Upper cross syndrome: Causes, Symptoms and Treatment

In this video, Airrosti’s Casey Crisp, DC explains the mechanics of Upper Cross Syndrome, also known as UCS. He explains that different muscles may be too tight or too loose, and how this imbalance can lead to tightness and pain throughout the upper body. This may specifically lead to neck, shoulder, and upper back pain. By targeting these imbalances directly at the source and working to stretch and strengthen those muscles, Airrosti helps eliminate UCS pain in an average of just three visits. Learn more about Airrosti’s unique approach here.


Although you may not be familiar with the term Upper Cross Syndrome (also known as Upper Crossed Syndrome, or UCS for short), you’ve probably seen it. UCS is often caused by poor posture over an extended period of time. It results in rounded shoulders, head in front of the body, and an apparent curve in the neck and upper back. While UCS is a condition routinely suffered by the elderly, it is also extremely common in office workers and even athletes. In fact, it’s one of the most common postural problems in both the young and the old.


The muscles of the human body are interconnected. When one muscle becomes weak, another muscle takes over the work. In the condition known as UCS, mid-back muscles (serratus and lower trapezius) become very weak. As a result, the pectoral and neck muscles tighten. This causes pain throughout the upper body, including shoulder pain and neck pain, as well as a reduced range of motion.

Simply put, UCS is a muscle imbalance caused by the weakening and lengthening of the posterior upper back and neck muscles, combined with the tightening and shortening of the opposing anterior pectoral (chest) and neck muscles. This imbalance leads to joint dysfunction.


Individuals with a sedentary lifestyle are most at risk for developing UCS. Long hours of sitting at a computer, watching television, or playing on a smartphone can contribute to bad posture. This prolonged poor posture can weaken the rhomboid and neck flexor muscles, while tightening and shortening the pectoral and upper trapezius muscles. This is what’s known as the “cross” pattern where the condition gets its name. This imbalance causes the spine to pull forward, significantly increasing the amount of stress on the supporting muscles.

While poor posture and too much sitting is a leading cause of UCS, it is not uncommon to find UCS in athletes, especially swimmers and weightlifters. This is due to overuse of the muscles in the area of the neck, shoulders, and upper back.


Unlike most conditions, UCS often manifests in a very visible way. Many people will notice their shoulders become more rounded and hunched over time, while the neck and head crane forward. The spine will also start to curve inward near the neck and outward in the upper back and shoulder area.

The imbalanced muscles associated with UCS put stress on the surrounding muscles, tendons, bones, and joints, causing most people to develop symptoms that include:

  • Headaches
  • Neck pain or strain in the back of the neck
  • Chest pain and tightness
  • Pain in the upper back, especially the shoulders
  • Difficulty sitting, reading, watching television, or driving for long periods of time
  • Restricted range of motion in the neck or shoulders
  • Numbness, tingling, and pain in the upper arms


UCS is a chronic condition that can leave significant muscle imbalances in the body and lead to chronic back pain. If someone with UCS swims, bikes, or runs, it can lessen their mobility and reduce overall performance.

The effects of this condition can harm athletic performance, reducing range of motion. If not treated, the condition can cause eventual damage to the spine from continual pressure on the front of the vertebrae.


As with most musculoskeletal conditions, the best way to combat UCS is through preventative stretches, exercises, and improved posture. Once the condition has progressed, Upper Cross Syndrome treatment involves the strengthening of the weakened posterior musculature and stretching of the tight anterior musculature.

Because of chronic poor posture, people with Upper Cross Syndrome generally have numerous problems in the upper back and neck. It is very important to get treated by a musculoskeletal specialist, such as an Airrosti provider, to address the specific problems in the body.

To increase the flexibility of the muscles and joints and ensure full range of motion, there are muscular adhesions and trigger points that must be removed. Manual treatment should be followed by specific strengthening and stretching exercises to prevent future injury and to further restore strength and function.


If you’re experiencing pain and limited range of motion associated with Upper Cross Syndrome, don’t wait to get treated. This is a condition that only gets worse over time. Airrosti can quickly and safely resolve the source of this pain, while giving you the tools and knowledge you need to stay pain free.

If you think you may have UCS, click here to schedule a risk-free Airrosti appointment today. In most cases, this condition can be fully resolved in as few as 3 visits (based on patient-reported outcomes).

Reviewed by Casey Crisp, Doctor of Chiropractic

Disclaimer: Always consult with your doctor before starting any exercise program. If you experience any numbness, tingling or reproduction of your symptoms, please contact your doctor.

review icon

Patient Testimonials

Related Posts

Phone Icon

Airrosti Newsletter Sign-up

Search for other injuries

Follow Us on social media

Find An In-Clinic Location (oh, TX, VA, WA, & DC)

Enter Your Zip:  
vip chat illustration

Got Pain?

Book your 15-minute, NO COST video chat with a provider to learn about your injury and treatment options. SIGN ME UP