Posture 101: Your stiff upper back is a literal pain in your neck

*A quick note, if you have ongoing pain or discomfort, please consult a medical professional. This post is meant to inform, but in no way is medical advice.
I used to have neck pain all the time.
I tried all the standard fixes – massage, stretching, ergonomic chairs – with limited results until I finally clued in that my neck wasn’t the problem. My ridiculously stiff upper back was.
Improving my upper back (or if we want to be technical thoracic spine) mobility took me from chronic neck problems to almost zero neck pain.
Despite my enthusiasm for this topic, it’s dawned on me that many of us are still fuzzy on why our stiff upper backs are large contributors to our cranky necks.
Here’s why your thoracic spine is the MVP when it comes to reducing and preventing neck pain.
This is your spine.

Photo credit: Shutterstock
The orange part is your neck. The green part is your upper back or thoracic spine.
If the drawing were more accurate, you would see that the green part is where all your ribs attach. You would also see that it’s what your shoulder and arm bones sit on top of.
Since it’s attached to the ribs, the thoracic spine has some inherent stiffness relative to the rest of the spine, but it should still be able to move in all directions.
However, somewhere between the computer, TV, texting and driving, we’ve end up with immobile thoracic spines, which gets us into trouble for the following reasons:
Your thoracic spine dictates where your head and shoulders go.
Most of us have an upper back that is too curved or too flat. While these postures look different, both are a sign of a too stiff thoracic spine and they both put strain on the neck.
Because of where they’re located, the position of your head, neck and shoulders is inherently controlled by the position of your thoracic spine.
If the thoracic spine is too curved, then your bowling ball of a head will fall forward, putting the large neck muscles in constant strain and turning off the deep neck stabilizers. The shoulders will also be pulled forward, creating even more pull on the neck, because they’re…well…muscularly attached to each other.

Notice where the head and shoulders fall when the upper back is too rounded.
Conversely, if the thoracic spine is too flat, then the shoulders will fall down off the back and the head will be displaced, creating excessive pulling on the neck and turning off the deep neck stabilizers.

This is mostly my true posture and an example of a somewhat flat thoracic spine. If you were to look at me from the back, you’d see my shoulders “winging” off due to a lack of support from my spinal position.
This is why you can’t “fix” a neck by going after it directly. It’s too heavily influenced by the structures below it.
If your thoracic spine can’t move, your body will have to borrow that range of motion from other joints.
Each part of the spine is specialized for certain spinal motions. When the whole spine moves well, we get good shock absorption minimal compression on any one joint.
However, if you have an entire segment that doesn’t move, then the rest of the segments will have to take up the slack.
For most of us, this means we move too much from the neck and lower back, while bypassing movement in the upper back almost completely.
Over time this leads to a breakdown and pain in the neck and low back.
Your thoracic spine is inherently connected to how you breathe and how you breathe has major ramifications on your neck.
This could be a standalone article, but your thoracic spine houses your primary breathing muscle, the diaphragm, which has a direct effect on how well your core works.
When your thoracic spine is locked, normal breathing is disrupted and the deep core muscles become inhibited.
This causes your system to rely on your accessory breathing muscles instead, which are located in your neck, again contributing to neck pain.
So…how can you address a stiff thoracic spine?
The answer is pretty simple. You practice moving your thoracic spine.
A fun fact on this topic.
If you’re inhibited in one direction (for most of us this would be thoracic extension, due to that sitting induced “slump”) a quick hack to regain movement is to move that area through other planes of motion.
So the majority of us would benefit from a program that looks something like this (note order not set in stone):
- Side bending
- Thoracic rotation
- Passive thoracic extension
- Deep neck muscle activation (aka cervical flexors)
- Active thoracic extension
Then I’d throw in some shoulder stability exercises, because now that your spine is in a better position, your shoulders are too and stable shoulders = a happier neck.
If you want something to do at home, I’ve made a video of said program 😉
Pilates exercises for thoracic mobility and less neck tension
Pilates exercises for thoracic mobility and less neck tension
https://www.youtube.com/watch?v=QgWLRxkzJhc&feature=youtu.be
And if you need some inspiration for shoulder stability, check out this post on the rotator cuff or this one about push up helpers.
There are 6 comments on this post
very nice progression Nikki!
Thanks Mary!
I love your explanations!! Thank you so much for sharing!! Great job!! Greetings from Germany! 🙂
Thank you so much! Appreciate you taking the time to comment <3
xo
Nikki
I have long-standing upper back issues that cause annoying shoulder, neck, and chest muscle pain. So many sites focus on the “hunchback” exercises so thank you for featuring movements for us flat spine folks! Looking forward to giving these a try.
Hi Laura! You’re welcome. I’m working on some new content around this too, so stay tuned 😉 If you have any questions in the meantime, please don’t hesitate to reach out! Nikki