Aching between your shoulder blades, tight shoulders, a stiff upper back by the end of the day: upper back pain is a common but often overlooked part of pregnancy. Most of the time it’s muscular, and there’s a lot you can do to ease it. Occasionally, though, pain in this area is a sign that something else needs attention.
Upper back pain in pregnancy is usually caused by posture changes, a heavier chest, muscle fatigue, and long periods sitting or standing. Moving often, a supportive bra, good pillow support, and gentle mobility exercises usually help, and pregnancy physiotherapy can help when it doesn’t settle. Call your provider right away if the pain is severe, sudden, under your right ribs, or comes with headache, vision changes, shortness of breath, fever, or chest pain.
Is Upper Back Pain Normal During Pregnancy?
Back pain is very common in pregnancy. Lower back and pelvic pain get most of the attention, but plenty of people feel it higher up, around the shoulder blades and between the shoulders. Mild, achy pain that eases when you move or change position is usually muscular. Pain that is new and severe, keeps getting worse, or comes with other symptoms should be checked rather than written off as “just pregnancy.”
What Causes Upper Back Pain During Pregnancy?
- Posture changes: as your belly grows, your centre of gravity shifts and your shoulders and upper back work harder to keep you upright.
- A heavier chest: breast growth adds load to the shoulders and upper back, especially without good bra support.
- Muscle fatigue: the muscles around your shoulder blades are doing more work than usual, which can feel like a dull ache or tightness.
- Long periods in one position: desk work, phone scrolling, or standing all day let stiffness build.
- Sleep changes: side-sleeping without enough pillow support can leave you stiff in the morning.
- Stress: tension tends to collect in the neck and shoulders. It can add to the problem, but it shouldn’t be assumed to explain severe or unusual pain.
Where Does It Hurt? What It May Mean
Where you feel pain can offer clues, but it can’t confirm the cause on its own.
Where You Feel Upper Back Pain and What It May Mean
- – Between the Shoulder Blades: Often related to muscle fatigue, prolonged sitting, or poor desk posture. Get it checked if the pain is severe, constant, or doesn’t improve with movement.
- – Across Both Shoulders: May be caused by sustained posture, chest load, or stress. Seek medical advice if you experience numbness or tingling in your arms.
- – One Side of the Upper Back: Could be due to muscle strain or your sleeping position. Get it checked if the pain persists or occurs with fever or pain while urinating.
- – Under the Right Ribs or Right Shoulder Blade: Sometimes related to muscle tension, but it can also indicate a liver or gallbladder problem. Contact your healthcare provider promptly, especially if you also experience a headache, vision changes, swelling, or nausea.
How to Relieve Upper Back Pain During Pregnancy
For mild, muscular-feeling pain, these everyday changes often make the biggest difference:
- Move often. Change position at least every 30–45 minutes. A short walk or a few shoulder rolls between tasks keeps stiffness from building.
- Set up your workspace. Raise your screen to eye level, support your back, and rest your feet flat. Aim for relaxed and supported, not forced upright.
- Get a supportive bra. As your size changes, a well-fitted, supportive bra (including at night if that helps) takes load off your upper back. Getting refitted is worth it.
- Use pillows when you sleep. Lie on your side with a pillow between your knees and one to hug, so your top shoulder isn’t rolling forward all night.
- Try gentle warmth. A warm (not hot) compress or shower on your upper back for 10–15 minutes can ease tight muscles. Avoid hot tubs and saunas, and don’t put heat on your belly.
- Check before taking medication. Some common pain relievers, such as ibuprofen, are generally avoided in pregnancy. Ask your doctor, midwife, or pharmacist before taking any medication or using medicated creams.
Gentle Exercises for Upper Back Pain in Pregnancy
These simple movements help many people with upper back stiffness. Move slowly, breathe normally, and stay in a comfortable range.
- Shoulder rolls: sitting or standing, slowly roll your shoulders up, back, and down 5–10 times.
- Shoulder blade squeeze: gently draw your shoulder blades back and slightly down, hold for 3–5 seconds, then release. Repeat 10 times, keeping your neck relaxed.
- Cat-cow on hands and knees: slowly round your upper back toward the ceiling, then gently let it relax back to neutral. Move with your breath for 5–10 rounds.
