I’ve Pulled a Muscle in My Upper Back: What to Do

January 18, 2024

By Justin Field, M.D.
Dr. Field is a board certified, fellowship trained orthopedic spine surgeon. Dr. Field has specialized training in minimally invasive spine surgery and motion sparing technologies, such as cervical and lumbar Artificial Disc Replacement, as well as non-fusion stabilization. In addition, he has extensive training in adult deformity correction and treatment.

Your back has 33 bones, plus your shoulder blades, ribs and collar bones. There is a large number of tendons, muscles and tissues, as well as deep muscles and superficial ones. A lot of mechanics and movability go into ensuring your head stays aligned with your spine and that your shoulders, neck and arms all move correctly, as well as the back itself. You can twist, turn, reach, rotate and contact all within the space. And yet, compared to the lower back, the upper back is not as well documented in terms of spinal pain. That just shows you what a protected, working machine it is.

That isn’t to say it doesn’t happen. Approximately 15-19% of people in the U.S. suffer from chronic upper pain in their lives, and 30.7% of adults have upper back pain in general. Let’s discuss what you can do immediately and long term to help your injury as well as understand what it is.

Understanding a Pulled Upper Back Muscle

The upper back, also called the thoracic region, is made up of several components. Here are a few of the muscles involved:

  • Trapezius: This muscle resembles the shape of a trapezoid, hence the name. It extends all the way from the neck to the mid-back section and across the shoulders. 
  • Rhomboids: Underneath the Trapezius is the slanted rectangle muscle called the Rhomboids. They connect the scapula and are needed to retract and elevate the bone. 
  • Latissimus dorsi: This is a broad, flat muscle that extends on either side of the back. It helps move the arm movement and provides stability. 
  • Erector Spinae: The erector spinae is a collection or group of muscles that run along the spine. They are responsible for maintaining posture and bending movements. 

Signs of a Pulled Back Muscle

Pulled muscles can display a mix of symptoms depending on how the condition occurred. The following are observations often found with pulled muscles in the back:

  • Localized pain and stiffness: We are all familiar with the first sign. You get up from sitting or reach forward for something, and you feel that sharp, acute pain in the upper back area. Certain movements that involve the neck and shoulders will trigger it. GStiffness is not as painful but is more of a general area issue. Movements like turning your head or bending over just feel like a hassle. 
  • Spams: This is similar to a cramp where a movement might trigger it, and your muscle involuntarily contracts and strains. It is alarming, and the pain is acute. Gentle massaging the area can help just ease those muscles.
  • Swelling: If your back pain comes from a direct injury, you could see swelling and puffiness in that area. If you gently touch your back, you can feel the tenderness.
  • Radiating pain: Sometimes, people feel the pain start in one area but then branch into other zones, such as the neck or shoulders. 

Common Triggers of an Upper Back Pulled Muscle

A muscle strain on the upper back can be caused by:

  1. Overexertion: If you lifted a heavy object or engaged in intense physical activity without proper conditioning or protection for your back, you could cause injury.
  2. Poor posture: Sitting for long periods of time in a poor position, especially when using computers or mobile devices, can strain your upper back. 
  3. Sudden movements: If you twist or move suddenly, it can cause strain.
  4. Repetitive motion: Overuse of the same muscles again and again can cause injuries, especially if the muscles are not warmed up properly. 

Effective Management of a Pulled Upper Back Muscle

Back injuries take a long time to heal. It can be a matter of weeks for some, and months or even years for others. The strategy to combat this is to do a mix of immediate care, pain relief strategies and rehabilitation exercises.

Immediate Response to a Pulled Muscle

There is a method of treatment known as the R.I.C.E method, which has been used with sports trainers for years. R.I.C.E stands for rest, ice, compression and elevation. You can use this method for any muscle injury, including ankles, knees and the upper back:

  1. Rest: Simply rest immediately after you have been injured. Don’t do activities that cause stress in the affected muscle. You don’t want to expand the damaged area any further.
  2. Ice: A bag of frozen peas, a few crushed ice cubes in a damp cloth or an ice pack will work. You want to put it on as soon as possible to stop the inflammation for about 20 minutes. You can then rest it for two to four hours and put the ice pack back on again. Do not put the ice directly onto the area, as that will be too cold. Wrap it in a towel and keep it for 20 minutes or less; otherwise, you could cause further damage. Your goal is to reduce the swelling but not stop it.
  3. Compression: Compression bandages can reduce the swelling. Use an elastic medical application that has some give to it. It should be snug, and the area should still have good circulation. If the area starts to feel numb, you get pins and needles or increased pain, then the bandage is on too tight. Unwrap it, wait a few minutes for circulation to return and then rewrap it a bit looser. The bandage should only be on for the first two to three days. If you find it you need it longer, consult a medical healthcare professional. 
  4. Elevation: Raise the body part above the heart level. You will want the fluids to gently move out of the area and not have a reason to stay pooled. Gravity will do this for you. For upper backs, this means staying seated rather than lying flat down. Prop yourself up with a few pillows or a sponge wedge.

Rehabilitation and Recovery

After a physical examination, a healthcare professional will probably prescribe over-the-counter pain relievers to help with inflammation and pain management. Pain management works by blocking the pain nerve from sending the signal to the brain. The brain then thinks the muscle is OK, so it relaxes it. You know the muscle is damaged, so you rest and don’t put any strain on it, and the muscle feels relaxed as the pain meds kick in. It can then heal without being pressured or strained by the pain or movement.

Heat therapy is another option after 48 hours. The first 48 hours are about cooling the area down to reduce the swelling. But after two days, you want to use heat to relax the muscles and increase blood circulation in the area to heal. 

Rehabilitation exercises are all about gentle moving and stretching the area to start getting the muscles working again, but safely. Your aim is to build up strength and increase the blood flow so that the body heals correctly. If your muscle stays contracted and it heals like that, you might find you won’t have as much stretch as you did before. So you want to slowly stretch it out.

Stop immediately if you have acute pain or discomfort. A physiotherapist can also suggest some strengthening exercises suited to your specific condition. Another gentle way is to just spend half an hour focusing on your posture. Inhale and straighten your back. Roll your shoulders so they are relaxed, and lift your chin to be level with the floor. Once you are in a good posture point, hold for a few minutes before relaxing the muscles on an exhale. 

How Desert Institute for Spine Care Can Help

The Desert Institute for Spinal Care is a leader in minimally invasive spine care and surgical techniques. We can create a customized treatment for you to reduce your back pain and inflammation. Our goal is to treat the symptoms and find the root of the problem. Once we know why there is an issue, we can go about readjusting and tailoring programs so that the injury can heal and prevent it from returning.

Schedule an appointment to discuss your treatment plan options for the pulled muscle in your upper back

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