Upper and Mid Back Pain Treatment Sydney CBD
Pain between the shoulder blades and a stiff mid back are the classic complaints of long days at a desk, and they also limit lifting, overhead work and deep breathing. We release the rhomboids, trapezius and spinal muscles, mobilise the thoracic spine and ribs, and restore the posture and shoulder blade control that keeps the area calm.
How we treat upper and mid back pain
We assess how your mid back rotates and extends, how the ribs move when you breathe, how your shoulder blades sit and move, and what your desk looks like. Treatment on the day combines remedial massage and myofascial release of the rhomboids, trapezius, spinal muscles and the chest muscles at the front that pull the shoulders forward, dry needling for stubborn trigger points, cupping across the upper back, and gentle mobilisation of the thoracic joints and ribs.
The lasting part is the exercise program: thoracic extension over a rolled towel or foam roller, open-book rotations, lower trapezius and serratus strengthening with wall slides and rows, a doorway chest stretch, and a workstation set-up that lets the shoulder blades rest.
Common patterns we see in the CBD
Desk workers with a burning spot under one shoulder blade by mid afternoon, lifters with mid-back tightness after overhead pressing, cyclists with a locked thoracic spine, and people with a sharp rib pain after a sneeze or an awkward reach into the back seat. Each responds well once the driver is identified.
Sources and further reading
General information from the Active Performance Clinic team. Last updated 27 October 2026.
Upper back conditions: symptoms and causes
| Condition | Common symptoms | Common causes |
|---|---|---|
| Thoracic spine stiffness | A stiff, aching mid back that is worse after sitting, limited twisting and reaching, a feeling of needing to crack the back, sometimes neck or shoulder pain as a result. | Prolonged sitting and screen posture, little rotation or extension movement through the day, previous injury, age-related changes. |
| Pain between the shoulder blades (rhomboid and trapezius strain) | Burning or aching between the shoulder blades, knots that refer pain around the ribs or up into the neck, worse with typing, driving or carrying bags. | Sustained rounded-shoulder posture, weak lower trapezius and serratus muscles, carrying a bag on one shoulder, sudden lifting or a heavy training session. |
| Postural upper back pain | A fatigue-like ache across the upper back that builds through the day, eases with movement and returns with sitting, often with tight chest muscles and a forward head. | Workstation set-up, hours of laptop or phone use, low activity, stress and shallow breathing. |
| Costovertebral (rib) joint sprain | Sharp, localised pain beside the spine that catches with a deep breath, cough, sneeze or twist. | Awkward lifting or twisting, heavy coughing, a fall or a sudden reach. The small joints where the ribs meet the spine become irritated. |
| Scapular muscle imbalance (shoulder blade dyskinesis) | Winging or uneven shoulder blades, clicking around the shoulder blade, upper back and shoulder pain with overhead work or pressing. | Weak serratus anterior and lower trapezius with tight chest and upper trapezius muscles, often after a shoulder injury or with heavy upper body training. |
General information only. It does not replace a diagnosis. Seek urgent medical care for pain after significant trauma, or pain with fever, numbness, weakness, or changes to bladder or bowel function.
Treatments we use for upper and mid back pain
Upper and mid back pain FAQs
Why does it hurt between my shoulder blades when I sit?
Sitting with rounded shoulders and a forward head stretches the rhomboid and mid-trapezius muscles and loads the thoracic joints for hours. The muscles fatigue and develop tender trigger points that ache and burn. Treatment releases them, and standing breaks, a better monitor height and a few strengthening exercises stop the cycle.
Can a stiff upper back cause neck pain or headaches?
Often, yes. When the thoracic spine and ribs are stiff, the neck does extra work to turn and look up, and the muscles around the shoulder blades tighten and refer pain up to the base of the skull. Treating the mid back is frequently the missing piece for recurring neck pain and tension headaches; see our headaches and migraines page.
When should I see a doctor instead?
Upper back or chest pain that comes on with exertion, or with shortness of breath, sweating or pain spreading to the arm or jaw, needs emergency care: call 000. See a doctor for pain after a fall or accident, pain with fever, unexplained weight loss, or pain that wakes you at night and does not ease with movement.
Get upper and mid back pain assessed in Sydney CBD
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