Upper back pain is a common reason patients seek care at Woodroof Chiropractic & Acupuncture in Olathe. It may present as stiffness, sharp pain, aching between the shoulder blades, or discomfort that worsens with posture, breathing, or movement. Lasting improvement begins with identifying why the pain developed—not simply treating the symptoms.
Upper back pain develops when thoracic joints, ribs, muscles, or nerves become irritated, restricted, or overloaded—often due to posture, repetitive strain, or injury. Accurate diagnosis helps determine the most effective treatment approach and realistic recovery timeline.
The Real Cause of Sharp Mid-Back Pain
Find out why deep breaths, twisting, or sitting make your mid-back pain worse and what you can do to start feeling better today
How We Evaluate Upper Back Pain
Every patient begins with a detailed consultation to understand when symptoms started, what aggravates or relieves them, work and lifestyle demands, prior injuries, and any previous care. This context helps guide clinical decision-making from the start.
A focused physical examination follows, assessing thoracic joint motion, rib mobility, muscle tone, posture, breathing mechanics, and neurological findings when appropriate. Movement patterns are evaluated to identify areas of restriction, compensation, or tissue overload.
When clinically indicated, diagnostic imaging such as X-rays may be recommended to evaluate spinal alignment, joint integrity, rib involvement, or degenerative changes. This step is critical because the diagnosis directly determines treatment selection, prognosis, and how long care may take.
Orthopedic & Neurological Testing (How We Narrow the Diagnosis)
During the physical exam, we use targeted orthopedic and neurological tests to determine whether mid-back pain is local and mechanical in nature or related to nerve irritation, referred pain, or underlying joint dysfunction. No single test establishes the diagnosis—findings are interpreted alongside your clinical history, movement assessment, neurological screening, and imaging when clinically indicated. This process helps determine which tissues are driving pain, how care should be directed, and what recovery timelines are realistic.
For patients whose mid-back pain is determined to be local and mechanical, evaluation commonly includes:
- Thoracic Active Range of Motion (AROM) - Assessment of thoracic flexion, extension, rotation, and side bending helps identify movement restrictions, asymmetries, and symptom reproduction. Pain that is reproduced with specific thoracic movements and remains localized to the mid-back region often indicates joint restriction, muscular tension, or localized tissue irritation.
- Postural and Movement Assessment - Observation of seated and standing posture, shoulder position, and thoracic movement patterns helps identify prolonged flexed postures, rounded shoulders, or repetitive reaching activities that increase mechanical stress on the mid-back.
- Palpation and Segmental Motion Testing - Gentle assessment of thoracic joint motion, costovertebral joints, and surrounding musculature helps identify restricted segments, localized tenderness, or protective muscle guarding, which are common contributors to mid-back pain.
- Respiratory and Rib Motion Assessment (when appropriate) - Evaluating rib movement during breathing and trunk rotation helps determine whether rib or costovertebral joint irritation is contributing to pain, particularly when symptoms worsen with deep breaths, coughing, or twisting.
- Neurological Screening (when appropriate) - Basic neurological checks help confirm that symptoms are not associated with thoracic nerve involvement, supporting a diagnosis of local mechanical mid-back pain.
When findings indicate localized thoracic joint or soft tissue dysfunction without neurological involvement, treatment is typically focused on restoring normal thoracic and rib motion, reducing mechanical stress, and improving tissue tolerance. Care commonly includes thoracic adjustments, in-office mobility work, targeted stretching, and guided home exercises, with hydromassage, cupping, or other soft tissue therapies incorporated as clinically appropriate.
What Causes Upper Back Pain?
Upper back pain most commonly develops from mechanical stress placed on the thoracic spine and rib joints. Prolonged sitting, forward-head posture, rounded shoulders, and sustained arm positions can overload joints and surrounding tissues over time.
Repetitive movements, lifting, or sudden twisting can strain muscles or irritate the joints where the ribs attach to the spine. In some cases, inflammation in these areas leads to sharp pain with deep breathing, coughing, or certain movements.
