If I use my arms a lot, I get a stabbing pain in my upper back. It even feels like a knife is stabbing me in my chest at the same time. Ii usually use my heating pad or take my meds if it is time.
Also some times I have figured out it's trapped gas. In that case I take a Bentyl too. This is an anti-spasmotic drug for this purpose.

Epsom salts in a warm water bath. Works better than meds for me.

Oh yes, but I have DDD in my thoracic spine which adds to that. A soak in an Epsom bath really helps, not only with that but with my other joint and muscle aches too

Yes i do...pain meds.

Have you had an mri? Neck mri? Do you have numbness and tingling on your fingers?
I use a TENS therapy unit on my shoulders and neck along with a heating pad.