Pulled muscle in upper back – Types, Causes, Treatments

Pulled muscle in upper back – Types, Causes, Treatments

Pulled muscle in upper back – Types, Causes, Treatments

1. Pulled muscle in upper back - An overview


Pulled muscle in upper back (between the base of the neck and the bottom of the ribcage). 12 bones make up the upper back (which the doctors call the thoracic spine).The 1st bone of the upper back begins from the base of the neck. And the 12th bone ends just below the rib cage. The upper back pain can appear between the 2 extremes (i.e. the 1st and the 12th bone of the upper back). Most people describe upper back pain as a burning or pulling sensation (In one place which is the location of injury or spasm). The pulled muscle pain (occurring anywhere in the thoracic spine) can make it very difficult to work and sleep comfortably.

2. Feeling experiences



  • Pain in the upper back (in between the shoulder blades).

  • Pain when one takes a deep breath (while coughing or sneezing).

  • Also, Pain when one moves the shoulder.

  • Pain like a muscle spasm

  • The area feels tender when touched


3. Types of pulled muscle in upper back


A pulled muscle in the upper back can be classified as...

3.1) Strains


It is found more common where a tendon or a muscle is stretched or torn. Strains are typically caused by an overload or stretching that results in a partial or a complete tear of muscle or tendon.

3.2) Prains


Under the condition, a ligament is torn o stretched. A ligament connects bone to bone at a joint. A sprain is considered a more serious injury and takes a longer time to recover.

Conclusively, it does not matter whether the upper back is strained or sprained. Because of the treatment and prognosis (prognosis is a guess and forecast regarding the outcome of the treatment) is the same for both the type of injuries.

4. Causes of pulled muscle in upper back


4.1) Most likely causes of upper back pain


Pain on the upper back is usually the result of posture/muscle overuse and injury. Common causes of upper back pain include the following.

4.1.1) Muscle de-conditioning and poor posture


Humans may de-condition their muscles over time by failing to use them correctly. In some muscles (including back muscle) de-conditioning is easy to occur (while sitting at a desk for work with the wrong posture for long).

Slouching (in a chair while at a desk for work) may cause a loss of strength in the muscles. Over time, the weakling of muscles may lead to pain in the area as the person experiences strains or irritation. When a person slouches, the gravitational pull and the pressure of the body itself push on the spine/neck/ discs/ ligaments and in consequence, the pressure can lead to pain and other complications. 

The treatment procedure includes physical exercise (as well as the use of a standing desk) that may improve strength on the back. Conditioning the muscles requires patience. However, for healing the chronic upper back pain (resulting from weak muscle), consulting a physical therapist is essential. 

4.1.2) Muscle overuse


It is another cause of muscle back pain. This typically occurs due to repeating the same motion. The repetitive use can cause the muscles in utter strain/tightness/irritation.

In such a case, the treatment procedure typically begins with resting the affected area (as well as using heat or ice packs to promote blood circulation in the muscle tissues). 

4.1.3) Traumatic injury


A traumatic injury can also lead to back pain. This may result from situations that include: traffic accidents /slipping and falling / work-related accidents/ lifting luggage in an incorrect way /putting too hard labor. Under such conditions, the injury is obvious and the pain will appear just after the incident. At other times, the pain may not develop until the situation (inviting the trouble) is repeated.

Conclusively, traumatic injuries can be severe. The consequences of injuries (such as fractured vertebrae) may put the person at the risk of chronic muscular problems (including chronic pain/nerve damage/paralysis).

For treatment, the patient may be referred to as the physiologist or physical therapist. However, severe injuries may require surgery.

4.1.4) Herniated disc


Although it is less common, it may sometimes happen in the upper back. A herniated disc occurs when a piece of cushion pokes through and puts pressure on the spine. Even a small amount of pressure can result in significant pain in the middle of the back (in addition to numbness or weakness in the arms or legs). Effective treatments are rest and anti-inflammatory medications.

4.1.5) Pinched nerve


A pinched nerve (in the middle back) may cause numbness and pain on the arms or legs. Problems arise of controlling urination and weakness or loss of control in the legs.

