Upper Back Pain Therapy & Treatment

The usual primary cause for upper back pain is muscle strain resulting from poor posture. Other less common causes are back injuries like a vertebral fracture, car accident trauma and scoliosis; and other secondary reasons for upper back pain that are more systemic in nature need to be ruled out by a Doctor of Physical Therapy or a physician.Upper Back Diagram View

Physical Therapy is the main form of rehabilitation for pain caused by an upper back strain. The physical therapist would help you address the underlying causes of poor posture and hone in on the exact joints and muscles that are causing the pain. Your physical therapist can help work with your body through exercise, posture re-education and manual therapy on joints and muscles to restore you to a better and pain-free range of movement. In the process of visiting a physical therapist, you could also very well learn how to minimize and avoid the reoccurrence of upper back pain.  

Posture re-education is the crux of healing most upper back pain. It can be difficult to change habits that have formed over decades of life, but a physical therapist can gradually coax the body to improve its posture through progressive strengthening of postural muscles, and teaching the patient different cues to obtain this. Sometimes we use mirror aids to help the patient see their dysfunctions, and at other times, we address their work desk environment to help facilitate a healthier posture.   

Physical therapy often involves a combination of active and passive methods. Passive treatments relax muscles that have spasmed and have become tight and guarded. These are called passive treatments because the patient does not have to actively participate, and the physical therapy does the work with his/her hands. Your joints in the upper back may need to be worked on as well to promote healthy joint kinematics, and this usually involves the physical therapist mobilizing the joints themselves. This is typically a painless procedure, and the patient usually feels a lot of relief afterward.  You physical therapy plan of care may start first with passive procedures to allow the back to calm down and reduce pain and spasms, but the eventual goal of physical therapy is to have the patient be engaged in active treatments.

Following are a list of examples of passive treatments:

  • Deep tissue mobilization: This involves relieving chronic muscle tension, built up by excessive guarding, stress and daily strain on the muscle. The muscles of the upper back may tense up to protect a faulty or injured joint. Your physical therapist will use direct manual pressure, and may use other methods like cupping, ASTYM, or Graston to achieve this. Deep tissue work can be very beneficial in allowing the muscle tissue to release and heal, especially when paired with gentle flexibility and stability exercises.
  • Heat therapy: Heat therapy may be recommended or performed by your physical therapist. The application of heat allows for vasodilation and more blood flow to the target injured area and muscle. Since blood contains a lot of restorative nutrients and oxygen, increasing blood serves to facilitate a more rapid healing.  
  • Cold therapy: Cold therapy is usually applied if the injury is acute and fresh, and when there are signs of inflammation in the injured area. Cold therapy is sometimes useful as a numbing agent if the pain in the area is very distinct and localized.
  • Transcutaneous electrical nerve stimulation (TENS): A TENS machine may be recommended to you by your physical therapist or by a physician. TENS machines work by passing an electric current to the region of pain. The electric current varies from each individual and depends on the patient’s tolerance. The parameters are set to a safe level where the patient can wear it on them for a long period of time. (However it is NOT advisable to use a TENS machine when you are pregnant, have any form of cancer, have a pacemaker, or in water) A TENS machine works by increasing your production of endorphins (a natural painkiller made by your body) and by stimulating the gate mechanism of pain modulation. The gait mechanism works by giving the patient a vibratory sensation that competes with and supersedes the pain sensations, thereby reducing the pain non-narcotically. Typically, physical therapists choose to use this method when the patient’s pain is high and difficult to manage.

As mentioned earlier, the goal of physical therapy is to encourage active participation on posture re-education and strengthening so the patient is armed with the knowledge of how to prevent recurrence of the upper back injury. The active component of physical therapy involves teaching you various therapeutic exercises to help improve flexibility of the chest and paraspinal muscles, as well as strengthening the muscles that help keep good posture alignment so that the posture retraining becomes more effortless. Range of motion is emphasized because oftentimes the upper back pain is due to stiffness and inability to move in certain directions. Core stability is also emphasized to bolster posture and decrease occurrence of future low back pain. Core stability also helps tremendously with return to sports and more strenuous activities that involve trunk and extremity control. Your physical therapy program tailored to you and your history of upper back pain, so each plan of care is individualized to the patient. Though a set of exercises may help you, it may not been that they are transferable to another patients with upper back pain – especially since the exact cause and joint dysfunction may be very different in origin.

As mentioned earlier, posture and ergonomic changes is the crux of upper back physical therapy. The biggest activator of this is the patient and needs full cooperation for success in rehabilitation and future prevention. Though staying with bad posture may seem more comfortable at its present injury, it is only a result of weakened deconditioned muscles staying in their more laziest form. Though strengthening and posture retraining may feel and sound difficult, the goal is to create muscles in the back and core that do not require being lazy and inactive to feel comfortable and pain-free.

Staying strong, stable and flexible is the mainstay of recovering from upper back pain. It starts with passive methods by a physical therapist, but adherence of the home exercise program that they prescribe will guide you to a healthier and more pain-free habit of living. Come visit one of our convenient Portland area clinics and have one of our therapists help you with your upper back injury treatment today!

Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
Lindsay Nied
Lindsay Nied
23:33 18 Dec 17
I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
JoAnn Hatch
JoAnn Hatch
08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
Clare Perry
21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
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