Shoulders & Upper Back Pain

Upper Back Pain and Pain across top of Shoulders

Analyse your body position as you work and the length of time you are in any one position. Good working posture is with head on top of your spine with chin slightly dropped. Your whole spine should be in a lengthened not slumped position and your shoulders and arms should be relaxed as you work.    

Cause: Work surface too high or too low.

Solution: Adjust desk height or chair height to work with elbows bent at right angles and wrist slightly lower than forearm. This is easier with a height adjustable desk.

Cause: Arm rests obstructing elbows.

Solution: Adjust arm rests so your bent arm can move easily with no obstruction. If chair arms are not adjustable, either remove them entirely or change your chair.

Cause: Chair back is too wide.

Solution: Your bent arm should be able to swing behind your body but if the chair back is too wide you lose this freedom of movement. Change you chair so the back width fits your body.

Cause: Working in a tense manner.

Solution: Incorporate micropauses into work habits – every 15 minutes you Stop, Drop and Flop your hands at your sides – PAUSE for 5 seconds – breath out then resume work. This relaxes muscle tension which helps blood supply to working tissues.

Cause: Stress – work or home. stress-initiatives

Solution: Reduce stress at source (specialist advice may be necessary); alternate less stressful activities (manager / team input); Reduce stress reactions (relaxation and communications training). Have a good exercise regieme.

Cause: Keyboard too far away

Solution: When using keyboard your elbows should not be reaching out from your body. Pull chair in close to desk and pull the keyboard close to front of desk so your upper arm is vertical and your elbows are beneath your shoulder tip. Your arms hang relaxed at your sides as you work.

Cause: Mouse incorrectly positioned

Solution: The numeric pad on the keyboard causes the mouse to be positioned out to the right, so if you are having right shoulder or upper back pain you need to reduce this sideways reach. Try using the mouse in the left hand OR change keyboard to one with a separate numeric pad so the mouse can be placed straight in front of the right shoulder.

Cause: Poor working posture – poking chin  Turtleimage

Solution: You need to keep the top of your neck above the bottom of your neck i.e. a long neck with head on top not a short squashed neck with head in front of your body. Position documents on raised central stand (Microdesk) above the keyboard eliminating looking down at documents flat on desk; tilt bottom of screen upwards so screen is directly looking at your face not your chest; adjust brightness and font so you can read letters easily without peering; top of screen height should be level with eyebrows so you are looking approx 15° down to the centre of the screen.

Cause: Upper back not touching chair back.

Solution: Adjust the chair back so you can feel the whole back and relax your back muscles as you work. Pull chair in close to front of desk and possibly use a footrest to keep your back back and so you can feel the upper back on the chair back as you work.

Cause: Work tasks not in neutral zone close to your body → twisting, reaching sideways or forwards for calculator, tablet, iphone, writing tasks etc.

Solution: Problems of twisting head to the side or reaching sideways or forwards for secondary tasks to using the keyboard can cause discomfort. You need to raise and centralise what you are doing. Maybe use a sturdy document holder such as the Microdesk for secondary tasks ensuring you are working in a neutral posture zone.

Cause: Chair back too low or too high.

Solution: Determine how your back fits the chair back and adjust to fit the curves of your back. Each chair is easily adjustable when you try the levers – see page on equipment adjustment.

Cause: Chair height incorrect for variation in tasks – reading / writing / keyboard work.

Solution: Chair height depends on the task so typing on keyboard requires the chair to raise the body so the bent arm is level with the keyboard, but if writing flat on desk you can lower the chair so the forearms are supported on the desk as you write.

Cause: Using the smart phone for long periods with head dropped.

Solution: Monitor the time you spend looking at phone with head in lowered position and do opposite position stretches regularly. See exercise page for upper back and neck.


Always ensure you completely recover from past injuries restoring full range of pain free normal movement. Graduate your return to work with professional advice.

Where is your pain? Click on a red pain zone