When the ache between your shoulder blades has been there for months, it can start to feel like part of you. It is there when you sit down at your laptop, when you lie down at night and when you wake up stiff the next morning. Around menopause, keeping your upper back moving and strong matters more than ever, and small daily habits can make a real difference to how it feels.

Why the upper back changes in midlife

Your upper back has a natural gentle curve. Through midlife, that curve tends to increase, and research suggests the change can speed up in women in their 50s. Part of this is muscle. The muscles that hold your upper back upright can lose strength more easily as oestrogen falls. Part of it is habit, as long days at a desk keep the upper back rounded for hours.

Bone plays a role too. Bone thins faster in the years around the last period, and the bones of the spine are among those most affected. Strong back muscles help support those bones, which is one more reason strength work matters at this stage.

Why long-term pain can feel stubborn

When pain has been around for a while, your nervous system often becomes more sensitive, a bit like an alarm that goes off more easily. Stiff, unused muscles and a tired nervous system can keep that alarm switched on.

The encouraging part is that the upper back responds well to movement and strength. Giving it regular, gentle challenge tends to calm things down over time.

Keeping your upper back mobile

Your upper back is built to turn and gently arch back, but long days at a desk give it few chances. Something to try a few times a day:

• Sit tall, cross your arms over your chest and slowly turn to each side.
• Sitting back in your chair, clasp your hands behind your head and gently lean your upper back over the top of the chair.
• On your hands and knees on the floor, slowly round your back up, then let it gently dip down.
• Take a few slow, deep breaths, letting your ribs widen as you breathe in.

If you would like a guided stretch, VIDA has short videos you can follow at your own pace.

Building strength in your upper back

Strength is what helps your upper back stay comfortable for longer. In a study of women in their 50s, those who did back-strengthening exercises three times a week for a year did not see the usual increase in their upper back curve. A separate long-term study of postmenopausal women linked stronger back muscles with fewer fractures in the spine years later.

Something to try two or three times a week:

• Back lifts. Lie on your front on the floor with your arms by your sides and gently lift your head and chest a little way, then lower.
• Worktop press-ups. Lean your hands on a kitchen worktop, lower your chest towards it, then push away.
• Shoulder blade squeezes. Sit tall, draw your shoulder blades back and down, hold for five seconds, then relax.

If you would like to follow along, VIDA has a short video of shoulder blade squeezes you can use at your own pace. Start with a few repetitions and add more as they feel easier.

The link with sleep

Sleep and upper back pain are closely linked. Night sweats and early waking are common around menopause, and a poor night tends to leave muscles stiffer and your nervous system more sensitive to pain the next day.

Some things that can help:

• Keep your bedroom cool, with light layers you can push off easily.
• Use a pillow that keeps your head level, rather than pushed forward.
• Get up at the same time each morning, even after a rough night.

Bringing it into your day

Short, regular breaks from sitting help stop stiffness building between your shoulder blades. Standing up to reach your arms towards the ceiling between meetings takes less than a minute. Walking, carrying shopping and stair climbing also support the bones of your spine. Your VIDA pain check-in is a good way to keep track of how things are shifting over time.

What to take away

• Turn and gently arch your upper back a few times a day.
• Strengthen your back two or three times a week with back lifts and worktop press-ups.
• Keep your bedroom cool and your pillow at a height that keeps your head level.
• Break up sitting by reaching your arms up between meetings.
• Stay active with walking and stairs to support your spine.

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