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Upper Back Pain

image of rib cage, a common source of upper back pain

Upper back pain and mid back pain is just as problematic as neck pain or lower back pain, but doesn’t seem to get the same attention as those other areas. The anatomy of the thoracic spine is a little different than the rest of the spine, so pain here can also act a little differently. This is primarily due to the ribs that attach to the spine here and the shoulder blades that sit on top of the ribs and attach to them through multiple muscles.


Muscular pain is the most common source for upper back pain, generally, but it is multiplied by the sheer number of muscles residing in the upper and mid back. Muscles extending to the arms, neck, and lower back originate here, so problems in other locations of the back can cause pain here. Muscle pain usually feels like soreness, aching or a bruise. Poor posture is a big culprit in muscular upper back pain, particularly in the trapezius.

Some women can experience upper back pain due to a large chest. The combination of the weight of the breasts, bra straps, and self-consciousness can lead to forward rounded shoulders, which is a prime reason for upper back pain. This can also be an issue during pregnancy.

The rib joints can also be pain generators. Particularly in the upper back, where they need to move and allow full motion to the shoulder blades, when ribs start to malfunction, they can cause a surprising amount of pain. The pain feels sharp and can hurt with breathing, many people confuse the pain with heart attack or lung symptoms.

Intervertebral discs and spinal nerves are less of a problem in the middle back than in the neck or lower back. That is because the ribs reduce the amount of motion between the thoracic vertebrae and the discs here are smaller.

However, there are nerves that run between each rib, and burning or electrical pain radiating around the side, even into the front of the body, can come from these nerves.

Some internal organs can refer pain to the mid back. In addition to chest pain, abnormal heart attack symptoms can include shoulder or upper back pain, but is usually accompanied by anxiety, sweating or vomiting. More information on heart attack symptoms from the Mayo Clinic can be found here. Pain from the stomach, like an ulcer, or gall bladder, sometimes cause pain in the upper back. Chiropractors are trained to identify these serious causes for back pain, and can help you figure out what is causing your pain.

Painful Rib Joints

The ribs can become stiff and restricted like the other joints in the back. When they don’t move properly, they can feel like something is stuck, and can even cause the muscles attached to them to complain. Breathing can become painful, and that means the painful rib has to keep working despite the pain it is causing.

The fancy name for a popped-out rib is costovertebral dysfunction. One of the main causes is overreaching the arm in exercises, such as yoga, or bent over rows with weights. Another common reason for ribs to get painful is a scrunched forward shoulder while sleeping. See my advice on sleeping posture to position your head better at night and possibly prevent this type of injury.

Rib pain usually starts in the back, but since the ribs wrap around and attach to the sternum, some chest pain, called costochondritis can develop from this condition. Some shoulder pain can also originate from problems between the ribs and shoulder blade.


Since painful rib dysfunction is caused by poorly moving joints, a chiropractor is the best place to start for this condition. I often find that people have been dealing with this type of pain for months, and have no luck with medications, which do nothing anyway to address the cause of the problem. Chiropractic adjustments work particularly well for rib problems, and the pain can resolve quickly when the joint starts moving correctly again.

Posture exercises, correct form in the gym, and good sleeping posture are important considerations for prevention.

Make an appointment

Make an appointment with Dr French, Chiropractor in Norwalk, CT

If you have been dealing with this type of issue, we would love to see if we can help you get back to your life. If you are in the Norwalk, CT area, see what makes our office special, or click below to make an appointment. You can always contact us with question, we are happy to help.