- Side-lying chest opener: lie on your side with knees bent and a pillow under your head and between your knees, arms straight out in front. Slowly lift your top arm up and back to open your chest, only as far as feels comfortable, then return. Repeat 5 times each side.
- Wall slides: stand with your back against a wall, arms bent like a goalpost, and slowly slide your arms up and down within a comfortable range. Repeat 8–10 times.
Your joints are more flexible in pregnancy, so aim for gentle movement rather than deep stretches, and avoid forceful twisting. Stop and seek advice if you feel pain, dizziness, unusual breathlessness, contractions, bleeding, or fluid leakage. If your pregnancy is high-risk, check with your provider before starting new exercises. A pregnancy physiotherapist can tailor these to you.
How Pregnancy Physiotherapy and Massage Can Help
If your pain keeps coming back, disrupts your sleep, or makes work and daily tasks harder, it’s worth getting assessed. A pregnancy physiotherapist looks at how you move, sit, sleep, and work, then builds a plan around you. It may include:
- Practical posture and workstation adjustments
- Exercises chosen for your symptoms and stage of pregnancy
- Hands-on treatment where appropriate
- Sleep and positioning strategies
- Advice on carrying, lifting, and staying active comfortably
Prenatal massage can add relief for tight shoulders and upper back muscles, using side-lying positioning that’s safe for pregnancy. At Harmony, our pregnancy physiotherapists and Registered Massage Therapists work together (with your consent), so your care stays connected. If your symptoms suggest something non-muscular, we’ll point you to your doctor or midwife first.
When to Seek Medical Help
Most upper back pain in pregnancy is muscular, but a few symptoms need prompt attention. Don’t wait for a physio appointment for these.
Call 911 or go to hospital if upper back pain comes with:
- Chest pain, sudden shortness of breath, or coughing up blood. Pregnancy raises the risk of blood clots, which can travel to the lungs.
- Sudden, severe, or tearing pain
Contact your doctor or midwife right away if you have:
- Pain under your right ribs or right shoulder blade, especially with a severe headache, vision changes, sudden swelling of your face or hands, or nausea. These can be signs of preeclampsia.
- Fever, chills, or feeling very unwell, or one-sided back pain with burning when you pee (possible kidney infection)
- Severe abdominal pain, vaginal bleeding, or leaking fluid
- Regular painful contractions or cramping before 37 weeks
For new pain that is lasting or getting worse and you’re not sure why, check in with your provider. It may well be muscular, but it’s worth ruling other causes out.
Frequently Asked Questions
Is upper back pain common during pregnancy? Yes. Posture changes, a heavier chest, and muscle fatigue make it common, especially in the second and third trimesters. Pain that is severe, persistent, or comes with other symptoms should still be checked.
Why does my back hurt between my shoulder blades while pregnant? Usually it’s tired, overworked muscles from posture changes, chest load, or long periods sitting. Moving often, a supportive bra, and gentle exercises usually help. If it’s severe, constant, or on the right side under your ribs, contact your provider.
Can I get a massage for upper back pain during pregnancy? Yes, for most pregnancies. A Registered Massage Therapist trained in prenatal care will use side-lying positioning and adjust pressure for you. If your pregnancy is high-risk, check with your provider first.
Is upper back pain a sign of labour? Not on its own. Back pain with regular contractions, cramping, pelvic pressure, bleeding, or leaking fluid does need prompt advice from your provider.
Can I use a heating pad on my upper back while pregnant? Gentle, warm (not hot) heat on your upper back for short periods is generally fine. Avoid hot tubs, saunas, and heat on your belly. Ask your provider if you’re unsure.
When should I see a physiotherapist for pregnancy back pain? When it affects your sleep, work, or daily activities, or keeps coming back. No referral is needed to book pregnancy physiotherapy at Harmony.
Support for Upper Back Pain During Pregnancy in Ottawa
Upper back discomfort can make pregnancy more challenging, particularly when it affects sleep, work, or daily movement. Understanding possible triggers and using suitable comfort strategies may help, but persistent pain deserves an individual assessment.
Harmony Physiotherapy & Wellness offers pregnancy physiotherapy services in Ottawa and Nepean. If you are looking for support with pregnancy-related musculoskeletal discomfort, learn more about Pregnancy Physiotherapy or contact the clinic to discuss your needs.
This article is for general information and does not replace medical advice, diagnosis, or individualised pregnancy care.