Upper Back Muscle Strain (Thoracic Strain): Symptoms, Causes & PT Treatment
Updated July 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.
Frequently asked questions
Sources (3)
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.