The Surprising Connection Between Neck Pain and A Weak Upper Back

The Surprising Connection Between Neck Pain and A Weak Upper Back

Plus, A Tale of Two Patients: One Who Strength-Trained, and One Who Didn’t

Do you ever find yourself trying to rub out a sore spot in your neck or find it difficult to turn your head? Neck pain is a common concern that can range from a mild nuisance to a big problem. And while neck pain can have several different causes, one contributing factor often gets overlooked: weakness in the shoulders or upper back.

When we deal with persistent aches and pains, poor muscle strength often turns out to be a significant underlying factor. When a muscle isn’t as strong as it should be, other muscles have to step in to compensate, which puts unnecessary strain on them — and makes them more susceptible to overuse injuries. The result? Seemingly random aches and pains that “come out of nowhere.”

If you’re struggling with persistent neck pain, there’s a chance that the problem is rooted in your shoulders or upper back. Slouching and prolonged sitting weakens those upper back muscles, forcing your neck muscles to work overtime — and leading to pain. Let’s look at two case studies from the OSR Physical Therapy files. Both people suffered from neck pain, but only one went through a dedicated strength training program. What happened next?

Ally’s Story: No Time for Strength-Training

Ally was a receptionist who spent long days typing on a computer, answering the phone, and doing other clerical work. She started to notice a slight pain in her neck while she was at work. Although she ignored it at first, the pain persisted. She knew she needed to seek help.

Ally made an appointment with us, where we took her through a comprehensive assessment, including several movement and functional screens. We determined that she had strained the soft tissue in her neck due to her sedentary job. 

We started Ally’s treatment with acute pain management using manual therapy techniques and some gentle mobility stretches, which did help her immediate symptoms. However, we knew it wouldn’t be enough to fully resolve her pain, so we suggested she begin a multi-week therapeutic exercise program to restore strength in her upper back and shoulders, helping to reduce the strain on her neck.

Unfortunately, Ally had decided to go back to school, and between work, her classes, and her family, she simply didn’t have time for physical therapy. So, while we were able to help Ally in the short term, her pain persisted in the long term, eventually landing her back in our clinic a year later.

Sarah’s Story: A Dedicated Strength Training Program

Sarah’s situation was very similar to Ally’s. She was a marketing assistant who also spent a great deal of time on both her laptop and a mobile phone, and she also experienced a gradual onset of neck pain. And, like Ally, she paid us a visit when it became too much.

We gave her a similar diagnosis: a strained neck muscle brought on by improper posture and prolonged sitting. We also provided her with acute pain relief. The difference? Sarah was able to continue her treatment with a six-week therapeutic exercise program.

We met with Sarah twice weekly to guide her through a custom set of targeted neck, shoulder, and upper back exercises. We started with gentle stretches and mobility work before progressing to resistance training exercises. With the help of some dumbbells and an exercise band, Sarah built strength through her upper body, providing her neck with the support it needed.

We also helped Sarah set up her workstation to be more ergonomic, including adjusting the height of her computer monitor and rearranging her keyboard. And we gave her some tips for maintaining postural awareness throughout the day. The result? After six weeks, Sarah’s neck pain was entirely resolved — and she didn’t have to seek additional treatment!