You woke up with pain in your upper back.  It may feel like a knot or spasm.

Isn’t it truly amazing that we can hurt ourselves in our sleep?

Sometimes it’s from something you did the previous day but maybe you just slept “crooked.” Maybe you laid too long with an arm out in front as you slept on your side and that strained the muscle.

Or perhaps you slept with your neck tilted to the side and that caused an unhappy scalene muscle in your neck. If it gets unhappy it can develop trigger points.  Trigger points in the scalene muscle can cause a knot or muscle pain in your upper back.  In fact, they do it all the time.

Sometimes this pain could be a one-time issue that will never happen again after it’s done healing. Or, it could be a sign that there are muscles elsewhere pulling on that area which needs to be “released” to prevent recurrence.

Tennis Ball Therapy or other self-help measures can often help you get rid of the pain in your upper back.  But if they don’t, then you need to know more about how your body works.

That’s why I developed the program Knots In Your Back. (<– click here if you would like more information about the program.)  In it, I will show you all of the areas that can cause your pain and how to make them stop!

Sometimes the problem IS actually where the pain is.  This is especially true if you have only had the pain for a day or two.

But if you have had your pain for a longer time, your pain is probably just a symptom.  The CAUSE of your pain is elsewhere.  And the CAUSE of most pain is muscles!

And that’s good news!  Because muscles can be treated and you CAN get rid of your upper back pain!


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12 Comments on What Causes Upper Back Pain In The Morning

  1. ele says:

    My pain lies mainly on top of the shoulder going into the left arm/some to my neck and head…
    I had several massages in that area and had three knots worked out (more in left top back area) only the top muscle seems to be lingering and pain is still there but feel weak on that side with my arm..What can I do?…exercise (pilates, yoga)??

  2. Hi Ele,

    You asked me to respond by email and I did. I suggested it may be the muscles in your neck causing symptoms in your upper shoulder. I also suggested “unrolling” the upper trapezius muscle rather than pushing directly into it to relieve your shoulder pain. Thank you for writing.


  3. Charlotte says:

    Hi there,
    I’ve been having really bad pain in my upper back for about three mornings in a row now. There are two things that I think it could be 1) our bad bed, or 2) I breastfeed while laying down at night. It’s really bad, and hurts to breath in too deeply or when I turn to reach at all behind me. I have never had a massage before. My question is, after I stop feeding while in bed, (because that I can control) when, or should I ever need to see a doctor about this? I can’t afford to go and get a new mattress. So that is out of the question. Unless BC medical covers that, which I doubt. Thank you.


  4. Hello Charlotte,

    I apologize for my delay in responding. Perhaps you are already starting to feel better?

    When you are feeding your baby in bed, are you sitting up or laying down? Laying down works well for many women.

    But if you are sitting up, you are probably letting your head fall forward, and maybe dozing. If so, that’s probably the cause of your upper back pain. Muscles are getting strained.

    A professional massage may help a great deal (it depends on the massage therapist) but you can use cold packs or ice therapy at home. Ice helps relieve the discomfort and is the ‘drug of choice’ if your nerves are involved.

    If you do see a massage therapist, here is an article to help you find one who can help you:

    There are many more articles about massage in the Massage category at

    Here are a few articles about ice therapy:

    Probably not too much sense in seeing your doctor because most doctors, unfortunately, don’t know much about muscles. Their primary knowledge is most often medicine. Medicine for muscle pain masks symptoms more than it helps heal.

    There are muscles on the back of your shoulder blades that will cause the type of symptoms you mention. If you are nursing in a side-lying position, you may be straining those muscles. Make sure your head is well supported and you might be able to change arm position to prevent the muscle strain.

    You might also try a folded bath towel or flat pillow under your ribs between your armpit and hip bone when you are side-lying. That may help take strain off your shoulders.

    And squeeze your shoulder blades together when you are not holding your baby. That will help strengthen them so they will be less likely to be strained when you hold your sweet baby or work with your arms in front of you.

    I hope this helps and that you feel better really quickly. Please write again if you would like to share more information about your symptoms or how things are going with your upper back pain.

