By Dr. Joshua Kiely, DC

Cindy is an accountant, and when it comes to tax season she always ends up with pain across her shoulders and neck. Spending long hours at her computer without breaks really takes its toll. She has tried her best to keep “good” posture, but it doesn’t seem to help.

By the end of tax season, Cindy usually feels like someone has poured concrete between her shoulder blades and it causes a stiff and achy sensation when trying to move her neck or raise her arms.

This article will describe a very common diagnosis: strained upper back muscles - otherwise known as “pulled” muscles. We will cover the anatomy and common treatment strategies for pulled upper back muscles.

This article is meant for educational purposes and should not be used for diagnosis or self-treatment. If you are experiencing pain, please discuss your condition with a qualified health professional.

Upper Back Anatomy

When we refer to the upper back we are thinking about the area from the bottom of the shoulder blades up to the base of the neck. The upper back contains about 6 thoracic vertebrae, one cervical vertebrae, the ribs attached to the vertebrae, both shoulder blades, and several muscles that attach to each of these bones. 

In my chiropractic clinic, the most common upper back strains I see involve the rhomboids or trapezius muscles.

Rhomboid Strains

The rhomboids can be found in the middle of the back between the shoulder blades. These muscles travel from the inner edge of the shoulder blade and attach to several of the vertebrae in the upper back (C7-T5). To be more specific, the rhomboids are actually two muscles, the rhomboid major and rhomboid minor. 

The main function of the rhomboids muscles is stabilizing the shoulder blade during movement of the arm. They also retract, elevate, and rotate the shoulder blades.

When the rhomboids are strained, we usually feel a tense sensation between the shoulder blades and sometimes we experience a sharp or dull pain traveling upward in the spine. Any movement that requires the arm or shoulder blade to move can also be sore. 

The rhomboid muscles play a large role in pulling movements such as rows and also in throwing movements. Weightlifters may find that a strained rhomboid can even impact their ability to set their shoulders for presses and squats.

Trapezius Strains

The trapezius is a large diamond-shaped muscle that originates at the base of the skull, fans out to attach to the outside edges of both shoulder blades, and travels downward to the bottom of the ribcage, attaching to several vertebrae throughout the neck and mid back. 

The main function of the trapezius muscle is to stabilize the spine and provide postural support. In addition to this function, the trapezius muscles contribute to shoulder blade and arm movement, as well as neck and head movement. 

As a chiropractor, I frequently see patients that complain of stiff and achy trapezius muscles. These muscles may become fatigued from working in bent over positions or working at a desk in front of a monitor. The trapezius often becomes very sore and sensitive when we stay in one position all day without breaks or incorporating a variety of movements.

A strained trapezius muscle may feel very similar to a strained rhomboid muscle, but we may notice the location of the symptoms is along the tops of the shoulders instead of between the shoulder blades.

Chiropractic Treatment of Upper Back Muscle Strains

Upper back muscle strains will often resolve on their own within a few weeks, however, they can be very painful while they are healing. As an Ottawa chiropractor, I find that many patients desire treatment to reduce the symptoms and speed up resolution. Every individual is different and treatment is always connected to the findings during a medical history and physical exam.

A comprehensive treatment for upper back muscle strains may include multiple modalities. The goal of each treatment option is to reduce pain while improving the function of the injured muscle. Modalities I frequently utilize in my chiropractic practice for strained upper back muscles include:

• Soft tissue therapies including deep tissue massage and assisted stretching

• Spinal manipulation therapy targeted at the painful spinal joints

• Gentle joint mobilizations in the upper back and neck

• Acupuncture to reduce pain sensitivity and help with tension

As with any condition, it is important that patients are educated about the condition, given a reasonable timeline for care and recovery, and provided tips on what they can do on their own to optimize recovery.

A customized plan for engaging in beneficial exercises as well as education on strategies that can be self-administered by patients for symptom relief can be very helpful in ensuring a comfortable and speedy recovery. 

If this sounds like something you might be struggling with let us know. We can set up an appointment in-person in the comfort of your own home or in our Westboro clinic. If you’d prefer to manage this on your own, we can provide online rehab, education and lifestyle suggestions to get you feeling better.