Upper Back Spasms: Treatment and Prevention Tips
Medically reviewed by orthopedic surgeon Jonathan Lee, MD, senior expert physician at Hinge Health
If you've ever experienced a muscle spasm in your upper back, you know how painful it is. A back spasm is sudden tightness and pain in your back muscles. It's estimated that up to 10% of men and 20% of women experience upper back pain, including spasms. Most of the time, back spasms can be treated at home with ice, heat, over-the-counter medications, and some gentle stretching and strengthening exercises. Sometimes upper back muscle spasms require care from a doctor or further investigation.
Here, learn more about what causes upper back muscle spasms and how to prevent and treat them - especially with stretches and exercises from our Hinge Health physical therapists.
What Causes Upper Back Muscle Spasms?
Upper back muscle spasms are frequently caused by strained rhomboid muscles, notes Heather Broach, PT, DPT, a physical therapist at Hinge Health. These are muscles in your upper back that connect the inner part of your shoulder blades to your spine. If they are strained or torn, they may spasm (tighten up). Here are other common reasons you may experience upper back spasms:
Overuse. This is especially common with overhead activities such as weightlifting, playing tennis, or even just reaching to put objects on a high shelf.
Acute injury. Whether it's a car accident or a fall, injuries can cause muscles to tear and surrounding tissue to swell, which can trigger a spasm, says Dr. Broach.
Posture issues. This is especially likely if you sit in front of a computer for an extended period.
Herniated disc. Discs act as cushions between the bones (vertebrae) in your spine. If a disc bulges from its place, it can put pressure on a nerve and cause surrounding upper back muscles to tighten in response, says Dr. Broach.
Dehydration. If you've ever gotten a bad Charlie horse when dehydrated, you know drinking plenty of fluids is important to prevent arm or calf muscle spasms. Dehydration can contribute to spasms in your back muscles too.
Symptoms of Muscular Spasms in the Upper Back
Some common upper back spasms symptoms include:
Pain in your upper back between your shoulder blades and spine (as mild as a dull ache or as severe as a sharp pain)
A knot or tightness in your upper back muscles
Pain when you move your shoulders
Risk Factors for Back Spasms
While upper back pain spasms can happen to anyone, certain risk factors may make them more likely, such as:
Smoking. Smokers are at greater risk for chronic back pain in general, since lighting up damages blood vessels that nourish your spine. About one-third of current smokers report back pain, compared to less than a quarter of people who never smoke.
Being overweight. If you already have a back condition, you have an increased risk of upper back spasms due to your excess weight putting pressure on your spine.
Slouching. Posture issues won't cause upper back spasms, but if you're already predisposed to them, it can make them worse. There's no such thing as perfect posture, but making sure to get up and change positions regularly throughout the day can help prevent pain.
Stress and anxiety. When you're stressed, your body releases hormones such as adrenaline and cortisol, which can cause back muscles to tense and spasm in anticipation of physical fight or flight. "I once had a patient who would develop terrible migraines and upper back spasms on Mondays," Dr. Broach recalls. "It turns out she spent her weekends with her mother, who was in an assisted living facility. This left her stressed and anxious, which triggered her spasms."
When to See a Doctor
Most of the time, upper back spasms resolve on their own with home treatment, says Dr. Broach. But if you don't start to feel better after a couple days, or they return, see your doctor. They can develop a treatment plan and/or prescribe physical therapy. If you experience any of the following symptoms along with your back spasms, however, see your healthcare provider right away:
Loss of bladder or bowel control
Muscle weakness in your arms or legs
Numbness, weakness, or loss of a sense of feeling on one side of your body
Loss of balance and coordination
How Are Back Spasms Treated?
The following tips from our Hinge Health physical therapists and medical doctors can provide relief for back muscle spasms.
Ice and heat therapy. "Ice is best for the first 48 hours after an acute injury. But after that, heat becomes your best friend," says Dr. Broach. Moist heat, such as a hot water bottle, heated gel pack, or moist heat wraps, are best, she notes. "Heat brings blood to the tissue, to make sure it gets maximum hydration," she explains.
