Pulling, pinching, squeezing, stabbing: Is your upper back pain always drawing attention to itself? How to understand it better – and protect yourself from upper back pain.
For many people, the left shoulder is slightly higher than the right. Physiotherapist Alexander Srokovskyi makes this observation again and again in his everyday working life. And he has a guess as to what’s behind it: “asymmetrical activities like driving a car. You have one hand further up on the steering wheel, the other further down on the gearshift.”
Just an example of a typical posture that many people take again and again in everyday life – and which can become painful in the upper back pain over time. Because if we get out of the car and walk, the following happens: “The muscles work more on one side and less on the other,” says Alexander Srokovskyi. The result: Some muscle groups become permanently overstretched, while others shorten. An imbalance arises, a muscular imbalance, as experts call it.
Muscles under tension
This makes the musculoskeletal system more unstable and the muscles can no longer hold the spine as well. And above all: This means that some muscles are exposed to a lot of tension, which is ultimately the starting point for upper back pain. Or as Srokovskyi summarizes: “The cause of upper back pain is often that a single small structure has to withstand a lot of stress.” Many postures in everyday life can contribute to this, of course not just driving. Maybe you regularly find yourself sitting slouched and crooked at your desk or dining table. Or the way your head tilts forward slightly as you scroll through miles of social media feeds.
The orthopedist Matthias Manke knows from his own experience: When patients come to the doctor’s office with back problems, they often suspect a clear cause. According to the motto: It has to be the intervertebral disc or wear and tear. However, the doctor estimates that such muscular imbalances play a role in 85 percent of upper back pain cases. If no clear cause can be found for the back pain – no herniated disc, no spondylolisthesis, no tumor, no curvature of the spine due to scoliosis – then in medicine it is called non-specific.
Psyche as a trigger
Our psychological state can also lead to non-specific upper back pain, the heavy backpack of worries, fears and problems that many people carry around with them. “When we experience stress, the entire musculoskeletal system is much more sensitive,” says Matthias Manke. Painful tension occurs more easily. It may be frustrating not to have a clear explanation for your back pain – especially if it keeps pulling and pinching. The good news: Non-specific back pain is usually harmless – the unpleasant pulling sensation often goes away on its own.
Nevertheless, the following applies: “In acute cases, it is important to clarify what could be behind it,” says Alexander Srokovskyi. In such a situation, do you find yourself wishing that the doctor would quickly fix the problem with an injection, painkillers or a prescription for massages? However, these measures do not address the root of the problem. “upper back pain is a signal that we have to do something ourselves,” says Matthias Manke. But what exactly? The short answer is: move, move, move. According to Manke, this can start with changing routines in everyday life. Stairs instead of elevator, travel short distances on foot or by bike, not in the car.
Movement in the workplace
If you work in the office and sit a lot, you should also incorporate healthier routines there. “Ergonomics in the workplace is actually movement in the workplace,” says Alexander Srokovskyi. He recommends changing positions every half hour. It’s best combined with a mini break of one to two minutes in which you stretch, do a short exercise, take a few steps, then continue feeling refreshed.
But it doesn’t work without exercises that specifically strengthen the back muscles. When it keeps pinching or pulling, many people have the impulse to go to the gym, work with weights, strength training is good. That’s true – but you should approach it with a plan for your own back’s sake. “It’s not about building up in the classic sense that the muscles get bigger and bigger,” says Srokovskyi. “It’s more about the deep muscles, so that the muscles can work better together like gears.” So-called functional training is suitable for this, in which movements are trained in which several muscle groups have to work together.
And what about stretching? “Many people think: everything works with stretching, stretching, stretching,” says Manke. “In this way we make our muscles more flexible, but we do not offer them any strength development.” But you need it to protect yourself from pain in the long term. Which muscles should we strengthen to make friends with our back? According to Matthias Manke, core exercises are crucial. “The core includes the back muscles, the pelvic floor, the side abdominal muscles and the rectus abdominal muscles.” You can strengthen them, for example, with push-ups or planks.
Train pelvic floor
And we should also pay some attention to the pelvic floor – this also applies to men. Our entire spine is based on this muscle plate that closes off our pelvis at the bottom. And this is what a pelvic floor exercise looks like: “Sit down normally – ideally on a slightly soft surface and slide the palms of your hands under your buttocks. You can feel two ischial tuberosities,” explains Manke. The next step is to imagine that you want to move these humps towards each other – this causes the pelvic floor to tense up. “It’s basically like an unfolded umbrella and now you want to fold it up.” It’s not about causing a big movement – it’s all about the tension. Then you let go of the muscles again. This exercise can be done several times a day.
According to Srokovskyi, it’s like this for many people: their upper back is too tight and their lower back is too flexible. An exercise that counteracts this goes like this: You stand up and spread your arms about 20 to 30 degrees away from your body. “The fingertips are spread wide, the bottom goes back. You squat slightly, but really only slightly. You try to keep your knees more back,” describes the physiotherapist. Now you should notice a slight pull in the back. Then you push your shoulder blades back and down, build up tension – also in your arms, up to your spread fingertips – and press your feet into the floor. “You imagine you’re about to jump. But of course you don’t actually jump.” You hold this tension for three seconds, then let go and go back in, ten times in total. “You activate the pelvis and the upper back at the same time,” explains Srokovskyi.
Back to driving: We can also do something for our backs while behind the wheel. “Press the back of your head firmly into the headrest. Of course, it has to be perfectly adjusted,” says orthopedist Manke. This mini-training strengthens the back neck muscles, which are overstretched in many people.