    The Pain Relief Coach

  5. Shawn says:

    All of the joints of the body are dependent on each other and NO position should cause pain. If you can get at the root of the imbalance then you can sleep, breastfeed or whatever in any position you’d like! Keep up the great work Kathryn! You are helping tons of people get better

  6. Hi Shawn,

    Ideally we would all be perfectly balanced. When we aren’t we have pain.

    I appreciate your comments. And it looks like people in Palm Beach Gardens area have a wonderful resource in your clinic.

    Thank you for writing.

    The Pain Relief Coach

  7. Emma says:

    Hi Kathryn,
    I have been experiencing pain in my middle of my back when I wake up for about 3 days now. The pain softens as the day is going along but never stops. I am 14 and am a very serious ballet and contemporary dancer dancing 6 days a week. I also pulled a muscle last Saturday in the middle of my back but it was only hurting when I did certain things and very mildly. Could that be related to my current problem? My back now hurts hunching over tones and twisting my back as in going to reach something behind you. Help!

  8. Hello Emma,

    I would guess that your current middle of the back pain when you awake is related to the muscle pull last Saturday. Here are two things I could suggest if you cannot go to a professional massage therapist.

    1. See whether you can isolate the painful area by laying on a tennis ball. If it feels like ‘good pain’ you are probably on the tight muscle that is causing your discomfort so just keep pressure on it with the tennis ball for about 5 minutes.
    2. Use cold packs on your back across the whole width of your back from the middle of your shoulder blades down to your waist. You can ‘ice’ the area off and on in short blocks of time.

    Your muscles are probably already starting to heal because of your age and good conditioning. I anticipate that when the week is out you will be pretty much better.

    I hope you will be feeling better quickly, Emma. Some massage therapists specialize in sports massage or pain relief massage and, if this continues to bother you, that would be my next best suggestion. Massage can make all the difference in the world in getting rid of back pain naturally.

    The Pain Relief Coach

  9. darren firth says:

    i have really bad pains in the middle of my back when i wake up in the mornings sometimes i get them in the lower back but mostly the middle of my back!! its like im badly winded and cant breath to deep ive had this bout 9 months now ands its mainly only when i wake in the mornings! i ve been to the doctors and been for an x ray but they came back all clear any suggestions please would be gratefull ??

  10. Hi Darren,

    Right off the top of my head I’m thinking of two things– it could be the way you sleep or your mattress.

    Or, there is a muscle that divides your body cavity into halves. It’s called the diaphragm and is below your ribs. That muscle will pull on your back in the middle of the back. It is a muscle that is used for breathing so it will cause shortness of breath when tight.

    The diaphragm may be tightening up due to the way you sleep. Do you curl up?

    Or maybe it bothers you because it is tight and you do NOT curl up but lie straight?

    This muscle can be released or relaxed by a professional skilled massage therapist who knows how to do a diaphragm release. You can also learn to relax it yourself if you are thin or normal weight.

    Here’s how: Bend forward from the hips and roll your shoulders forward. Place your fingers at the bottom of your ribs, pointing toward your collarbone. Let your fingers slide up on the inside of your ribs as you exhale. Hold the pressure for twelve seconds or so. Do this a few times each day. If you are pressing in far enough, you will feel discomfort. That means you are touching the tight muscle.

    Darren, I hope this helps you get rid of the pain in the middle of your back naturally.

    The Pain Relief Coach

  11. Paula says:

    Hi. I had the exact same thing and the solution turned out to be so simple. The muscle spasm was being caused by dehydration. I wasn’t drinking enough water and when I lost even more water at night through heat the muscle in my upper back just simply “seized”! So after mattress changing, chiropractors, massage therapists, the lot…the solution was simply just to drink
    more water! Hope this helps

  12. Hi Paula,

    Thank you very much for sharing! Muscles need sufficient water to function well. Your message is great and so is water. Bodies crave it whether we realize we are thirsty or not.

    Sometimes we are so busy we just don’t think about taking a refreshing drink. You may not notice…but your body does!

    Eating lots of water-filled fruit and vegetables and soups helps with water intake, too. Stuff like potato chips and candy doesn’t.

    I’m glad you found an easy, natural fix to your muscle spasms. Good job! 🙂

    The Pain Relief Coach