Chest, shoulder, neck muscles contributors to lower back pain

2 January 2020

One thing almost always overlooked or ignored by most physical therapists in treating your lower back pain (LBP) is the contribution of shoulder, neck and chest muscles.

This can result in numerous useless treatments, sometimes over many weeks, where the therapist not only could aggravate or prolong the LBP problem, but also cause you additional financial stress and/or drain your private health fund rebates.

As a remedial massage therapist, I occasionally get a client whose only problem is LBP or neck and shoulder pain and headaches and he/she just wants me to concentrate in those areas.

Sorry, but if that’s the case you are going to the wrong therapist!

I look at the “big picture” and consider a range of factors that could either cause or contribute to your LBP so I can usually make a noticeable difference in just ONE session.

That definitely includes shoulder, chest, neck and spinal muscles right up to the head.

But isn’t that a long way from the lower back?

There are many connecting muscles and other soft tissue between the lower back, neck and chest, but the main ones are the Latissimus Dorsi muscle (usually knows as the Lats) and the spinal muscles which go from the hip to the base of the skull.

The Latissimus Dorsi is not only the largest muscle in the upper body but it has a range of actions with the spine, back, shoulders and arms.

These include extension and transverse extension (eg bending backwards and sideways), spinal rotation (twisting), internal rotation of the shoulder joint (bringing your arm around to the front) and other shoulder/arm movements.

It attaches from the side of the spine from the T7 to L5 vertebrae, the lower three or four ribs, the lower angles of the shoulder blades closest to the spine, to the top of the sacrum/hip area, and to near the top of the Humerus (upper arm bone). If that sounds a bit technical, it goes from mid to lower back (spine and ribs), and also attaches to the top of the hips and the top of the arms.

Just the fact the Lats attach to and affect the movement of the arms, shoulders and hips and has connections to chest and neck muscles, should alert physical therapists to the possibility that any tightness or issues with these muscles may be, and often are, a major contributor with LBP.

The Lats assist the Pectoralis muscles (Major and Minor) in the chest to draw the arm around to the front, so any issues there also will affect the Lats and their connections to the hips. These connections include a large, broad area of what is known as the Thoracolumbar fascia across the lower back.

The Pecs (chest muscles) are among the hardest working and busiest muscles in the body with their role of bringing the arms to the front – where they are for most of any given day or even lying on your side at night.

The interesting thing with those muscles is because they are a special type of muscle, they can be very tight or weak without feeling sore and therefore don’t indicate a potential problem. So most therapists totally ignore them.

But other muscles between the shoulder blades and up into the neck also help to move the shoulder/arm, and therefore impact the Lats as well. If they are also tight, weak, or otherwise not functioning as they should, they also will affect the lower back.

It should be obvious by now that if any massage or other type of physical hands-on bodywork therapist just focuses all their LBP treatment on the lower back, they either didn’t listen to their university or college anatomy and physiology lecturer, or they just want to keep you coming back.

For more information on lower back pain, click on this link to the article Low Back Pain – A “Big Picture” Perspective.

David Hall ©


Townsville massage therapist based in Mount Louisa and specialising in Remedial Massage for all types of muscle and/or joint aches and pains, headaches and migraines and preparation for and recovery from sporting, exercise and fitness activities including Defence fitness tests. I guarantee the best value for money remedial massage in Townsville. CALL NOW on (07) 4774 6973 or 0438 774 819 to book an appointment.