Managing Upper Back (Thoracic) Pain in the Workplace: Causes, Prevention, and Relief

Upper back discomfort is commonly reported in office settings, highlighting the importance of good ergonomics and posture management. Upper back pain, also known as thoracic or middle back pain, affects the area between the base of the neck and the bottom of the rib cage, including the area between the shoulder blades. While lower back pain often receives more attention, thoracic discomfort is equally important, as it can impact productivity, wellbeing, and staff engagement.

In modern workplaces, upper back pain often arises from poor posture, workstation setups, repetitive tasks, and sustained awkward movements. It can affect employees of all ages and roles, particularly where work involves prolonged sitting, repetitive movements, or tasks in awkward positions.

How Common is Thoracic Pain?

Upper back pain is relatively common:

Each year, a small but significant proportion of employees experience it.
Around 16–20% of people will experience upper back pain at some point in their lifetime.
Thoracic pain is more common in children and adolescents, and among adults, women report it more often than men.

What Causes Upper Back Pain at Work?

Posture and workstation setup: Slouching, forward head posture, or poorly positioned monitors and keyboards. Prolonged use of laptops, tablets, or other digital devices can exacerbate poor posture, contributing to thoracic strain.
Repetitive movements and sustained awkward positions: Tasks involving repeated reaching, lifting, or holding awkward postures can strain thoracic muscles.
Muscle imbalances and weakness: Weak postural muscles can lead to compensatory tension in the upper back.
Load and asymmetric strain: Carrying heavy items or backpacks on one shoulder creates uneven stress on the thoracic spine and surrounding muscles.
Stress and tension: Ongoing workplace stress, high workloads, tight deadlines, and other psychosocial pressures can increase muscle tightness, exacerbate pain, and contribute to upper back discomfort.

Other Causes:

Health conditions such as osteoporosis, osteoarthritis, spinal stenosis, disc herniation, or ankylosing spondylitis.
Accidents or sudden injuries including strains, sprains, fractures, slips, trips, falls, sports injuries, or car accidents.

Preventing Upper Back Pain in the Workplace

Ergonomic DSE (display screen equipment) workstation assessment: Ensure chairs, monitors, keyboards, and input devices support a neutral spinal posture. Professional DSE assessments can be helpful for staff reporting discomfort.
Task and workflow adjustments: Reduce repetitive or sustained awkward movements. Encourage task rotation and opportunities for standing or movement.
Load management and lifting guidance: Provide training on safe lifting and carrying to avoid asymmetric strain.
Postural education and training: Offer workshops on posture, spine awareness, and body mechanics, including practical demonstrations for common workplace tasks.
Strengthening and mobility exercises: Promote exercises targeting postural muscles, shoulders, and thoracic spine. Encourage regular micro breaks with simple stretches.
Early reporting and occupational health support: Establish systems for staff to report discomfort early. Provide access to physiotherapy, occupational health, and wellbeing services.
Stress and wellbeing integration: Implement stress management initiatives, mindfulness programmes, or relaxation techniques.
Workplace culture and leadership: Encourage managers to prioritise musculoskeletal health, model good ergonomics and regular movement breaks, and respond promptly to staff reports of discomfort. A proactive approach is more effective than a reactive one, helping reduce the risk of chronic pain and maintain productivity.
Remote and hybrid work support: Hybrid and home-based setups present unique challenges. Providing guidance on home workstation setup, encouraging the use of adjustable chairs and monitor stands, and promoting regular movement helps employees maintain comfort and reduce upper back strain.
Monitoring and evaluation: Review absence data, ergonomic audits, and staff feedback to identify trends and improvement opportunities.

Ergonomic Tips to Relieve Upper Back Pain

Gentle stretching and mobility exercises: Encourage staff to take short, frequent breaks to perform stretches.
Physiotherapy or occupational health consultations: Persistent pain should be assessed professionally. Physiotherapists can provide tailored exercises, manual therapy, and advice on posture and movement. Occupational health teams can identify workplace factors contributing to discomfort.
Stress management initiatives: Muscle tension often increases with stress. Mindfulness, relaxation techniques, or breathing exercises can reduce muscle tightness and promote overall wellbeing.
Workstation and workflow review: Persistent pain may indicate that workstation setups or daily tasks are placing too much strain on employees. DSE assessors should evaluate equipment, the individual’s tasks, the work environment, and physical and psychological factors. Practical adjustments, such as alternating tasks, job rotation, or modifying lifting and reaching activities, can reduce strain and improve comfort.
Employee education and self-management: Educate staff on recognising early signs of upper back strain, safe movement techniques, micro breaks, posture checks, and gentle exercises.
Tracking and follow-up: Encourage staff to report ongoing discomfort, and track interventions to ensure effectiveness. Regular follow-up prevents chronic pain and supports productivity.

When to Seek Professional Help

While most cases of upper back discomfort can be managed with good ergonomics, posture, and gentle movement, professional support should be sought if:

Pain persists despite rest or simple stretches.
Pain radiates to the arms, chest, or other areas.
Numbness, tingling, or weakness occurs in the arms or hands.
Sudden or severe pain follows an injury or accident.

Accessing physiotherapy or occupational health: Early intervention from qualified professionals can prevent discomfort from becoming chronic. Physiotherapists provide tailored exercise programmes, manual therapy, and posture advice. Occupational health teams can identify workplace factors and support adjustments to tasks, workstation setup, and work schedules.

Early reporting systems and follow-up: Organisations should have clear procedures for staff to report discomfort early. Timely reporting allows interventions before symptoms worsen. Regular follow-up supports ongoing musculoskeletal health and reduces long-term absence.

Productivity and Morale Impacts

Unmanaged upper back pain affects more than physical comfort. Persistent discomfort can contribute to absenteeism, presenteeism, reduced engagement, and lower overall productivity. Organisations that proactively address musculoskeletal health can support staff wellbeing, maintain performance, and foster a positive workplace culture.

Conclusion

Upper back (thoracic) pain is common but often overlooked in the workplace. Organisations that prioritise ergonomics, movement, and staff wellbeing can reduce discomfort, improve productivity, and support long-term health. Preventing thoracic pain is not solely an individual responsibility; it requires embedding a workplace culture that values staff health and safety.

Organisations seeking to improve musculoskeletal wellbeing should consider ergonomic training, DSE assessor courses, and wellbeing educational workshops covering posture, movement, and strategies to reduce upper back strain, ensuring staff are supported both in the office and when working remotely.

Ready to Take Action?

Support your team’s musculoskeletal health and wellbeing by booking a CIEHF-accredited DSE assessor course or a workplace wellbeing workshop. Equip your staff with the knowledge and tools to reduce strain and improve overall comfort. Enquire today to find the right solution for your organisation.