Acupuncture for Upper Back Pain

How Chinese medicine understands upper back pain

The upper back is where several channels meet. In Chinese medicine, the Bladder channel runs in two lines down either side of the spine, and many of its points there are linked with the internal organs. The Small Intestine channel zigzags across the shoulder blade, and the Gallbladder and San Jiao channels cross the top of the shoulders. Pain here is usually read as Qi and Blood blocked in these channels.

The common patterns are:

• Liver Qi stagnation. Tight, aching muscles between the shoulder blades that tighten with stress, along with a tight jaw, headaches or irritability. Treatment eases the tension through the whole body.
• Wind and Cold. Sudden stiffness and ache after a cold draft, air conditioning or sleeping by an open window. Treatment warms and releases the area.
• Qi and Blood stagnation. Sharp, fixed pain after a strain, a twist or years of the same posture. Treatment moves circulation through the area.
• Qi and Blood deficiency. A dull, tired ache that is worse at the end of the day, with fatigue. Treatment builds you up as well as easing the pain.

Most upper back pain is a mix of posture, stress and tight muscle, which is why the treatment looks at more than one spot. Pain in the low back is covered on the back pain page, and pain mainly in the neck on the neck pain page.

What treatment involves

Your first visit at the clinic in Keswick starts with a lot of questions: where the pain sits, how you work and sleep, your stress, your breathing, and your general health. I look at your tongue and take your pulse. An assessment usually also includes checking how your upper back and neck move and where the muscles are tight.

Acupuncture is usually the main treatment. Points are chosen along the upper back and shoulder blades, and on the arms, legs and elsewhere for your pattern. I treat the whole body at every treatment, not only the area that hurts, so a tight neck or shoulders are always part of it. The aims are to ease pain and let the muscles relax.

Cupping is often used on the upper back to loosen the muscles over the shoulder blades, and tuina massage can work into the knotted areas. For a Wind-Cold pattern, moxibustion adds warmth. Where stress or poor sleep feeds the tension, Chinese herbal medicine is a formula written for your pattern and dispensed at the clinic.

The first appointment is 75 minutes, including the diagnosis and first treatment, and follow-ups are 60 minutes. Plan on 5–10 treatments to judge progress.

Between visits

• Change position often. Get up and move every 30 minutes when you sit at a desk or drive.
• Raise your screen to eye level and bring your phone up rather than your head down.
• Open the chest. Gently squeeze your shoulder blades together and roll your shoulders back a few times an hour.
• Carry evenly. Use both straps of a backpack, or switch sides with a heavy bag.
• Use heat. A heat pack across the shoulder blades for 10 to 15 minutes can ease tight muscles.

When to see your doctor first

Pain between the shoulder blades can sometimes come from the heart, lungs or other organs. Call 911 if:

• The pain comes with chest pain or pressure, shortness of breath, sweating, nausea, or pain in the jaw or arm.
• You have sudden, severe, tearing pain in the upper back.

See your doctor before starting treatment, or promptly if you are already coming in, if:

• The pain is worse when you breathe in, or comes with fever or a cough.
• You have osteoporosis, or have taken steroids for a long time, and the pain started with a minor fall or lift.
• You have pain at night that does not ease with rest, unexplained weight loss, or a history of cancer.
• A band of burning pain wraps around to the ribs, with or without a rash. This can be shingles.
• You have numbness or weakness in the legs, trouble walking, or bladder or bowel changes.