THE RED DOOR CLINIC · MELLIEĦA
Upper and middle back pain
The desk-and-driving pain. Assessment that finds what the upper back is compensating for.
Upper and middle back pain is the desk-and-driving pain: the ache between the shoulder blades, the stiffness that builds through a working day, the burning that arrives by late afternoon. At The Red Door Clinic in Mellieħa, an assessment looks at what the upper back is compensating for, usually the neck, the shoulders or the chair. This page covers the common causes, what an assessment involves, and when upper back pain needs medical care first.
Reviewed by Andrew George, Lead Physiotherapist · 5 October 2026
Common causes of upper and middle back pain
The thoracic spine, the upper and middle back, is built for stability, and it complains when asked to be mobile all day. Hours at a laptop round the upper back; a screen at the wrong height pulls the head forward; driving locks the mid-back in one position. The ache between the shoulder blades is usually the result.
We also see upper back pain that travels with neck problems, shoulder problems, and stress, the upper back is where many people carry their week. Rib joint irritation can also produce sharp, local pain in the mid-back, sometimes after a cough, a twist or a deep breath.
What an assessment involves
The assessment takes the story, desk set-up, driving hours, when the ache arrives and what eases it, and then looks at how the neck, upper back and shoulders move together. The upper back rarely misbehaves alone; the assessment finds what it is compensating for.
You leave with a working explanation and a plan: hands-on treatment where it helps, mobility work for the stiff segments, strength for the posture muscles, and practical advice on the desk or the driver’s seat that is feeding it.
Can massage help upper back pain?
Upper back tension responds well to massage, a back, neck and shoulder session or deep tissue work across the shoulder-blade area often eases the ache and the burning considerably. Many people book it alongside physiotherapy.
Massage eases the tension; it does not change the desk that produced it. If the pain is sharp with breathing, follows a fall, or comes with chest pain or breathlessness, seek medical care first, those features are not a clinic-massage question.
When to seek urgent care instead
Go to accident and emergency, or call emergency services, if you have a suspected broken bone, a joint that looks deformed, pain after a significant fall, chest pain, trouble breathing, a head injury with confusion or vomiting, numbness in the saddle area, or loss of bladder or bowel control. Sudden severe pain with swelling, or a limb that is cold, pale or blue, also needs urgent medical care rather than a clinic appointment.
If you are unsure, do not wait on a message to decide an emergency. Use emergency services first. For everything else, contact the clinic, say what happened, and we will tell you whether we can see you and what to do until then. We do not diagnose by WhatsApp.
How the clinic can help
A consultation and assessment with Andrew George, our lead physiotherapist, is €55, and follow-up physiotherapy is €45. The assessment looks at the movement that hurts and the cause behind it, and you leave with a working explanation in plain language and a plan that fits the week you actually have.
Where massage helps alongside physiotherapy, for tension, recovery and the guarded muscles around a sore area, the clinic houses qualified massage therapists in the same building. Massage and physiotherapy are not interchangeable: if pain, injury or a change in movement is the concern, start with the assessment.
Book through the contact form, by phone on 2152 4199, or by WhatsApp on 7924 1880. There is no online booking calendar; describe your symptoms and the team will help you choose the right first appointment.
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Tell us what hurts, what has changed, or what you want to get back to.
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Frequently asked questions
Is upper back pain posture-related?
Often, but “posture” is shorthand for a position held too long, not a character flaw. The plan is usually a mix of mobility work, strength, and changing the desk or seat that holds you in one shape for hours.
Why does it burn between my shoulder blades?
Burning between the shoulder blades is usually long-held muscle tension, the rhomboids and mid-trapezius working all day without a break. It responds well to a combination of massage and the right mobility and strength work.
LET’S FIND YOUR NEXT STEP
Your next chapter starts with a conversation.
Tell us what hurts, what has changed, or what you want to get back to.