How To Use The Foam Roller For Thoracic Spine (Upper Back) Pain


It’s time to face the facts – our spines are not built for sitting. Whilst that may seem obvious, we should remember that for tens, if not hundreds, of thousands of years we have spent the majority of our days walking around. Only very recently, with the advent of modern technology, have we began to spend much of our day sitting – in cars, at desks, computers and watching televisions! For a huge proportion of the population this has been to the detriment of their physical and spinal health, and may result in the dreaded back and neck pain! The good thing is that there are many things that can be done to treat or even prevent the onset of upper back (thoracic spine) pain. This article will discuss some common causes of upper back pain, the relevant anatomy, and of course what foam roller exercises you can do if you suffer from this problem.

What Can Cause Thoracic Spine and Upper Back Pain?

There are a quite a few common causes or sources of pain felt in the upper back region. Fruth (2006) suggested that the common ‘anatomical sources’ of pain can include:

  • The Joints – including facet, costo-transverse and costo-vertebral joints (see image below) (Triano et al., 1999)
  • The Intervertebral Disc (although much less common than in the lower back)
  • The Muscles (from strains to active trigger points/tightnesses) (Simons, 1996).
  • The Nerves
  • Pain referral from other parts of the body – including organs and other parts of the spine

Whilst these are ‘anatomical sources’ of pain, health professionals know that each presentation is very individual and will have a number of ‘contributing factors’ to the development of pain. Some common contributing factors include:

  • Poor posture – rounded shoulders and upper back (increased thoracic kyphosis), head sitting forward (increased cervical lordosis)
  • Stiffness in the spine – most commonly loss of rotation and extension movements (Edmonston & Singer, 1997).
  • Tightness in muscles of the upper back, shoulders, chest and neck
  • Weakness or under-active postural muscles

Anatomy and Muscular Contributions to Upper Back and Thoracic Spine Pain

There are a number of muscles around the thoracic spine, chest and neck that may contribute to the development of upper back pain. The first is loss of normal mobility (or stiffness) in the joints of the upper back (Edmonston & Singer, 1997), which include:

  • Facet Joints
  • Costo-vertebral Joints
  • Costo-transverse Joints

Further to stiffness in the joints, tightness/reduced flexibility and active trigger points in the following muscles contribute to thoracic spine and upper back pain:

  • Rhomboid Major and Minor
  • Trapezius – generally upper and middle portions
  • Pectoralis Major and Minor (which contributes to rounded shoulders)
  • Levator Scapulae

So, what can be done about this condition?

Foam Roller Exercises for Thoracic Spine and Upper Back Pain

The most appropriate exercises are those that:

1. Improve thoracic spine extension and rotation (essentially the opposite of rounded back and shoulder postures)

2. Target the myofascial structures of the:

  • Rhomboid Major and Minor
  • Trapezius – generally upper and middle portions
  • Pectoralis Major and Minor
  • Levator Scapulae

The videos below display all of these components:

Improving Thoracic Spinal Mobility

…if you take nothing else from this article – learn from this awesome video!!

Releasing Rhomboids and Trapezius

Should I Do Anything Else For My Upper Back Pain?

Yes! Unfortunately, the foam roller is only one component of the successful rehabilitation of upper back and thoracic spine pain. To fully resolve this complex problem you should also undertake:

  • Chest (pec major and minor), trapezius and rhomboid stretching (see vids below) (Hanten et al., 2000).
  • Postural muscle strengthening exercises (see vids below) (Fruth, 2006).
  • Be guided by your physiotherapist – who can take you through all of this including a full rehabilitation program

Pectoralis Minor and Major Stretches

Rhomboid and Middle Trapezius Stretches

What Size Will Be Most Useful?

Given that you are going to cover a medium to large sized area and i.e. the upper back and spine, the best foam rollers for this condition would be:


Edmondston SJ, Singer KP. Thoracic spine: anatomical and biomechanical considerations for manual therapy. Man Ther. 1997;2:

Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Physical Therapy 2006;86:254-268

Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther. 2000;80:997–1003.

Triano JJ, Erwin M, Hansen DT. Costovertebral and costotransverse joint pain: a commonly overlooked pain generator. Topics in Clinical Chiropractic. 1999;6:79 –92.

Simons DG. Clinical and etiological update of myofascial pain from trigger points. Journal of Musculoskeletal Pain. 1996;4:93–121.

Photo CreditWikiCommons


Put Your Heading Title Here