The treatment procedure is similar to the herniated nerve (when the pinched nerve results from the herniated disc). However, in some cases, the doctors recommend spinal steroids injection.

4.1.6) Osteoarthritis


It occurs as one gets old when the cartilage (that cushions and protects the bones) wears away. Under the condition, the back pain appears in the bones and the joints (and nor in the muscles). It is the most common form of arthritis among old people. The condition can also put pressure on the nerve in the spine (causing numbness and tingling of the arms and the legs).

Treatment typically focuses on managing pain and keeping the joints to function properly.

4.1.7) Myofascial pain


Under the condition, the pain may result from the connective tissues in the back (which the doctors call fascia). Myofascial pain may begin in the wake of injury or overuse of muscles. But chronic myofascial pain may outlast an injury.

Treatment includes physical therapy and myofascial related therapy to enable the person to work.

4.1.8) Spinal infection


Spinal infection is a rare cause of upper back pain. A spinal epidural abscess is a collection of germs and pus (that form between the spinal cord and bones of the spine). The abscess can grow and swell leading to pain.

TreatmentAntibiotics may help and surgery may be a necessity to clear the abscess and reduce the risk of complications.

4.1.9) Lung cancer


In very rare cases, back pain may be due to lung cancer (it is a condition that causes the cells to divide in the lungs uncontrollably and the growth of tumor reduces a person’s ability to breathe comfortably)


4.2) Other causes     


Some specific conditions (affecting the spine or muscles) may lead to upper back painThese include:    

4.2.1) Scoliosis  


It is a medical condition in which the abnormal curvature in the spine occurs. The curve is usually S or C- shaped over 3 dimensions.

4.2.2) Fibromyalgia

It is a medical condition characterized by chronic widespread pain and heightened pain response to pressures. Other symptoms include tiredness/sleep problems/trouble with memory.

4.2.3) Spinal deformity

It indicates the abnormality in the alignment/shape of the vertebral columns (that leads to the reduced functional capacity of the spine).

4.2.4) Problematic kyphosis

Kyphosis is a condition where the top of the back is excessively curved. And the back pain may be particularly problematic in adults with kyphosis.

5. Pulled muscle in upper back Treatments


While analyzing the causes (leading to upper back muscle pain), cause-wise treatment options have been discussed in brief. However, in this chapter, detailed discussions have been made on various treatment procedures. In this connection, it needs to be mentioned that treatment procedure varies under each medical conditionAnd so, varying degrees of success will crop up.

The experts so far have recommended 4 best treatment options for healing the pain in the upper back muscle. Treatment usually includes home remedies (such as rest and specific exercises and more importantly, consulting the physical therapist). 

5.1) Ice therapy


Apply ice on the 1st 48- 72 hours  (no more than for 20 minutes at a time for every couple of hours). It will help reduce swelling and inflammation in the area, minimize muscle spasm and provide pain relief by numbing the area.

5.2) Moist heat


Right after the initial 72 hours, applying moist heat to the area (for 20 minutes every couple of hours) will help increase blood flow to the area and encourage healing.

5.3) Self-massage


Having a massage (in the affected area) may help decrease muscle pain and tightness in the upper back by increasing blood flow to the area thereby promoting healing.

5.4) Posture correction (while seated)


Veritably, pulled muscles (in the upper back area) are the result of chronic poor posture (especially, while seated at a desk).

It is, therefore, important to follow the correct sitting procedure which involves:

  • Shoulders over the hips

  • Knees bent at 90 degrees angle. 

  • Feet flat under the floors (supported on a stool if the feet can’t reach the floor)

  • Elbows should remain bent at 90 degrees angle (even when using a computer mouse).

  • Place the computer monitor at eye levels.

  • Head should be positioned properly so that ears are aligned with shoulders.


5.5) Exercise and light stretches


The following 3 stretches will help mobilize the muscles and stretch out the scar tissues (that might have formed).

