Upper Back Spasms: Symptoms, Treatment & Care Tips
A muscle spasm, or cramp, is a sudden, involuntary contraction of a muscle. It can occur in any muscle in the body, including those of the upper back. A muscle spasm may feel like a knot or tightness in the muscle. Some are very painful, while others are more mild. Early detection of the cause of the back spasm usually has better results for pain relief.
Causes of muscle spasms
You may not always know the cause of a muscle spasm. However, several things can increase your chances of having one.
“The most common causes of upper back spasms are muscle sprain or strain due to stress, bad ergonomics, a major fall, injury or auto accidents,” says Medhat Mikhael, M.D., a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
Alex Tauberg, D.C., a Pittsburgh chiropractor, says upper back spasms can also be caused by overuse of the muscle, dehydration, an electrolyte imbalance, or injury to the muscle or another muscle in the area.
Certain medications, such as water pills or diuretics, can cause dehydration or an electrolyte imbalance. Some medical conditions may as well, including diabetes or kidney failure.
Mikhael says more serious problems can cause upper back spasms. These can also result in nerve-related symptoms such as tingling, numbness or weakness in the arms or legs. They include:
- A herniated or bulging disc
- Osteoarthritis of the cervical spine (neck) or thoracic spine (upper and middle back)
- Degenerative disc disease
- Narrowing of the spine (spinal stenosis)
- Spine anomalies such as scoliosis or kyphosis
When to seek medical help
If you have a new pain in your back for two days, but it goes away, you may be fine. Anything that is progressively getting worse or more painful, however, may need to get upper back spasm treatment.
“Simple spasms that are focused on the muscles without systemic or nerve-related symptoms should not be of any worry,” says Mikhael.
However, he says these spasms can be of concern if you also have any tingling, weakness or numbness in the upper back, arms or legs. Other warning signs include:
- Overall weakness
- Major weight loss
- Any other symptoms that affect the whole body
These can be signs of a more serious spine condition such as a bulging spinal disc or narrowing of the spine. They can also be caused by cancer, infection, or compression fractures of the vertebrae.
Tauberg says other signs that a muscle spasm may be more serious include:
- Feeling light-headed, nauseous, or dizzy
- Heat rash, heat exhaustion, or heat stroke, which can occur after working or exercising in a hot environment
- Having repeated muscle spasms in the same part of the body
If rest and self-care don’t relieve the muscle spasms—or if you have any serious symptoms—seek medical help.
“If you are worried about a muscle spasm that you have had or are having, it is best to consult with a trained professional about your particular condition,” says Tauberg.
Muscle strains in the upper back
The upper back has several muscles, including those that are connected to the shoulder blades, ribs, and shoulders. These can all be affected by muscle spasms.
However, muscle spasms in the upper back often involve the rhomboid muscles. These connect the inner edges of the shoulder blades to the spine. They are involved in many upper body movements and help support your posture.
If the rhomboid muscles are strained, you may notice tightness or pain when you breathe or move your shoulders. Rhomboid muscle pain is often felt in the middle of the upper back but may extend to one or both sides.
Rhomboid spasms can happen during:
- Activities that involve reaching overhead, such as putting objects on a high shelf or serving a tennis ball
- Carrying a heavy backpack, especially if it is on one shoulder
- Poor posture, such as while sitting at a computer or desk for a long time
Preventing upper back spasms
Mikhael says if you don’t have any nerve-related or whole-body symptoms, there are several things you can do to prevent or treat upper back spasms. These include:
- Stress relief
- Regular aerobic exercise
- Improved workplace ergonomics, which is how you are sitting or standing while working
- Massage therapy
- Physical therapy
- Muscle relaxant, if prescribed by your physician
Tauberg also offers these tips for preventing upper back spasms, especially when exercising:
- Stay hydrated
- Perform dynamic stretches (a warm-up) before working out
- Perform static stretches after your workout
- Maintain a strong core
If these methods don’t help, or if the upper back spasms get worse, talk to your doctor. They will ask you questions, do a physical exam and may run additional tests to see what is causing the spasms.
Your doctor may suggest other stretches, chiropractic care, massage therapy, or physical therapy to help relieve the spasms. They may also recommend a prescription muscle relaxant to help the muscles relax, or a pain medication.
Self-care for upper back spasms
“When you have an upper back muscle spasm,” says Tauberg, “the best thing you can do is to first cease the activity you are performing.”
After that, he suggests doing light stretches to loosen up the upper back. This should be followed by light warm-up exercises to increase blood flow to the area.
What you do next depends upon how you feel.
”If the spasm has reduced, you can slowly begin to return to the activity you were performing,” says Tauberg. “If the spasm persists, using a warm compress can help to reduce the spasm.”
When using cold or heat therapy, apply the cold or heat pack for only 15 to 20 minutes at a time. When using ice for therapy, always use a towel and do not apply directly to the skin. Wait a couple of hours between applications.
You can also try gently massaging the muscles of the upper back.
You can massage the rhomboid muscles by lying down on your back with a tennis ball between your shoulder blades. Shift your position to gently massage the muscles with the ball. Avoid putting pressure directly on your spine.
A mild strain of the rhomboid muscles may heal within a few weeks, but a severe injury can take longer. As always, seek help if you have any concerns.
“Most upper back spasms are stress-related and do not reflect a serious condition,” says Mikhael. “So if symptoms persist and affect your quality of life, schedule an appointment with a qualified medical professional who can get to the root of your problem.”