"Upper back pain" I would assume to be in the upper thoracic spine. This area of the spine is prone to stiffness and kyphosis (slouching). Thus, treatment is two-fold. First, upper thoracic mobilization helps to break-up the stiffness. Mobilizing the thoracic spine can be accomplished with tennis balls in a sock, rolled up and down the spine against the wall. More technical methods include using wedges, therapy balls, foam rollers, and "yoga blocks". The goal is to get those thoracic segments to free-up from the confines of the ribs and sustained postures. Second, the treatment of the thoracic spine needs to involve strengthening of the muscles that hold you upright, keep your face from hitting the floor. The thoracic spine extensor exercises are very important, especially after a compression fracture (this should be ruled out). The thoracic spine is often neglected like the middle child of the spine. Get to know it like a friend. A good physical therapist will know exactly what I am talking about.
Let's talk about pain under the shoulder blade. This pain can come from the surrounding muscles, the cervical facet joints, or the thoracic spine. If the pain is worse in the morning, sleep posture could be the cause. For side sleepers, I recommend using a pillow placed in the front of the chest to rest the upper arm on (or use of a body pillow). If the pain is coming from the thoracic spine, then it should respond to the above mentioned treatment. If the pain is from the cervical spine, facet joint blocks could help (or old fashion rehab by reducing the cervical lordosis (curve) which tends to get exaggerated as one gets older). I do not advise chasing this pain with a scalpel.
Find the best physical therapist/manual therapist within your 100 mile radius. Finding the right therapist can save your life. (the best are fellows of the AAOMPT).
Dr. Christina Lasich, MD
P.S Here are some links to articles on our site that might be useful to you:
Let's Talk Pain Meds
Using Tylenol Responsibly
Why Yoga May Soothe Many Types of Chronic Pain