Back Pain

Back Pain by Region

• Neck (cervical) pain - see our dedicated neck pain page for causes and treatment specific to this region.
• Upper and mid-back (thoracic) pain - covered in detail below.
• Lower back (lumbar) pain - the most common presentation; see our dedicated lower back pain page for causes and treatment specific to this region.

General Causes of Back Pain

Regardless of region, several contributors show up again and again, especially among the Midtown professionals and commuters we see:

• Prolonged sitting and poor desk posture
• Muscle strain from overuse, poor lifting mechanics, or a sudden awkward movement
• Weak core and back-supporting musculature
• Carrying a heavy bag or backpack asymmetrically
• Stress-related muscle tension
• Prior injury that never fully resolved

Upper and Mid-Back (Thoracic) Pain

Pain in the upper or middle back, the region between your shoulder blades and your lower ribs, most often has a mechanical, musculoskeletal cause: poor posture (especially hunching over a desk or phone), overuse, or tight, overworked muscles between the shoulder blades. The large majority of cases are self-limiting and respond well to conservative care, similar to neck and lower back pain.

That said, thoracic pain is one region where it's worth being a little more careful. Though much less common, pain in this area can be referred from other organs rather than coming from the spine or muscles themselves. We'll always ask about your broader symptoms during an evaluation to make sure a mechanical cause is actually the right explanation before starting treatment.

When Back Pain Needs More Than Conservative Care

Most back pain, in any region, is appropriate for chiropractic and conservative care. A smaller number of cases need medical attention first. Contact your doctor or seek urgent care for:

• Fever, chills, or unexplained weight loss alongside back pain
• Pain following significant trauma, a fall, or (especially with a history of osteoporosis) even relatively minor trauma
• Progressive weakness, numbness, or loss of bowel/bladder control
• Pain that is constant, severe, and not improving despite several weeks of appropriate treatment

Seek emergency care immediately for sudden, severe chest or upper-back pain, particularly if you have cardiac risk factors since this can occasionally represent a heart-related emergency rather than a musculoskeletal issue. This is not something to evaluate with a chiropractic visit.

How We Treat Back Pain

After identifying which region and structures are involved, treatment typically combines chiropractic adjustments with guided exercise, soft tissue work, and posture-focused strategies you can use at your desk, often alongside physical therapy, for a more complete recovery. Most patients see meaningful improvement within a few weeks of consistent, appropriately targeted care.

Frequently Asked Questions

Is upper back pain treated differently than lower back pain? The general approach of hands-on treatment plus guided exercise is similar, but the specific techniques and exercises differ by region and by what's actually contributing to your pain.

Could my upper back pain be something more serious? Usually not, most upper back pain is mechanical. But because it occasionally can be referred pain, we'll ask about your broader health during your evaluation, and you should seek emergency care for sudden severe chest/upper-back pain with cardiac risk factors.

Which page should I read if my pain is specifically in my lower back? Visit our lower back pain page for details specific to that region.

If back pain in any part of your spine is holding you back, our Midtown Manhattan chiropractor can help identify the cause and build a plan to get you moving comfortably again. Call us today or request an appointment online.