Upper Back Pain Treatment in Amman | Physiotherapy

What is upper back pain?

The upper and middle back (the thoracic spine) runs from the base of the neck to the bottom of the ribs, where the ribs join the spine. Pain here usually comes from the muscles around the shoulder blades and from the joints of the spine and ribs. It may start after lifting, twisting or a sports movement, or build up with long hours at a desk or on the phone, little movement, carrying heavy bags, stress and poor sleep. The spine is strong and sitting itself is not dangerous; what usually aggravates the pain is staying still for too long.

Common signs

An ache or tightness between the shoulder blades or on one side of the upper back
Stiffness when turning, bending or reaching, or after sitting for a long time
Pain that may spread around the ribs, especially when twisting; chest pain or breathlessness is different and needs a doctor (see the urgent signs on this page)
Tight muscles in the upper back, shoulders and neck at the end of the day
Pain that usually eases with movement and returns after long periods in one position

Common misunderstandings

"Pain between the shoulder blades is always a muscle": usually it comes from muscles and joints, but sometimes it is caused by a problem in the heart, the lungs or the blood vessels, which is why we ask about the urgent signs first
"I need an X-ray or MRI to find the cause": most upper back pain does not need scans; the doctor requests them when there are signs that call for it, such as pain after a fall, with osteoporosis or with a history of cancer
"Complete rest until the pain goes": staying active and gentle movement help recovery more than long rest in bed

What usually helps?

Upper back pain often improves within a few weeks with simple steps. Staying active and keeping up daily activities is better than long rest, and changing position often with short movement breaks during desk work eases stiffness. The basis of care is gentle mobility exercises for the upper back, such as arching and rounding the back, turning and bending to each side, followed by strengthening exercises for the back and shoulder muscles, which may lower the chance of the pain coming back. Heat may ease muscle tightness. Physiotherapy with manual therapy alongside exercise may also help, especially if the pain has not improved after a few weeks. Medicines are for your doctor to prescribe or your pharmacist to advise on.

How we treat upper back pain at Revibe

We listen: where the pain is and how it started, your work, daily routine, sleep and stress, and any other symptoms such as breathlessness or chest pain
We examine the upper back, ribs, neck and shoulders: movement, strength and sensation, and make sure there are no signs that need a doctor first
We identify what may keep the pain going: long periods in one position, low activity, carrying loads, stress and sleep
We treat: manual therapy and joint mobilisation of the upper back and ribs, release of muscle knots around the shoulder blades, and dry needling or cupping when useful as part of the plan
We progress with a home exercise programme for upper back mobility and strength and for shoulder strength, and a gradual return to your activities and sport

When do you need urgent medical care?

Chest pain, pressure or tightness; or upper back pain with shortness of breath, coughing up blood, sweating, feeling sick or light-headed, or pain spreading to the arm, neck or jaw; or a sudden, severe pain in the chest or upper back, which may feel like tearing or ripping — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
Pain after a serious fall or an accident — go to the emergency department straight away
New back pain in someone with osteoporosis or who takes steroid tablets long-term, even after a minor fall, a cough or a sneeze (possible fracture) — see a doctor the same day
Numbness, weakness or tingling in the legs, unsteady walking, or new problems controlling your bladder or bowels — go to the emergency department straight away
Pain with fever, shivering or feeling generally unwell, unexplained weight loss, a history of cancer, or constant pain that is worse at night and does not ease with rest — see a doctor the same day

In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.

FAQ

Should I see a doctor before physiotherapy?

Not necessarily: in Jordan you can book a physiotherapy assessment directly. If you have any of the urgent signs on this page, see a doctor or go to the emergency department first. Pain between the shoulders usually comes from muscles and joints but occasionally has another cause, such as the heart or lungs, and the UK's NHS lists it among the non-urgent reasons to see a doctor. At the first assessment we check for these causes and refer you to a doctor if anything suggests one.

Can stress cause pain between the shoulder blades?

Stress and poor sleep are linked with upper back pain and may make it last longer. That is why we take them into account in the plan, alongside movement, exercise and hands-on treatment.

Can I keep working at my desk?

Usually yes. Sitting itself is not dangerous, and changing position often, short movement breaks and regular exercise help more than stopping work. We suggest practical changes that suit your job.

How many sessions will I need?

It depends on your condition and how long you have had it; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Back pain questions — 31 questions