By the Fitness Chiropractic team · Updated
Where does your back hurt?
Your back has three regions, and each tends to hurt for different reasons. Pinpointing where the pain sits — and what makes it better or worse — is the first step in any good back pain treatment plan.
Upper back pain
The upper back (thoracic spine) is built for stability because it anchors your ribs. Upper back pain is most often muscular: long hours at a desk or on a phone, rounded shoulders, or a lifting strain. Stiff joints where the ribs meet the spine can also make a deep breath or a twist feel sharp.
Middle back pain and pain between the shoulder blades
Back pain between the shoulder blades is one of the most common complaints we hear from people who sit for work. Tired postural muscles and stiff mid-back joints are the usual culprits. Sometimes the pain is referred from the neck — an irritated joint or disc low in the neck can send pain to the shoulder blade area.
Lower back pain
The lower back (lumbar spine) carries most of your body weight and does most of the bending and lifting, so it's the most common place to hurt. Strains, disc problems and arthritis are frequent causes. Because it's such a big topic, we cover it in detail on our page about lower back pain.
Acute vs chronic back pain
Acute back pain is recent — usually days to a few weeks — and often follows a clear trigger such as lifting, a fall, a sports injury or an awkward movement. It typically settles as irritated tissues calm down, and early, active care can help that happen sooner.
Chronic back pain lasts about three months or longer. The original strain may be long past, yet the pain hangs on. Stiff joints, weak supporting muscles, posture habits, stress and poor sleep can all keep it going, so chronic pain usually needs a plan that builds strength and movement over time — not just short-term relief.
Knowing which one you have helps your chiropractor choose the right approach and set realistic expectations.
Common causes of back pain
Most back pain is mechanical, meaning it comes from muscles, joints, ligaments and discs rather than from disease. Common causes include:
- Muscle strains and ligament sprains from lifting, twisting, sports or a sudden movement
- Posture and desk habits — see our tips on avoiding office-related back pain
- Stiff or restricted spinal joints, which can make the surrounding muscles tighten and guard
- Disc problems, such as a herniated disc or a bulging disc, which may also irritate a nerve
- Nerve irritation that sends pain down the leg, known as sciatica
- Wear-and-tear arthritis in the spinal joints, which becomes more common with age
- Injuries from car accidents, falls and contact sports
Your risk climbs with inactivity, extra body weight, smoking, heavy physical work and long hours of sitting.
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How our chiropractors treat back pain
Your first visit starts with a conversation about when the pain began, where you feel it and what makes it better or worse. A full orthopedic and neurological exam follows — checking movement, posture, reflexes, strength and sensation — so we can tell where the pain is coming from and spot anything that needs a medical referral.
Based on what we find, your plan may include:
- Chiropractic adjustments to restore motion in stiff joints of the upper, middle or lower back
- Soft tissue therapy and massage to ease muscle spasm and guarding
- Spinal decompression, a gentle, non-surgical traction therapy often used for disc-related pain
- Stretching and strengthening exercises to support your spine and reduce flare-ups
- Posture and workstation advice so your daily habits stop feeding the problem
Every plan is individual — two people with pain in the same spot can need quite different care. You can read more about our overall approach to chiropractic treatment.
How long does back pain take to improve?
Recent strains often ease within days to a few weeks, especially when you stay gently active. Pain that has been building for months, or that involves a disc or nerve, usually takes longer. After your exam, your chiropractor will give you a realistic estimate and re-check your progress as you go.
Easing back pain at home
A few simple steps can help while you wait for your appointment:
- Keep moving gently — short walks usually beat bed rest
- Use ice on a fresh injury, or heat on stiff, achy muscles, for 15–20 minutes at a time
- Break up long periods of sitting every 30 minutes
- Sleep on your side with a pillow between your knees, or on your back with a pillow under them
For more ideas, see our five ways to ease back pain.
When back pain needs urgent care
Back pain is rarely dangerous, but some symptoms need a medical doctor or emergency room first. Get urgent care if your back pain comes with:
- Loss of bladder or bowel control, or numbness in the groin or inner thighs
- Leg weakness that's getting worse
- Fever or unexplained weight loss
- A serious fall, car accident or other trauma
- Chest pain, shortness of breath or a throbbing pain in the abdomen alongside upper or middle back pain
- Pain that's constant and worse at night, especially if you have a history of cancer
If none of these apply, a chiropractic exam is a sensible first step for most back pain.
