Upper Back and Rib Pain in Pregnancy: What It Is & 5 Tips to Help!
By Jess Jenkins, The Mama Physio
Pregnancy is a time of huge physical transformation, and while it's truly amazing what our bodies are capable of, it’s also very common to experience physical discomforts along the way. One of the most common complaints I hear in the clinic, especially as pregnancy progresses, is upper back and rib pain.
This type of discomfort can feel sharp, achy, tight or even burning, and often shows up under the bra line, around the ribs, or between the shoulder blades. The good news? You don’t just have to “put up with it.” There’s a lot we can do to help relieve it.
Let’s take a closer look at why it happens and what you can do to feel better.
What Causes Upper Back and Rib Pain During Pregnancy?
Several factors contribute to rib and thoracic spine discomfort during pregnancy, and most are related to the incredible changes happening in your body:
Postural Changes
As your belly grows, your centre of gravity shifts forward, creating an exaggerated curve in your lower back (a lordosis) and more load through your upper back (kyphosis). To compensate, your shoulders often round forward and your head juts out, leading to tightness in the upper back, chest, and ribs.
2. Rib Flaring + Restricted Mobility
The rib cage actually expands during pregnancy to accommodate your growing uterus and to help you breathe more efficiently. This stretching can cause discomfort around the ribs and can also make the upper spine and rib joints stiffer and less mobile.
3. Increased Pressure from the Uterus
As your baby grows, your uterus pushes upwards into your diaphragm and lower ribs. This pressure, particularly in late pregnancy, can irritate the costovertebral joints (where your ribs meet your spine) or even compress the intercostal nerves (which run along the ribs), leading to sharp or burning pain.
4. Muscle Imbalances and Fatigue
Muscles between the ribs (intercostals), upper back, shoulders, and core can become tight, overworked, or fatigued as they try to support your changing body. Add in heavy breasts and less-than-ideal posture (hello, couch slouching or toddler wrangling!) and it’s no surprise these areas become sore.
5. Hormonal Changes
Relaxin softens ligaments and joints to prepare for birth, but it also makes the thoracic spine and rib joints more mobile and sometimes unstable, which can lead to irritation and discomfort.
5 Of My Top Tips To Help
There are several simple and effective ways to relieve thoracic and rib pain in pregnancy. As a Women’s Health Physio and a mum myself, here are the strategies I recommend most often:
1. Targeted Movement + Exercise
Staying active in pregnancy is key, but how you move matters. Gentle mobility, thoracic extension, and rib-opening stretches can be incredibly effective for releasing tension and restoring movement in the upper back.
My favourite stretches/mobility exercises are:
Arm openings (add 1 kg weight for additional stretch) - shown below
Thread the needle - shown below
Side stretch in a doorframe: Standing to one side of a doorframe, reach both hands overhead, with the outside hand uppermost, and hang to feel a stretch down the side of your body. LOVE this one! You can also do it in a mermaid sitting position, shown below.
Thoracic extensions over a foam roller
My favourite strengthening exercises (grab a weight, anything from 0.5kg to 6kg+):
Bent over rows (standing or kneeling)
Bent over bow and arrow with weights
Bent over extensions (shown above)
Inside my MOVE app, you’ll find safe, physio-tried-and-tested workouts, stretching sequences, and mobility flows tailored specifically for pregnancy, including sessions that target upper back and rib discomfort.
👉 Check out MOVE here and feel confident moving your body through each trimester.
2. Be Aware Of Your Posture
Posture is dynamic, not perfect, but being mindful of your alignment (especially whilst sitting at work!) can reduce pressure through your thoracic spine and ribs. Try to:
When sitting at a desk I always tell my patients to make sure they are sitting right at the back of their chair so that they can utilise the ergonomic back support, if any! If your chair lacks this, I would consider using a lumbar support. When your lower back is aligned well, your upper back balances into place because our body likes to maintain alignment with gravity.
Sit on a fitball during the day (if possible) or in the evenings when watching TV. This is also fantastic for birth preparation too!
Swap sides when holding or carrying your children
3. Utilise The 360 Degrees Breath
As your baby grows, your uterus pushes up into your diaphragm, the dome-shaped muscle that helps you breathe. This limits how much the diaphragm can move downward with each breath, which can lead to more shallow, chest-based breathing. Over time, this can cause tightness and fatigue in the upper chest, neck, and rib muscles; all of which can worsen rib and upper back pain.
Learning to breathe more efficiently can make a big difference. Try placing your hands around the sides of your ribs and focusing on 360° breathing. This is where you gently expand through the sides and back of your rib cage as you inhale, rather than just lifting through your chest. This style of breathing reduces tension in the muscles through your ribs and thoracic spine.
In the MOVE app there are educational tutorials on breathing to make sure that you are doing this properly throughout the classes. Check it out HERE.
4. Heat & Massage
A heat pack across your upper back and shoulders can help soothe tight muscles. You may also benefit from hands-on physiotherapy to release the intercostals, upper back, and diaphragm. Massage balls or foam rollers (gently used!) can also help between sessions.
When using a massage ball it is generally easier against a wall. Roll against the ball and apply pressure into any sore areas, breathing to help release trigger points.
5. See a Pelvic & Women’s Health Physio
If your rib or upper back pain is persistent or interfering with your sleep, work, or daily life, I’d love to help. During a physio session, we can:
Assess your posture and movement
Gently release tight muscles or joints through massage, joint mobilisation, muscle energy techniques and dry needling.
Provide taping or supports if needed
Guide you through safe, effective exercises for relief
Book an appointment with me here to get tailored, expert support for your pregnancy pain.
You Don’t Have to Suffer Through It
Upper back and rib pain might be common in pregnancy, but that doesn’t mean it should be dismissed. With the right movement, support, and treatment, you can feel more comfortable and confident as your body grows and changes.
Join me inside the MOVE app to feel better, move better, and stay connected to your body throughout pregnancy, and beyond. Sign up today with 20% off using “MOVE20” at checkout! Check it out HERE