Over-the-counter (OTC) medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve) tend to work better than acetaminophen (Tylenol) for upper back spasms, since they reduce inflammation. It's important to make sure that you are safely able to take these medications, based on your medical history.
Some doctors recommend taking the recommended dose regularly for three to five days while you have spasm symptoms, rather than only turning to it when your discomfort becomes unbearable.
Muscle relaxants. These are prescription medications that may be taken for a short period of time for back spasm relief. But they can cause drowsiness, don't work for everyone, and some doctors recommend that you shouldn't drive while you take them.
Physical therapy. If you experience upper back spasms frequently, your doctor may recommend physical therapy. A physical therapist will teach you stretching and strengthening exercises to help beef up surrounding muscles. "The stronger your back and core muscles are, the less likely they are to spasm," explains Dr. Broach.
You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.
Electrotherapy. This is a form of therapy that uses electrical currents to help relieve pain. One common tool is a transcutaneous electrical nerve stimulation (TENS) device, which is a small, battery-operated machine that has leads connected to sticky pads called electrodes. The theory is that these currents modify pain signals on their way to your brain, and/or the electrical shocks themselves stimulate release of your body's endorphins, says Dr. Broach.
Preventing Upper Back Muscle Spasms
If you're prone to spasms, there are many things you can do to manage and prevent them:
Adjust how you sleep and sit. At night, sleep on your side in a fetal position with a pillow between your legs, advises Dr. Broach. When you sit, roll up a towel or sweater and place it on the most rounded part of your upper back. "It pushes your chest out and pulls your head back, which shortens muscles and prevents them from spasming," says Dr. Broach.
Avoid heels. "If your shoes' heels are higher than your toes, your entire body will pitch forward," says Dr. Broach. This can trigger upper back spasms.
Get up frequently. Stand up and stretch if you've been sitting for more than 30 minutes.
Strike a pose. Yoga helps stretch tight back muscles that could otherwise spasm. Its poses also teach you how to stretch and strengthen your muscles, which helps reduce muscular tension in your upper back.
Get regular exercise. Low-impact activities like walking, swimming, stationary cycling, and low-impact aerobics all help strengthen the muscles in and around your upper back. If you do them regularly, they can help prevent new flare-ups.
Stay hydrated. It's important to drink plenty of liquids such as water so that you stay hydrated, says Dr. Broach. This encourages the flow of nutrients such as blood and oxygen to the tissues in your back. It also plumps up the discs in your vertebrae so that they can better support your back and spine.
Exercises to Relieve Upper Back Spasms
While all of the above steps can help muscle spasms in your back, one of the most effective is exercise therapy. This includes some stretches of your shoulder and upper back muscles. Research suggests that they can improve pain, posture, flexibility, and mobility. Here are a few gentle exercises from Hinge Health that are commonly used to prevent and treat upper back muscle spasm pain.
Scapular Squeezes These pull your shoulder blades together toward your spine, which stretches out the central muscles of your back, known as rhomboids.
Scapular Clocks These move your shoulder blades in a variety of positions, which helps keep muscles strong and flexible.
Head Rotation with Hand This lengthens your upper trapezius muscle, which starts at the base of your neck, goes across your shoulders and extends to the middle of your back. "It stretches it out in a gentle way to improve rotation, which is usually pretty limited," says Dr.Broach.
PT Tip: Consider a Vitamin
"Upper back spasms may be linked back to deficiencies in minerals such as magnesium or B vitamins, which both play a role in muscle function," explains Dr. Broach. Magnesium is found in green leafy vegetables (like spinach), legumes, nuts, seeds, and whole grains. B vitamin-rich foods include salmon, chicken, beef, and eggs, as well as leafy greens, legumes, milk, and yogurt. If you and your doctor think you're not getting enough from food, consider a daily multivitamin.
Learn More About Hinge Health for Back Pain Relief
Our digital programs for back and joint pain are offered for free through benefit providers. Click here to see if you're eligible.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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