Less commonly, nerve irritation or degenerative changes in the thoracic spine can contribute to persistent discomfort. Because multiple structures can be involved, identifying the primary pain generator is essential for effective care.
Common Symptoms of Upper Back Pain
Patients with upper back pain may experience:
• Localized pain or stiffness between the shoulder blades
• Sharp pain with deep breathing, coughing, or twisting
• Muscle tightness or protective guarding
• Pain that worsens with prolonged sitting or poor posture
• Discomfort radiating toward the neck, shoulders, or ribs
• Fatigue or tension across the upper back and shoulders
What Patients Commonly Report
Patients with upper back pain often report difficulty maintaining comfortable posture throughout the day. Symptoms may worsen with desk work, driving, or repetitive arm use.
Many describe temporary relief from stretching or massage that does not last, followed by recurring flare-ups tied to daily routines or work demands. These patterns often indicate an underlying mechanical issue rather than a one-time strain.
How Chiropractic Care Helps Upper Back Pain
Chiropractic care focuses on restoring normal joint motion, reducing mechanical stress, and improving how the spine and surrounding tissues tolerate daily load. When thoracic joints and ribs move properly, muscles are able to relax and function more efficiently.
Care may also help reduce inflammation, support healthy nerve function, and improve breathing and posture mechanics. The goal is to address the source of irritation—not simply mask symptoms.
Our Treatment Approach at Woodroof Chiropractic
Because no two cases of upper back pain are identical, treatment plans are customized based on your diagnosis, severity, and response to care. Treatment may include:
- Chiropractic adjustments to restore thoracic and rib joint motion and reduce mechanical irritation
- Spinal decompression when clinically indicated to reduce disc-related stress and improve tissue tolerance
- Hydromassage therapy to decrease muscle guarding and improve comfort between visits
- Cupping therapy to improve soft-tissue mobility and reduce tension patterns across the upper back and shoulder blades
- Corrective exercises and stretching to build capacity, improve posture mechanics, and reduce recurrence risk
As function improves and inflammation decreases, care is progressed and adjusted accordingly. Many patients notice improvement within the first several visits, though timelines vary based on the underlying cause and individual response.
Prognosis & What to Expect
Acute upper back pain caused by recent strain or postural overload often responds quickly once motion and tissue balance are restored. Chronic or recurrent cases may require a longer course of care due to adaptive changes in joints, muscles, and movement patterns.
Recovery timelines depend on factors such as symptom duration, daily workload, posture habits, and overall tissue health. Imaging or referral may be appropriate if symptoms fail to improve as expected or if findings suggest a non-mechanical cause.
Clear expectations are established early so patients understand both the why behind care and what progress should realistically look like.
FAQ — Mid Back Pain
Q: Why does my mid back hurt when I take a deep breath?
A: This usually indicates irritation of the joints between the ribs and the thoracic spine. When you inhale, the ribs expand — and if a rib joint is inflamed or restricted, it can create sharp or stabbing pain.
Q: Can mid back pain come from bad posture?
A: Yes. Prolonged sitting, computer work, and slouched posture place continuous tension on the thoracic joints and muscles, often leading to stiffness and pain.
Q: Can a rib go “out of place”?
A: While ribs don’t fully dislocate without major trauma, the rib joints can become restricted or irritated, causing sharp pain. Chiropractic adjustments help restore normal movement.
Q: How long does it take to feel relief?
A: Most patients notice improvement within 1–3 visits, depending on severity and how long the pain has been present.
Q: Do I need imaging for mid back pain?
A: Most cases do not require X-rays or MRI unless symptoms are severe, traumatic, or include red-flag warning signs. We evaluate this during your exam.
Ready for relief?
Call our Olathe chiropractic office at 913-735-6351 or schedule your visit online to begin a thorough evaluation and personalized care plan.
