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 Total Care Physical Therapy files. Both people suffered from neck pain, but only one went through a dedicated strength training program (both names have been changed). 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.

Exercise of the Month
Bent Over Rows
(Upper Back, Shoulders)
Hold a weight in your hand. Slightly bend your knees and bend at your waist to bring your torso forward. Make sure your back remains flat and about parallel to the floor. Pull the weight towards you. Make sure your elbows stay close to your body. Slowly return to the starting position. 3 Sets, 10 Reps. (Materials needed: dumbbells)
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!
Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723111/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093121/
Ready To Attack Your Neck Pain at the Source?
If you’re struggling with persistent neck pain, physical therapy at Total Care Physical Therapy can help you find lasting relief. Just as we did with Ally and Sarah, we’ll assess your symptoms and develop a customized treatment plan that seeks to resolve your neck pain altogether.
You Wouldn’t Flush Your Money Down the Drain…
So why let your insurance benefits go to waste?
Did you know… If you’ve already met your deductible this year or have funds left in your HSA account, you may still have visits remaining on your insurance plan.

Savor a Pain-Free Football Season
As Friday night lights illuminate the field and the spirit of football echoes throughout the community, ensure that back pain doesn’t get in the way while rooting for your team in the stands. Experience the thrill of the season without the discomfort of back pain. Our treatments are designed for your unique needs, ensuring you’re game-day-ready every time.
Your game plan to tackle back pain involves the following:
- Effective treatments to alleviate pain and guard against future flare-ups.
- Customized strategies to boost your mobility and strength so you can cheer on your favorite teams without hesitation.
- Tips to enjoy those tailgate barbecues and halftime huddles without a second thought to your back.
Get ready to chant, cheer, and celebrate without restraint. Connect with Total Care Physical Therapy today, and let’s ensure you’re in prime shape for every touchdown this season!
Three Exercises to Strengthen Your Shoulders and Upper Back
Maintaining strength throughout your shoulders and upper back is crucial to avoid neck pain! The physical therapists at Total Care Physical Therapy can help you develop a customized exercise program that addresses your needs and fits with your abilities.
Curious about what exercises we might include in that program? Here’s an overview of three common resistance training exercises we often use to help people with neck discomfort. Before trying any of them yourself, make an appointment with our team to ensure you’re using the right weight and proper form.
- Shoulder Press: With a dumbbell in each hand, make a “field goal ” shape with your arms: your arms are bent at a 90-degree angle with your palms facing up. Brace your core as you press the weights overhead, then slowly lower them back down to your starting position.
- Reverse Flies: Lean forward at your waist with your elbows slightly bent and dumbbell in each hand. Slowly raise the weights until they are in line with your shoulders.
- Modified Push-Ups: Push-ups are a great way to build upper back and shoulder strength, but if you find the standard push-up too difficult, never fear: the modified version is just as effective. Start on your hands and knees (instead of your feet) with the body in a straight line from head to knee. Slowly lower your chest until it’s a few inches off the floor, then rise back up.
A dedicated strength-training program is a great way to reduce neck discomfort. Schedule an appointment with us to get started with one of your own!
Sources: https://www.physio-pedia.com/Neck_Pain_Tool-kit:_Step_3

Fresh & Healthy Salsa Recipe
- 4 ripe tomatoes
- 1 red onion
- 3 garlic cloves
- 1 jalapeno (stemmed and seeded)
- 1/3 cup fresh cilantro
- 3 tbsp fresh lime juice
- 3 tsp ground cumin
- 1 1/2 tsp salt
- 15 oz crushed tomatoes (1 can)
- 4.5 oz diced green chiles (1 can)
Place the fresh tomatoes, onion, garlic, peppers, cilantro, lime juice, cumin, and salt in a food processor. Pulse until the contents are blended to the desired consistency. Pour in the crushed tomatoes and green chiles. Puree until mostly smooth. Refrigerate until ready to serve.






