Upper Back Muscle Strain (Thoracic Strain): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
An upper back muscle strain is an overstretch or irritation of the muscles around the shoulder blades and spine, often from a sudden movement, lifting, or sustained posture. It causes aching, tightness, and tender spots. It's rarely serious and most people recover within a couple of weeks by staying gently active. Physical therapy speeds recovery and addresses the posture or load that triggered it.
What is a thoracic strain?
A thoracic strain is irritation of the upper-back muscles and soft tissue, without nerve or structural damage, which is why it tends to settle well.
Symptoms
Common features are aching or tight pain around or between the shoulder blades, tender muscle spots, and stiffness that's worse with sustained postures or certain movements. Pain usually stays in the upper back.
What causes it / risk factors
A sudden lift or twist, a sustained slumped posture, carrying heavy bags, deconditioning, and stress-related muscle tension contribute.
How it's diagnosed
Diagnosis is clinical from your history and a hands-on exam. Imaging is usually unnecessary for a typical strain.
Physical therapy treatment
What a PT does. Your therapist eases the muscle tension, restores comfortable movement, and addresses posture and strength. Exercises & progression (overview). Gentle mobility, upper-back and shoulder-blade strengthening, and posture variety. Staying active beats rest. Recovery timeline. Most strains improve within 1–3 weeks.
Treatment options compared
Active recovery and PT are first-line. Short-term pain relief and heat can keep you moving. Imaging and injections aren't needed for a simple strain.
Red flags
Seek care for pain with chest pressure or breathlessness (emergency), leg weakness or balance problems, fever, or pain after significant trauma.
Already seen a doctor, or have imaging? Request a match — free.
If a doctor has checked you out and physical therapy is an option, tell us where you are. We'll send you cash-pay PTs nearby who treat this, with their prices and first openings — bring your results to the first visit. You choose; we don't give medical advice.
We check two or three cash-pay PTs near you. We reply within 1 business day with next steps.
Frequently asked questions
Often 1–3 weeks, with the worst easing in the first several days.
Sources (5)
- Briggs AM, et al. Thoracic spine pain in the general population: prevalence, incidence and associated factors. A systematic review. BMC Musculoskelet Disord. 2009. — PubMed
- MedlinePlus: Strains. — NIH/MedlinePlus
- MedlinePlus: Back Pain. — NIH/MedlinePlus
- Southerst D, et al. The effectiveness of noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. J Manipulative Physiol Ther. 2015. — J Manipulative Physiol Ther
- Hayden JA, et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021. — Cochrane
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.