Some time ago, I was chatting with a friend who I had worked with for some years. For as long as I had known her she had suffered upper back pain. Following a particularly bad episode, she had undergone some further treatment with her Chiropractor. She confided that whilst the treatments were helping her, it was causing her problems at work. She was frequently taking time out of work to attend appointments. Further, it was becoming increasingly difficult sitting at her desk without being in constant pain. As such her work was suffering and she was concerned this would affect her career going forward.Some time ago, I was chatting with a friend who I had worked with for some years. For as long as I had known her she had suffered upper back pain. Following a particularly bad episode, she had undergone some further treatment with her Chiropractor. She confided that whilst the treatments were helping her, it was causing her problems at work. She was frequently taking time out of work to attend appointments. Further, it was becoming increasingly difficult sitting at her desk without being in constant pain. As such her work was suffering and she was concerned this would affect her career going forward.
I remember looking at my friend and quite frankly, her posture was awful. She constantly looked like she had the weight of the world on her shoulders. She clearly was in a lot of pain and discomfort.
In the kindest possible way a friend can do, I pointed this out to her. I asked her whether she did any exercise to strengthen or stretch her upper back. The answer as I expected was no. She asked if I could give her some tips as she was aware I was into Yoga, Tai Chi, and general fitness.
Apart from the obvious move of joining a local class, I gently suggested that she considered trying to slowly build up her spinal muscles and shoulders to support her spine.
Between work and home life, my friend’s schedule was quite relentless. Therefore, we devised a plan of action between us to suit. The initial morning routine she kept to is detailed in the below and on average took no more than 15-20 minutes which she stuck to most days.
It took a little bit of discipline and nagging on my part, but after a couple of months, there was a marked improvement. She said that even at the 3-4 week point she felt more comfortable and pain-free. I could also tell that she looked healthier, she did not have that stooped look of someone under immense pressure.
Maintaining a daily routine will reduce the thoracic pain. It will reduce tension, strengthen the muscles, and improve posture.
Exercise for the upper back is particularly important as the vertebrae is directly attached to the ribcage which causes limited movements. As a result, the muscles become weak resulting in poor posture.
Not only is it necessary to strengthen the muscles in the upper back, but also to develop good habits of maintaining a good posture. It is so easy to get into bad habits of slouching and being hunched over a desk. Even learning to walk with good postural habits can see a marked improvement. It is simply a case of re-training your muscles and spine.
The upper and middle back is generally referred to in medical terms as the ‘Thoracic Spine’. The Thoracic spine is the largest part of the spine running from the base of the neck to the bottom of the rib cage.
The Thoracic Spine. Source: - Anatomography
The thoracic spine plays an important role in stability and the ability to stand up straight.
General trauma or injury may result in upper and middle back pain. However, the most common cause in recent years is bad posture and repetitive strain and motion due to modern day life.
Many of us spend countless hours hunched over a desk or a computer whether at work or at home. The constant repetitive motion causes a weakening, irritation, and tension in the surrounding muscles of the spine. This also affects the shoulders and the neck.
Even when you are looking at your mobile phone can cause a strain to the neck as you look down to read. The evolution of technology has been great but maybe not so great for the spine.
Localized Aches and/or sharp burning pain.
• Shoulder pain.
• Chest Pain (as the vertebrae in the upper back are connected to the rib cage.
• Muscles Spasms.
• Made worse by sitting or standing for long periods.
Osteopathy and Chiropractic Treatments.
• Physical Therapy.
• Anti- Inflammatory Painkillers.
• Steroid Injections.
• Upper Back Pain Stretches and Exercises.
• Muscle Relaxants.
• General awareness of maintaining good posture
In the case of each of these recommended upper back pain stretches, it is very important to be mindful to lengthen the spine and keep your navel pulled in. To do this, try and imagine a cord pulling you up from the crown of your head. To keep your navel in imagine your belly button being pulled by a cord from your back. Sounds odd I know, but it really does work.
1. Hug your knees to your chest. Once you have a good stretch gently rock your knees from side to side.
When your back has warmed up a little try to get you chin to touch your knees to increase the stretch.
2. Place both hands underneath the middle of the back and push the body up so that you are in a shoulder stand.
As you become more flexible, slowly start to aim to roll your hips all the way back until your knees are over your head.
The aim is almost as though you are trying to roll backwards.
3. The plank exercise has benefits for both middle and upper back pain. The plank exercise strengthens the entire core muscles of the body including the abs.
The core muscles provide stability for the middle and upper back. The core helps strengthen and maintain good posture.
Try and do this as long as possible (without feeling pain).
Ensure that your back remains completely flat to do this exercise correctly.
4. This exercise is called the ‘Cobra Pose’ in Yoga. This will help strengthen the spine and shoulders and open up the chest.
Lying face down with your feet together, soles facing upwards. Ensure that your hands are placed with fingers spread out directly in line with your shoulders. Your elbows should be touching your sides.
Using your hands, start to lift the body until you can lift your pelvis slightly off the floor and your arms are straight.
Depending on your flexibility, this exercise may take a few sessions before you are able to comfortably hold the position. As you build up just take it slowly to the point of your own flexibility.
5. Standing up straight (although this could also be done seated) place your hands as shown in the picture.
Pull your stomach in and ensure that your buttocks are not sticking out.
Once in place move your elbows out to the side to allow the chest to open- up.
You will probably need to move the hands slightly more onto the shoulders to be able to fully move the elbows out.
For the remaining exercises, you will be seated. Therefore, they are ideal to do at your desk or even whilst you are watching TV.
6. Sit on a chair with your arms crossed. Alternatively, to open up the chest you can place your fingers on your shoulders.
Keep your shoulders back, rotate to the right, hold for 5 seconds then rotate to the left and repeat
Your head should be aligned with the movement. Do not move your hips, only your upper body.
Rotate your chin down to your breastbone, hold, then rotate all the way back so you are looking at the ceiling.
Hold each position for about 5 seconds and repeat.
Then, keeping your back flat and arms extended, lower your body down until your arms are out in front of you. Your chest should be resting on your thighs.
Clasp your hands together in front of you. Reach as far forward as possible without moving your hips and lower back, to stretch the shoulders and the spine
Hold each stretch for about 5 seconds and repeat.
It is important that you are mindful throughout your day to be aware of your posture. There are obvious benefits to looking after your spine. As a bonus, a good posture also creates a more youthful appearance.
Here are some quick tips to develop and maintain a good posture:
• Have a stretch at frequent intervals throughout the day. Simply just stretching your arms behind your back whilst sitting or standing will do.
• Maintain a daily routine of upper back pain stretches and exercises. The exercises in this article will be a good basic level starting point.
• Be disciplined and aware of your posture. If you are watching TV or at your computer, sit up straight with your shoulders back. If you struggle to get into the habit, try a Posture Support Brace to begin to train the muscles and the spine for correct posture.
• Ensure that your workstation in the office or at home is in the optimum position for promoting a good posture.
It is difficult to find the time (and sometimes the energy) to fit in an exercise routine. However, you will be more productive, not to mention reduced or even pain-free, which will more that make up for the time and effort.
Always take any exercise to the point of your own limits and comfort. This article is not a substitute for advice from your medical practitioner. If in doubt you should always consult your Physician.
Bittleson J (2001) Secrets of Yoga. Darling Kingsley, London.