Upper Back Pain

 Why It Happens and How Chiropractic Can Help

Lower back pain is the most common reason people seek care. Most people will experience at least one episode in their life, and for many it becomes persistent, disruptive, and confusing.

You might have tried painkillers, physio, or just hoped it would go away, only to find the pain keeps returning. Whether you’re reading this because the pain started recently or has been ongoing for months, you’re not alone - and there are natural and effective ways to address it's root causes, not just mask symptoms. 

Why Upper Back Pain Happens


Upper back pain commonly develops due to a combination of:


  • Reduced movement in the thoracic spine
  • Postural strain from prolonged sitting or screen use
  • Altered rib and spinal mechanics affecting breathing
  • Compensatory tension from the neck or lower back


The thoracic spine plays a critical role in posture, shoulder function, and respiratory mechanics. When movement becomes restricted, surrounding muscles often overwork to compensate, leading to stiffness, fatigue, and pain.


Imaging such as X-ray or MRI can help rule out fracture, infection, or serious pathology, but they do not assess spinal movement quality or nervous system function.

What the Research Says About Chiropractic Care for Upper Back Pain

Effectiveness of Chiropractic Adjustments


Chiropractic care, has been shown to improve pain and function in people with thoracic and upper back pain.


Clinical trials demonstrate that thoracic spinal manipulation can significantly reduce pain intensity and improve mobility, particularly when upper back pain is associated with postural dysfunction or referred pain to the neck and shoulders (Cleland et al., 2007).


Systematic reviews have found that manual therapy directed at the thoracic spine can also improve outcomes in patients with neck and shoulder pain, highlighting the interconnected nature of spinal function (Puentedura et al., 2012).

Thoracic Spine and Nervous System Function


The thoracic spine houses nerve pathways that influence posture, trunk stability, and respiratory mechanics. Restricted movement in this region has been associated with altered muscle activation patterns and reduced spinal efficiency.


Research suggests that restoring thoracic mobility through manual therapy may positively influence neuromuscular control and overall spinal function (Haavik and Murphy, 2012).


This supports a whole-spine approach rather than treating symptoms in isolation.

Comparisons with Other Treatments



Thoracic spinal manipulation may produce faster pain reduction than exercise alone for some presentations

Manual therapy combined with exercise is often more effective than exercise-only approaches

Chiropractic care offers outcomes comparable to physiotherapy for many upper back pain cases


Clinical guidelines increasingly support conservative, non-invasive care before medication or invasive intervention for non-specific thoracic pain. Chiropractic care is safe and effective for upper back pain.

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Safety Profile


When delivered by trained and registered Chiropractors following appropriate assessment, thoracic spinal manipulation is risk free. Although thoracic spine fractures occur 1 in 2.0 - 5.8 million treatments, this risk is no higher than performing everyday activities. (Carnes et al., 2010; Rubinstein et al., 2019)


Most side effects are mild and temporary, such as short-lived soreness or stiffness. Serious adverse events are rare when proper screening and clinical reasoning are applied (Carnes et al., 2010).


This reinforces the importance of examination-driven care rather than routine or generic treatment and is central to the Health Blueprint™ process our Chiropractors at Adjusting to Health perform.

Why GPs Refer to us for Upper Back Pain


Many GPs refer patients with upper back (and lower back) pain for Chiropractic when:


  • They present with upper back pain
  • Imaging has ruled out serious pathology
  • Pain is persistent or recurrent
  • Posture or spinal mechanics are contributing factors
  • Patients are seeking non-drug, non-surgical options


This reflects growing recognition that Chiropractic care, when delivered appropriately, is a safe and effective.

When Chiropractic May Not Be Appropriate


Chiropractic care is not suitable when:


  • Red flags for serious disease are present
  • Symptoms suggest systemic disease
  • Progressive neurological deficits require urgent medical investigation


If you are concerned about the above, call the us and speak to our team for professional guidance and recommendations.

Research


Carnes D, et al. (2010) Adverse Events and Manual Therapy: A Systematic Review. Manual Therapy.



Cleland JA, et al. (2007) Thoracic Spine Manipulation in Patients with Neck Pain: A Randomized Clinical Trial. Journal of Orthopaedic and Sports Physical Therapy.


Haavik H and Murphy B. (2012) The Role of Spinal Manipulation in Modulating Central Nervous System Function. Journal of Electromyography and Kinesiology.


Puentedura EJ, et al. (2012) Thoracic Spine Thrust Manipulation versus Cervical Spine Thrust Manipulation in Patients with Acute Neck Pain. Journal of Orthopaedic and Sports Physical Therapy.


Rubinstein SM, et al. (2019) Benefits and Harms of Spinal Manipulative Therapy for Spinal Pain. BMJ.