Can a Stiff Upper Back Cause Shoulder Pain?

If you feel like your stiff upper back is losing range of motion and is starting to spread to other parts of your body then you are probably right. Especially if you keep working on these other areas and the pain just keeps coming back. Focusing on just one region of your body might be why you are not making progress. If you are lacking ra

nge of motion in one region then it’s neighbors are going to pay the price. If you keep getting flare ups of the same issue the joint by joint model can help explain this. Each person can be having these symptoms for different reasons which is why one-on-one care is so crucial. 

Why is this the case?

The thoracic spine is much better at rotation than the lumbar spine. So if you cannot rotate well through the thoracic spine then the lumbar spine has to contribute more and eventually can break down. The thoracic spine should also be able to extend backwards. If it does not do this well, then the shoulder has to work harder and can also run into issues. This is why we always have to look at the bigger picture to find the root cause. Each joint of your body has to contribute it’s fair share. You may have shoulder pain which needs to be addressed initially, but then as it improves we have to figure out why it was so painful to begin with, and that can lead us to different areas of the body to see what we can improve. The thoracic spine is an area that tends to need more range of motion. If it is not moving enough then it’s less stable neighbors like the shoulders and low back can suffer. 

How do I address this?

Screening the spine is going to be an important step. If testing of the thoracic spine helps improve your shoulder range of motion then that gives us a lot of valuable information. We won’t know for sure how much it will change prior to testing. Doing so can help isolate your problem areas and understand how they may be contributing to your shoulder or low back pain. Once we can fully confirm that the lack of mobility in your thoracic spine is relevant to your pain we can continue to break it out. Adding in more mobility exercises and then eventually strength training. Doing the mobility work will help increase your range of motion but it won’t last if you stop there. Adding in at home strength training will help improve your upper back strength so those segments of your spine can continue to move well. Targeting the Rhomboids, Lower Traps and Serratus Anterior can help maintain movement. 

What if I Plateau

Although the spine is a common cause of issues elsewhere it is not always the full story. People will sometimes come in and we work on thoracic spine work and they initially feel a lot of improvement and then it starts to slow down. That usually means that we have cleared up the spinal portion of your pain and now it is time to re-focus into the shoulder pain you have been dealing with. That can sometimes feel frustrating but it follows the systematic order to an assessment. The alternative is that you start with the shoulder and it gets 70% better and then stops. That usually means there is a spinal component that was never identified. That does not mean that it’s too late to deal with, it just adds in a bit of confusion in the recovery process. Addressing these issues one at at time in an orderly fashion allows us to track progress and make sure we are always spending our time working not the most important component. 

What to do next

If this describes you and you are getting frustrated with your pain then reach out to schedule a rehab-focused consultation to learn if this might be an explanation for your pain and a good addition to your back pain rehab.