Upper Back & Neck Pain

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Upper back and neck injuries are relatively rare in sport and more often occur from activities of daily living, such as waking up with a wry neck (torticollis).  Neck injuries that are sustained in sport must be taken very seriously, especially if they are associated with symptoms of concussion or referred pain into the shoulders and arms.

When should I see a doctor?

Significant trauma to the neck and upper back should always receive urgent medical care. Similarly, those that are associated with severe pain or ongoing impairment following a sporting injury should always be seen by a doctor or healthcare professional such as a physiotherapist, sports therapist, chiropractor or osteopath.

If you experience any of the following symptoms from an upper back or neck injury you should seek professional medical advice;

  • Severe neck or upper back pain.
  • Dizziness or a feeling of unsteadiness.
  • Blurred vision or altered vision.
  • Referred pain in the shoulders or arms following a neck or upper back injury, especially if the symptoms do not decrease within 24 hours.
  • “Pins and needles” (paresthesia) feeling or “loss if feeling” (anaesthesia) in the arms or hands.

First Aid for Minor Injuries

In the case of minor upper back and neck injuries, it is recommended to follow a modified version of the P.R.I.C.E. therapy principle. This series of treatment methods can be applied at home for at least the first 2 - 3 days. P.R.I.C.E. stands for Protection, Rest, Ice, Compression and Elevation.

  • Protection - Protect the injury from further damage. For neck injuries this is one of the most important principles to follow.  Where applicable, use of a soft collar may be recommended for a couple of days to help support the neck and reduce muscle spasm.
  • Rest - Refrain from exercise and try to reduce the demands of your daily activity to encourage recovery.  Heavy lifting should definitely be avoided.
  • Ice - The topical application of ice or cold therapy can assist in reducing the symptoms of pain and inflammation but should only be applied to the upper back and not to the neck.
  • Compression – This is not possible for neck and upper back injuries.
  • Elevation - This is not possible for neck and upper back injuries.

Read more about all of the the P.R.I.C.E principles.

Preventing Upper Back and Neck Pain

Upper back and neck injuries are rare in most sports except rugby and American football.  These sports in particular involve repetitive high forces from contact situations and often lead to muscular spasm or injuries to the joints (called “facet joints”) in the neck (cervical spine) or upper back (thoracic spine).

The other main factor leading to upper back pain and neck pain is weak localised muscular strength and poor posture, and the most common single cause is sitting at desk working on a computer for long periods.  The latter can be greatly improved by adjusting your seat and desk heights to the correct level and adjusting the computer screen to be at eye level and directly in front of you. 

There are a range of methods used to minimise the risk of developing upper back pain. Whilst these vary depending upon the specific sporting or activity, using exercises to improve posture and develop appropriate muscle strength in the area are advised.  A physiotherapist, sports therapist, osteopath or chiropractor will be able to advise you on exercises to correct posture and Pilates and Yoga are also two very useful activities that can be practiced to improve posture and core muscular strength (around the neck and back).  It is strongly advised to seek a professionals help to practice both of these.  Finally, sports massage, deep tissue massage and the use of heat packs are often found to be useful for relieving muscle spasm and reducing pain in the neck and upper back.