Thoracic Pain

John Miller Physiotherapist

Article by John Miller

Thoracic Pain

Upper Back & Rib Pain

Upper back pain (or thoracic pain) is one of the most common injuries in modern society. Injuries can vary from simple to complex. They can also result from posture or fatigue strain injuries, lifting injuries, falls, or even arm use, e.g. throwing injury.

The following links provide upper back pain and thoracic spine injury information plus guidance. Please consult your spinal health practitioner or doctor for specific advice on your upper back pain.

Thoracic & Chest Pain Needs a Thorough Investigation
Thoracic &Amp; Chest Pain Needs A Thorough Investigation

Related Articles

  1. Thoracic Facet Joint Pain: Offers an understanding of how facet joint issues contribute to upper back discomfort.
  2. Thoracic Outlet Syndrome: Explains the condition, symptoms, and treatment options for this syndrome affecting the nerves and blood vessels in the upper back and neck area.
  3. Common Causes of Upper Back Pain: Provides physiotherapy-based insights on managing upper back pain, including common causes and treatments.
  4. Rib Stress Fracture: Discusses how a rib stress fracture can contribute to upper back pain and outlines treatment strategies.
  5. Posture Correction: Highlights the importance of posture in preventing and managing upper back pain, offering tips for improvement.
  6. Osteoporosis: Examines the link between osteoporosis and upper back pain, along with prevention and management strategies.
  7. Posture Exercises: Suggests exercises to improve posture and alleviate upper back pain.
  8. Scheuermann’s Disease: Provides information on Scheuermann’s Disease, a condition affecting the spine that can cause upper back pain.
  9. Scoliosis: Offers insights into how scoliosis can impact upper back pain and suggests treatment options.
  10. Ankylosing Spondylitis, Fibromyalgia, and Rheumatoid Arthritis: These articles discuss systemic diseases that can cause upper back pain and their management strategies.

Thoracic Spine Red Flags

While most upper back pain is relatively straightforward from a diagnostic perspective and responds quickly to treatment, other potential sources of the thoracic cage and chest pain can be more sinister and require urgent intervention.

Cardiac conditions and malignancy are potentially life-changing sources of upper back pain that you should investigate and treat without delay. Due to the thoracic spine being more likely to be caused by a serious pathology compared to your neck or lower back, it is also wise to consult your trusted healthcare practitioner. You should consult your healthcare practitioner if you have any of the following red flags.

Red Flags

Red flags for possible serious spinal pathology include:

  • History of cancer, drug abuse, HIV, immunosuppression or prolonged use of corticosteroids.
  • Fever, chills, unexplained weight loss, or recent bacterial infection.
  • Pain that is:
    • Constant, severe and progressive.
    • Non-mechanical without relief from bed rest or postural modification.
    • Unchanged despite treatment for 2-4 weeks.
    • Accompanied by severe morning stiffness (rheumatoid arthritis and ankylosing spondylitis).
  • Recent violent trauma (such as a vehicle accident or a fall from a height) or a spine structure deformity.
  • Minor trauma, or even just strenuous lifting, in people with osteoporosis.
  • New back pain with age at onset < 20 or > 50 years of age.
  • Severe or progressive neurological deficits (muscle weakness, sensation/reflexes) in the lower extremities.

If you feel that you have any of the above symptoms, we recommend an urgent medical assessment.

Effective Management of Upper Back Pain and Injury

Physiotherapy Insights


Upper back pain and injury, predominantly affecting the thoracic spine, are prevalent issues causing significant discomfort and impacting daily activities. This article, infused with physiotherapy insights, aims to enlighten the general public about the causes, symptoms, and treatment options for upper back pain.

managing upper back pain
Managing Upper Back Pain

Managing Upper Back Pain

Upper back pain stems from various sources, including thoracic spine conditions, joint injuries, muscle strains, nerve irritations, and systemic diseases. Recognising these causes is vital for appropriate treatment.

Common Causes of Upper Back Pain

  • Joint Injuries: Facet joint pain is a frequent issue.
  • Muscle-Related Injuries: This includes back muscle pain, side strains, whiplash, muscle cramps, and DOMS (Delayed Onset Muscle Soreness).
  • Bone-Related Injuries: Conditions like Scheuermann's Disease, Scoliosis, and others.
  • Disc-Related Injuries: Including bulging, slipped, or herniated discs.
  • Nerve-Related Pain: Such as thoracic outlet syndrome and pinched nerves.
  • Systemic Diseases: These include Ankylosing Spondylitis, Fibromyalgia, and arthritis types.

Posture and Upper Back Pain

Poor posture is a significant contributor to upper back pain. Understanding and correcting sitting, standing, and sleeping postures can prevent and alleviate pain.

Physiotherapy Perspective

A physiotherapist's approach to treating upper back pain involves assessing the individual's condition and tailoring a treatment plan. This may include exercises, manual therapy, and advice on posture correction.

Latest Research and Techniques

Recent advancements in physiotherapy have introduced innovative methods for treating upper back pain. These include targeted exercises, advanced manual techniques, and utilisation of posture-improving products.

What to Do?

If you experience upper back pain, it's crucial to consult a physiotherapist for a professional assessment and personalised treatment plan.


Upper back pain, though common, can be effectively managed with the right approach. Understanding its causes and seeking professional physiotherapy advice are key steps towards recovery.

For more information, explore articles at PhysioWorks.

Related Articles

Joint Injuries

Muscle-Related Injuries

Bone-Related Injuries

Disc-Related Injuries

Nerve-Related / Referred Pain

Systemic Diseases

Posture Information

Sitting Posture

Standing Posture

Sleeping Posture

Posture Products