Upper back pain during pregnancy is common, especially from the second trimester onward, and it responds well to a combination of targeted stretches, postural adjustments, and simple changes to how you sit, sleep, and dress. The pain typically stems from a shifting center of gravity, loosening ligaments, and the added weight of growing breasts pulling your shoulders forward. Here’s what actually helps.
Why Pregnancy Causes Upper Back Pain
Your body produces a hormone called relaxin during pregnancy that loosens the muscles and ligaments around your pelvis, back, and abdomen. This loosening helps your body prepare for delivery, but it also makes your spine less stable and your posture harder to maintain. The result is that muscles in your upper back work overtime to compensate, leading to tension, stiffness, and pain between your shoulder blades.
At the same time, your breasts are getting heavier, which pulls your shoulders forward and increases the curve in your upper spine. As your belly grows, your center of gravity shifts forward too, and your upper back rounds to counterbalance the weight. This combination of ligament laxity, extra load, and postural change is why upper back pain can feel relentless, even when you’re not doing anything strenuous.
Stretches That Target the Upper Back
A few specific stretches can relieve tightness in the thoracic spine (the mid-to-upper portion of your back) without putting pressure on your belly. Aim to do these once or twice a day, holding each position for several seconds.
Cat-cow stretch: Start on your hands and knees with your head in line with your back. Pull your stomach in and round your back upward, like a cat arching. Hold for a few seconds, then relax your stomach and let your back flatten (but don’t let it sag). This gently mobilizes the entire spine and releases tension between the shoulder blades.
Child’s pose (backward stretch): From hands and knees, keep your arms straight and curl backward toward your heels as far as your knees comfortably allow. Tuck your head down and keep your arms extended in front of you. Hold for several seconds. This lengthens the muscles along your upper back and opens up the space between your vertebrae. If you have a fitness ball, you can place your hands on it instead of the floor, which lets you push the small of your back upward and deepen the stretch.
Seated torso rotation: Sit on the floor with your legs crossed. Place your left hand on your right foot and gently rotate your upper body to the right. Repeat on the other side. This targets the muscles that run along either side of your spine and helps restore some rotational mobility to a stiff upper back.
Chest opener: Stand in a doorway and place your forearms on either side of the frame, elbows at shoulder height. Step one foot forward gently until you feel a stretch across your chest and the front of your shoulders. This counteracts the forward-shoulder posture that drives so much upper back pain during pregnancy.
Fix How You Sit
If you spend time at a desk, the way your workstation is set up matters more during pregnancy than at any other time. When your forearms aren’t supported, the muscles in your upper back and shoulders have to contract constantly just to hold the weight of your arms while you type or use a mouse. Research on pregnant computer workers has found that providing forearm support at the desk reduces the load on the back.
A few practical changes make a big difference. Position your keyboard and mouse close enough that your elbows stay near your sides, and rest your forearms on the desk surface or padded armrests. Raise your monitor so the top of the screen is at eye level, which prevents you from rounding your upper back to look down. If your chair doesn’t support the curve of your lower back, a small rolled towel behind your lumbar spine helps keep your whole spine stacked more naturally. Stand up and move every 30 to 45 minutes.
Sleep Setup for Less Pain
Side sleeping is standard advice during pregnancy, but it can make upper back pain worse if your spine isn’t properly aligned. The key is keeping your hips and shoulders stacked so your upper back doesn’t twist or sag.
Place a pillow (or several) between your knees, feet, and thighs so that your upper leg sits level with your pelvis and mirrors the position of the bottom leg. If you feel strain through your mid-back, tuck a rolled towel or small pillow between your ribs and hips to fill the gap. For more persistent pain, elevating your head and upper body with a wedge pillow or stacked cushions under your head, neck, and upper spine can take pressure off the thoracic area. A full-length body pillow can simplify all of this by supporting your belly, knees, and arms at once.
Check Your Bra
This is one of the most overlooked causes of upper back pain in pregnancy. A bra that’s too tight puts pressure on the muscles, joints, nerves, and blood vessels around your shoulders and ribcage. But a bra that’s too loose fails to support your growing breasts, forcing your upper back muscles to work harder to maintain posture.
Look for wider bands and thicker shoulder straps, which are less likely to dig into your skin. The band should be loose enough to comfortably fit two fingers underneath. Wireless styles tend to be more forgiving as your ribcage expands. If your current bras are getting snug but you’re not ready to buy new ones, a bra extender costs under five dollars and gives you the extra room you need. Getting refitted every trimester is worth it, since your ribcage can expand by several inches over the course of pregnancy.
Prenatal Massage and Chiropractic Care
Prenatal massage therapists use positioning (typically side-lying with pillows) and techniques adapted for pregnancy to release tight muscles in the upper back and shoulders. Even a single session can provide noticeable short-term relief, and regular sessions every two to four weeks help manage chronic tightness.
Prenatal chiropractors use gentle pressure, stretching, and specific joint adjustments that are safe during pregnancy. By realigning the spinal column and the ligaments and muscles around it, chiropractic care can ease the postural strain that drives upper back pain. Some practitioners use the Webster Technique, which focuses on the sacrum and the round ligament in your abdomen, though for upper back issues specifically, thoracic spine adjustments are more directly helpful. Look for a licensed chiropractor trained to treat pregnant patients and clear the visit with your OB or midwife first.
Over-the-Counter Pain Relief
Acetaminophen (Tylenol) remains the safest first-line pain reliever during pregnancy. The American College of Obstetricians and Gynecologists reaffirms that it is the analgesic of choice, recommending the lowest effective dose for the shortest necessary duration. Current evidence does not support a causal link between acetaminophen use in pregnancy and neurodevelopmental disorders in children, despite some headlines suggesting otherwise.
NSAIDs like ibuprofen (Advil) and naproxen (Aleve) are generally avoided, particularly after 20 weeks, because they can affect fetal kidney function and reduce amniotic fluid levels. In the third trimester, they also carry a risk of causing a critical blood vessel in the baby’s heart to close prematurely. Stick with acetaminophen for flare-ups, and pair it with ice or a heating pad on the upper back for 15 to 20 minutes at a time.
When Upper Back Pain Signals Something Serious
Most upper back pain in pregnancy is muscular. But pain under the ribs on the right side, or deep shoulder pain that feels like someone is pinching along your bra strap or the side of your neck, can be referred pain from the liver. This is a warning sign of preeclampsia or a related condition called HELLP syndrome.
This type of pain is different from the dull, diffuse ache of muscle strain. It tends to be more acute and specific, and it’s often accompanied by other symptoms: sudden swelling in your face or hands, headaches that don’t respond to acetaminophen, vision changes, or a general feeling that something is wrong. If your upper back or right-sided rib pain is sharp, persistent, or paired with any of these symptoms, contact your provider immediately. Preeclampsia can escalate quickly, and early recognition changes outcomes significantly.