Upper back pain during pregnancy

By trimester

Weeks 1–13

1st trimester

Breast tenderness and early growth often begin now, but the postural chain reaction behind upper back pain, extra breast weight pulling your shoulders and upper spine forward, usually has not built up enough yet to cause much discomfort between the shoulder blades. Upper back pain this early is more often muscle tension unrelated to pregnancy biomechanics.

Weeks 14–27

2nd trimester

This is often when upper back pain starts in earnest. Breast tissue keeps expanding, your shoulder girdle rounds forward, and your upper spine's natural curve shifts to help balance the changes happening lower in your body.

Weeks 28–birth

3rd trimester

The postural shift tends to continue into this trimester, and many people notice upper back discomfort most now. A well-fitted supportive bra, posture breaks, and stretches targeting the shoulder blades and shoulder girdle tend to help the most at this stage.

What does the evidence show for upper back pain between the shoulder blades?

• As breasts enlarge during pregnancy, the added weight tends to round the shoulder girdle and upper back forward, with the shoulder blades spreading and the shoulders rolling inward, a postural pattern distinct from the ligament-driven changes behind lower back pain. 1
• The natural curve of the upper spine, called thoracic kyphosis, measurably increases as pregnancy advances, moving from an average of about 10.7 degrees in the second trimester to about 11.5 degrees in the third, working alongside a similar increase in lower-back curve to keep the body balanced as the center of gravity shifts forward. 2
• Upper back pain in the cervico-thoracic region is far less common in pregnancy than lower back pain, showing up in roughly 6 to 8 percent of women across the second and third trimesters compared with 35 to 37 percent for lumbosacral pain, and unlike lower back pain it does not reliably ease after delivery. 3
• A published case report describes severe thoracic pain between the shoulder blades that occurred nightly and was consistently worse lying flat during pregnancy, a positional pattern the authors say should prompt providers to look for another cause rather than assume ordinary postural back pain. 4
• Pain between the shoulder blades that comes on after eating, particularly after a fatty meal, and radiates toward the right shoulder is a recognized pattern of biliary (gallbladder) pain that providers weigh as a differential alongside musculoskeletal causes of interscapular pain. 5

When should I call my provider about upper back pain between the shoulder blades?

Most upper back pain in pregnancy is postural, changing with position, movement, and rest. Pain that is severe, wakes you at night, or stays constant when you lie flat breaks that pattern, and a published case report describes exactly this combination during pregnancy needing further evaluation rather than being written off as ordinary postural pain. Pain between the shoulder blades that comes on after eating, especially after a fatty meal, and radiates toward the right shoulder can also point to a gallbladder cause rather than a muscular one. Either pattern is worth a call to your provider rather than waiting it out. If you are ever unsure which side of the line you are on, make the call. Obstetric teams handle these check-ins as routine, not as overreacting.