5.5.1) Exercise no. 1 (W and exercise)


Static stretches (It involves holding stretches for 30 seconds or more) 

Dynamic stretches (It is highly recommended. It involves holding each stretch for 1- 2 seconds with 30 repetitions)

Advice: One needs to perform the stretches only after the pain has lessened.

Methods (7 steps involved to perform the workout)

  • Step-1: Begin the stretch by standing straight with the back.

  • Step-2: Make W shape  with the arms

  • Step-3 Bend both the arms at 90 degrees angle (to each other)               

  • Step-4: Keep the bent arms in the stomach area.

  • Step-5: Squeeze the shoulder blades together.

  • Step-6: Stretch out the arms (slightly raising upwards) to make a Y-shape (with the body). 

  • Step-7: Make 10 repetitions  (while moving dynamically between the postures W and Y)


5.5.2) Exercise no.2 (Cat and Cow exercise needs a low range of motions- 4 steps)



  • Step-1: Begin the exercise by kneeling on all fours (with the hands positioned straight  under the shoulders and the knees positioned straight below the hips)

  • Step-2: Inhale and tighten the core muscles (while rounding the back).

  • Step-3 Exhale and  arch the spine gently

  • Step-4: Move dynamically through the procedures following 10 repetitions.


5.5.3) Exercise no.3 (Seated rows with light resistance bends)


Methods(4 steps for neck stretch exercise)

  • Step-1: Begin the workout by placing 1 arm (behind the back) and press the shoulder down

  • Step-2: Place the other hand on the opposite side of the head. 

  • Step-3: Gently bring the ear towards the shoulder and press down with the hand (holding for 1-2 seconds and come up to neutral position)

  • Step-4: Repeat the procedure 10 times on the side (that bothers the most).


Advice: If the stretch causes more pain, then stop and try a different stretch.

6. Preventive measure for pulled muscle in upper back



  • Take a regular break (from sitting or lying down to stretching and moving different muscle groups)

  • Take frequent breaks when working at a desk (so that the muscles stay loose and strong). 

  • And Take a few minutes to stretch the muscles (or warm the body before any activity).

  • People (lifting heavy luggage) should avoid twisting or lifting (with their back).

  • Practice regular massages (to pacify tension of the muscles)

  • It is essential to work under a physical therapist (for people having weak muscles).

  • Avoid wearing heavy backpacks

  • Always remain alert about postures (such as, walking upright/sitting correctly/using back support, if needed). 


7. Caution (the habits/postures that need to be avoided)


7.1) The posture (sleeping on the stomach) should be avoided. When one sleeps on the stomach, then the head is turned on one side (which lengthens the muscle on one side of the neck. At the same time, the posture shortens the muscle on the other side of the neck). This muscle imbalance leads to pain in the neck and upper back. And in consequence, the wrong posture restricts the joints (in the neck and the upper back) from functioning properly. (Muscle balance is necessary for normal muscle movement. It indicates the respective equality between the antagonist and the agonist).

Additionally, ‘sleeping on the stomach’ causes the shoulders to fall forward (into an anterior position). This results in the tightening of pectoral muscles which can contribute to a cycle of neck-shoulder-upper back pain (pectoral muscles are thick fan-shaped muscles which make up the bulk of the chest muscles. The muscles lie under the breast and help flex/extend/rotate the humerus –the long bone of the upper arm).

7.2) Initially, resting in the bed may be comfortable. However, it should be avoided, as prolonged bed rest may make things worse. Because it leads to decreased muscle strength and increased muscle stiffness (which only aggravates the pain already experienced).

8. Key global information



  • Upper back muscle pain is less common (as compared to lower back muscle pain)

  • Various studies reveal the fact that 1 in 10 (of men) and 1 in 5 (of women) might suffer from upper back pain.


9. Concluding remark


A pulled muscle in the upper back is not a matter of concern. Because the majority of the injuries heal up within a month. However, it can still cause some serious pain and discomfort (that puts retardation on the physical ability to well perform daily home and job responsibilities). Trying some of the treatment procedures (along with physical exercise s outlined above) help reduce pain and discomfort to get back to normal activities sooner.

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