistance band in both hands with your palms facing up and your elbows bent and close to your sides. 
• Keeping your elbows close to your body, move your hands out to the sides to pull the band apart.
• Slowly release the tension on the band and return to the starting position.
• Continue for several rounds.

Row

• Sit up tall on a sturdy chair with the middle of a resistance band anchored around your feet, legs extended straight in front of you. Hold one end of the band in each hand with your arms straight out toward your feet. 
• Bend your elbows and pull your hands back to the sides of your ribcage, squeezing your shoulder blades together. 
• Slowly release the tension on the band and straighten your arms to return to the starting position.
• Continue for several rounds.

Shoulder extension

• Sit up tall on a sturdy chair with the middle of a resistance band anchored around your feet, legs extended straight in front of you. Hold one end of the band in each hand with your arms straight out toward your feet.
• Keeping your arms straight, pull your arms down and back slowly and with control.
• Raise your arms back to the starting position. 
• Continue for several rounds.

T with resistance band

• Sit up tall on a sturdy chair with the middle of a resistance band anchored around your feet, legs extended straight in front of you. Hold one end of the band in each hand with your arms straight out toward your feet.
• Keeping your arms straight, squeeze your shoulder blades together and spread your arms apart until they form a T shape.
• Slowly and with control, bring your arms back together.
• Continue for several rounds.

Other treatment options for high back pain

Exercise alone may not treat or prevent all types of upper back pain. If your pain doesn’t get better over time, talk to your healthcare provider. They might recommend over-the-counter pain relievers, prescription pain medications, or muscle relaxants.

Some people find relief from steroid or nerve block injections in the spine. And while surgery is rare, it can be an option for certain people with high back pain.

Various in-person treatments and lifestyle adjustments can complement these medical treatments.

In-person treatment options

In addition to speaking with a medical doctor about thoracic spine pain, you might also look into these additional strategies for relief.

• Physical therapy: A physical therapist can help identify the best exercises and stretches for you to try for your upper back discomfort. They can also help you make posture and ergonomic adjustments (more on those below) and use manual therapy to ease your pain.
• Massage therapy: A massage therapist can knead the muscles in your back to loosen them up and reduce discomfort.
• Chiropractic care: A chiropractor also uses their hands to limit back pain, typically by trying to improve mobility in your spine. But there’s limited evidence to support chiropractic care. Talk to a healthcare provider if you’re considering trying it. 

Habits that prevent flare-ups

You can also make small tweaks to your daily routine that can help ward off high back pains.

Good sitting habits

Notice how you're sitting right now. How long have you been in that position? Have you moved recently? Are you slouching for hours? Are your muscles tensing too long?

No single position is meant to be held all day. “Shifting how you sit, standing up, or taking a short walk redistributes stress across different parts of the body and helps keep tension from building up,” Peterson says.

Try changing positions regularly throughout the day. If you tend to lose track of time, consider setting an alarm or calendar reminder for every 30 to 60 minutes to stand up, stretch, or take a short walk.

Ergonomic adjustments

When you spend a lot of time in a certain position, you can make minor tweaks to your setup or environment that better support your back, neck, and shoulders. These are called ergonomic adjustments.

Here are some you can try:

• If you’re using a smartphone or tablet, put it on a stand so you’re not hunched over as you look down at it in your hands.
• Use headphones (or speakerphone, if you’re in private) for phone calls to avoid leaning your head and neck to the side to talk on the phone.
• Position your screen at eye level so you're not looking down for long stretches.
• Keep your keyboard and mouse close enough that you're not reaching forward.
• Use a chair that supports your lower back and lets your feet rest flat on the floor.
• Consider investing in an ergonomic chair and/or an adjustable desk that you can use in both sitting and standing positions.

Not sure where to start for upper back pain relief? Talk to a Bold Care provider about your symptoms. They can help you identify the best exercises for high back pain and help you get on the path toward healing.