Upper Back Pain from Sitting at a Desk: Causes and Fixes

Many people who work at a computer know the feeling: a dull ache between the shoulder blades or across the top of the back that builds through the afternoon.

This guide covers why leaning towards a screen loads the upper back, what to change at your desk, some gentle exercises and when to see a doctor.

What counts as the upper back

The upper and middle part of your back is the thoracic spine. It sits between your neck and your lower back. Around it are the muscles that hold your shoulder blades in place and help keep your head and shoulders upright.

Cleveland Clinic lists posture, strains from regular activities and repetitive strain at work among the common causes of upper back pain.

Why leaning in rounds your back

When you concentrate on a screen, it is easy to drift towards it. Your head moves forward, your shoulders follow and your upper back curves.

Physical therapist Jennifer Danzo, writing for Cleveland Clinic, describes the chain like this: when the head moves forward, its weight pulls on the muscles at the back of the neck, the chest muscles get tight and the shoulders start to round forward.

Desk work tends to hold that shape for long stretches. Sitting still in one position keeps the same muscles working without a rest, which is why changing position and moving often matters as much as the set-up itself.

Set up your desk

The UK Health and Safety Executive (HSE) gives a simple checklist for good posture at a computer:

Screen: top of the screen level with your eyes, about an arm's length away.
Chair: seat height that supports the front and back of your thighs equally, with a gap of 2 to 3 cm between the front of the seat and the back of your knee.
Lower back: the chair back should give good lower back support. A cushion can add support if it does not.
Keyboard and mouse: keyboard just below elbow height and the mouse in line with your elbow, so your arms can stay close to your sides.
Shoulders: sit high enough that you do not need to shrug your shoulders, and let them relax.
Alignment: keep the screen and keyboard central in front of you so you do not twist your back.

Move more, sit still less

The NHS advice for back pain is to stay active and keep up your daily activities as much as you can. Walking, swimming, yoga and pilates may help.

At work, short breaks taken often are easier on your back than long ones taken rarely. Use them to stand up, walk a few steps and change position.

Gentle exercises to try

The exercises below come from Cleveland Clinic and a Cambridge University Hospitals physiotherapy leaflet. Move slowly, stay within a comfortable range and stop if an exercise makes the pain worse. If you are already seeing a physiotherapist, follow their advice first.

Chin pull-back: sitting tall, pull your chin straight back without tilting your head up or down, and hold for a few seconds.
Doorway stretch: stand in a doorway with your elbows bent at 90 degrees and your forearms on the frame, step one foot back and lean forward until you feel a stretch across your chest.
Shoulder blade squeeze with a band: hold a resistance band anchored in front of you, keep your elbows near your ribs and squeeze your shoulder blades together as you pull back.
Lean back over the chair: sit on a chair with a high back, feet flat on the floor, and gently lean back so the part of your spine above the chair back extends.
Seated rotation: cross your arms over your chest, turn your upper body to one side, return to the middle and turn to the other side.

When to see a doctor

Some symptoms need a doctor rather than a better chair. The NHS suggests seeing a GP if:

the pain does not improve after treating it at home for a few weeks
it is stopping you doing your day-to-day activities
the pain is coming from the top of your back, between your shoulders, rather than your lower back
it does not improve after resting or is worse at night
you have lost weight without trying to

Ask for an urgent GP appointment or get help from 111 if the pain is severe and starts suddenly or is getting worse quickly, or if you feel hot, shivery or generally unwell.

Call 999 or go to A&E if you have chest pain, or pain, tingling, weakness or numbness in both legs. Cleveland Clinic adds that you should get medical help immediately for any symptoms that could come from a heart attack or a blood clot in the lungs.

Building the habit

The hard part is noticing when you have slid towards the screen again, and remembering to get up.

Upsaro is a webcam posture reminder for Windows and Mac that measures your distance to the screen and lets you know when you lean in. It also reminds you to take breaks and stretch, with a guided exercise library. Upsaro is a wellness tool, not a medical device, so persistent or worrying pain is still a job for your GP or a physiotherapist.