Clinical name: Thoracic (upper back) pain
Direct answer
Aching or tightness between the shoulder blades, or across the upper back, is most often related to sustained postures, muscular overload from repetitive tasks, or reduced mobility through the thoracic spine — the section of your spine between your neck and lower back. It’s usually very responsive to targeted mobility and strengthening work.
What this means
The thoracic spine is the middle section of your spine, running from the base of your neck to your lower back, and it’s naturally less mobile than your neck or lower back due to its connection with the rib cage — which is part of why stiffness here is so common.
What typically causes it?
Prolonged forward-leaning postures (screens, phones, driving), repetitive overhead or reaching tasks, reduced thoracic mobility, and muscular fatigue in the muscles between the shoulder blades that work to hold your posture upright against gravity all commonly contribute.
Could this be coming from my neck instead?
It’s genuinely common for neck-related issues to refer pain into the upper back and between the shoulder blades, since the two regions work closely together — an assessment can help clarify whether the primary driver is the thoracic spine, the neck, or both.
What tends to aggravate it, and what helps ease it?
Prolonged forward-leaning postures, repetitive reaching or overhead tasks, and general fatigue tend to aggravate upper back pain. Regular postural breaks, thoracic mobility exercises, and strengthening the muscles between the shoulder blades tend to ease it and build longer-term tolerance.
How is it treated?
Treatment typically combines manual therapy and mobility work to restore thoracic movement with strengthening for the postural muscles of the upper back and shoulder blades, alongside addressing any specific tasks or postures that are driving the overload.
How long does it typically take to improve?
Many people notice improvement within a few weeks of consistent mobility and strengthening work, particularly when combined with regular movement breaks from the aggravating posture or task.
Who’s behind this advice
Reviewed by: Core Healthcare Banyo 2026
Clinic services: Assessment and diagnosis of back pain and related symptoms (including leg, buttock and pelvic pain); manual therapy; individualised treatment and management planning based on your assessment findings; Pilates-based rehab classes, strengthening and exercise rehabilitation, including musculoskeletal and sports rehab; posture and workstation advice; women’s health physiotherapy for pregnancy-related back and pelvic pain.
Related reading
• Desk job back pain — how do I fix it?
• My child’s spine looks curved — does it need treatment?
• Will core strengthening actually help my back pain?
Next step
Back pain that’s left to “settle on its own” often takes longer to resolve and comes back more easily than back pain that gets an early, targeted assessment. A proper assessment identifies exactly what’s driving your symptoms and gets you started on a specific plan — not just advice to rest and see how it goes. Book a back assessment with a physiotherapist at any of Core Healthcare’s seven clinics across Brisbane, Logan, the Gold Coast and Northern NSW, or ask your physio about this at your next session.