Catch In Upper Back

By: Ehren Allen, DPT/COMT

Feeling a "catch" in your upper back can be really irritating. Fixing it can be tricky.  But, there are some simple ways to help "un-catch" your back.  Watch this VIDEO on why BACK PAIN CAN'T WAIT.

What Part of the Back is Considered Your Upper Back?

The upper back is also called the Thoracic spine. It starts at the base of the neck and ends at the lower back or lumbar spine. There are 12 vertebrae or bones in the thoracic spine and each vertebrae has ribs attached.  

Press on your ribs and follow the bottom rib around to the back of your spine with your fingers. That is the end of the upper back. 

Man with no shirts reaching to the upper back with red area showing pain or catch in upper backCatch In Upper Back

What Does a Catch in Your Back Feel Like?

A catch in the Upper back Feels like:

  • Locking 
  • Pinching
  • Stabbing
  • Sharp

These symptoms are usually only provoked with certain movements.  Typically, they happen with leaning backward or to the side of the catch. This can happen with certain sports like tennis, paddle ball, baseball and volleyball.  Often you will wake up the next morning after playing these sport with a "catch or locking sensation" in your back. 

What Causes A Catch in Your Upper Back?

There are several things that can cause a catch in the upper back. They Include:

  1. Facet Joint pain 
  2. Costovertebral joint pain (where the ribs meet the spine)
  3. Muscle spasm
  4. Trigger points

Image of skeleton from the front and back with labelled anatomy for facet joints, CV joints or costovertebral joints, and costal cartilage at ribsUpper Back skeletal anatomy
Facet Joint Pain

Facet joints are the joints in the spine that connect the vertebrae (spine bones) and allow them to move. There is a facet joint on each side of the spine at every level. The facet joints move to allow the spine to bend and twist. When a facet joint is painful or stiff, it can cause sharp pain with movement. It may also hurt when you take a deep breath. 

Costovertebral Joint Pain

Costovertebral joints (CV joints.) are the joints where the ribs attach to the spine. There are 12 ribs on each side of the thoracic spine. The ribs attach to the 12 thoracic vertebrae on each side. The ribs wrap around the body and the top 10 attach  to the sternum in the front of the chest. They connect to the sternum through cartilage called costal cartilage. 

The ribs swing upward when you take a breath. They pivot and move at the CV joints. If a CV joint is stuck or stiff, it can limit movement and cause a catching or sharp pain in the upper back. 

Muscle Spasm

A muscle spasm is an involuntary contraction of a muscle. Spasms can happen as a protective response in the body when a joint or other structure is injured. Spasms can also happen with electrolyte imbalances that keep muscles from relaxing. 

A muscle spasm is usually a symptom of another issue and not the primary problem. Muscle spasms can be painful and they can happen when you have a catch in the upper back from a joint.

Trigger Points

Trigger points are areas in muscles that become irritated and hyper-sensitive. A trigger point can cause local pain and radiating symptoms. There may be a sensation of a catch in the upper back with trigger points. Trigger points may be associated with other disorders such as Fibromyalgia, depending on the location and number of trigger points. 

When Should I Worry About Upper Back Pain? Can Your Lungs Hurt In Your Back?

The vast majority of the time, a catch in the upper back comes from a movement issue in the Thoracic Spine. There are cases where issues in the lungs can cause pain in the upper back.  If the pain: 

  • Wakes you at Night
  • Hurts when you breath
  • Hurts when you cough or sneeze
  • increases for no reason
  • Does not change with any movement
  • OR you have a Productive Cough

You should do see your doctor for a further medical evaluation. 

If you are having difficulty breathing, seek medical care immediately.  Click HERE to Learn about COVID-19 Symptoms.

How Do You Fix a Catch In the Upper Back?

Gentle movement is best at first. When the catch happens, there may be inflammation in the area. Avoid hard, forceful movements or stretching. Most of the time, when you gently move the joints and muscle tissue, the pain will decrease and movement with improve.  

Try these simple exercises at home to move the area gently. 

1. Seated chin tucks - Sit up straight and draw the chin and head backward (make a double chin).  Hold 10 seconds 5XImage of woman in pink shirt doing a chin tuck or neck retraction stretchSeated Chin tuck

2. Shoulder Rolls - Bring your shoulders toward your ears and then back, squeezing the shoulder blades together. Repeat 20X

Image of woman in teal shirt doing shoulder rolls in seated positionShoulder Rolls
3. Open Books - Lay on your sides with knees bent.  Place the top hand behind your head. Rotate the upper body all the way forward, then all the way back.  Repeat 15X on each side.

Image of a man on his side doing open books in forward position with hand behind headOpen books start position
Image of a man on his side doing open books in end position with hand behind headOpen Book End position

Ice may be used to calm the surrounding muscles and decrease pain for the first 2 to 3 days. Heat may be used after the fist 48 hours to help muscles feel better.

If the catch continues, joint mobilization is helpful to restore facet and CV joint movements. Joint mobilization is performed by a physical therapist. Find a physical therapist that specializes in manual therapy and joint mobilization. 

How Do You Prevent an Upper Back Catch?

A catch in the upper back can happen with a sudden movement or it can occur over time. The most common reason for upper back catches and pain is poor posture. 

Improving your posture is the best way to prevent a catch in the upper back. Here are some tips:

  • Sit up straight with spine is erect position, starting at the pelvis
  • Keep shoulder back
  • Adjust your computer monitor to eye level
  • bring your keyboard and mouse closer
  • Avoid using a laptop (harder to adjust to fit your body)
  • Get up and move every 30 minutes
  • Use a sit to stand desk

Image of proper postural position in sitting and standing with desk at 4 different heightsSit to Stand Desk

Click HERE to learn more about Ergonomics at Work

Should You Wear A Brace to Help Posture?

The quick answer is typically no, you should not wear a brace or harness to help with posture. Our bodies are naturally lazy. When you provide external support, it may feel better temporarily.  But, the muscles that are supposed to support your posture will become weak because they do not have to work as much. 

It is better to strengthen your postural muscles and use them to support your body. 

There are some medical conditions and bone disorders that may require the use of a brace or harness to maintain posture. But for most people, bracing is not necessary. 

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