Middle Back Pain: Definition, Causes & Treatments

According to The National Institute of Arthritis and Musculoskeletal and Skin Disease (NIAMS), back pain is among the most common reasons that people visit a doctor, and it affects up to 8 out of 10 people.

Back pain, and specifically, middle back pain or lower thoracic pain, refers primarily to the pain that is felt between the bottom of the neck and the top of the lumbar spine.

The middle back is made up of 12 vertebrae, muscles, ligaments, blood vessels, spongy cartilaginous disks, and nerves. Which make up what is known as the thoracic spine.

The thoracic spine has many functions, including providing support to the head and neck, giving structure to the body, allowing for twisting of the torso, and facilitating the movement of the upper limbs. The ribs also protrude from the middle back, creating a curved cage which protects the vital organs.  Including the heart, liver, and lungs. Due to its constant use for many bodily activities, the middle back is prone to pain and injury. And while it is not as common as other types of back pain, it can cause severe discomfort. And even develop into other serious complications if left untreated.

Fortunately, the symptoms of middle back pain are easily diagnosed. The causes well known, and treatments readily available to help people suffering from this condition manage it successfully.

Getting informed about middle back pain is the first step to knowing how to manage it. And ensure that it does not escalate to levels which compromise your ability to perform day to day tasks.


What Should You Know? (Back Pain Facts)

  • In general, Back pain is the biggest cause of disability for people age 45 and younger in the world.
  • 25% of adults have at least a day of back pain during a typical 3 month period.
  • Experts say roughly four out of five people will have a back problem in their lifetime.
  • Americans spend at least $26 billion per year treating back pain.
  • Adults with back pain are 3 times as likely to be in fair or poor health. And +4 times as likely to experience mental distress.
  • Half of the American workers have had back pain symptoms each year. Making it one of the most common reasons for missing work.

What Is Middle Back Pain?

Middle back pain refers to pain that occurs in the thoracic spine. which begins just below the neck and extends to the middle of the body trunk. It usually starts as a dull, throbbing ache, or sharp pains that may spread to other parts of the body. It may last for a short time or be chronic, last more than 3 months. Middle back pain manifests in different forms. Including middle left back pain, middle right back pain, sharp pain in the middle of the back and sudden middle back pain. It is important to identify exactly where on your body the middle back pain is originating from. As well as what type of pain you are experiencing to help your doctor make a correct diagnosis.

Early diagnosis is important to discover the underlying causes. And prevent middle back pain from developing into more serious conditions such as disability. You should especially seek treatment if this type of back pain continues unabated for an unusually long time. Or if you suspect that it is caused by something more serious. While over the counter pain medications may help to alleviate the pain somewhat, it is always prudent to seek the advice of a health professional to help manage the symptoms successfully as well as ensure that it does not develop into a life-threatening condition.

The pain could be on the right (Middle Back Pain Right side) or left side (Middle Back Pain Left Side).

Causes of Middle Back Pain

Middle back pain has several causes, including injuries, irritation, structural and medical conditions.


The muscles, ligaments, nerves and other soft tissues that the thoracic spine is made up of are subject to irritation brought about by poor posture, sitting in one place for prolonged periods of time and overuse of the middle back muscles caused by repetitive activities.

Sudden injuries or trauma

People who live sedentary lifestyles are at risk of getting middle back injuries if they engage in sports, intensive home improvement projects, gardening and any other vigorous activity that requires considerable physical output. These injuries may result in tearing of the muscle fibers in the back, resulting in strain and subsequent middle back pain. Trauma from car accidents falls and other catastrophes may also result in middle back pain.

Structural Causes

  • Scoliosis
  • Herniated discs.
  • Kyphosis or upper spine curvature
  • Spinal cancers
  • Degenerative disk disease
  • Scheuermann’s disease.
  • Spinal stenosis. (narrowing of the spinal canal)

Medical Conditions

  • Osteoporosis.
  • Osteoarthritis
  • Paget disease
  • Osteomyelitis
  • Life-threatening conditions such as fibromyalgia, Kidney stones, bone marrow cancer and aortic aneurysm.

The two main reasons bed rest may be recommended for middle back pain are to reduce pressure on the discs in the spine and to stop the mechanical stresses that are irritating pain receptors. A short period of bed rest may help reduce acute middle back pain. However, in most instances, more than 1 or 2 days of rest can be detrimental to recovery from middle back pain, potentially leading to increased pain and other adverse results, such as:

Muscle atrophy ( 1% to 1.5% per day).

Cardiopulmonary deconditioning ( 15% loss in 10 days).

Bone mineral loss.

Risk of blood clots.

Loss of wages.

Creating an “illness” mindset.

With that considered, a program of back exercises may help limit back pain.

Also Read:

What Causes Pain in The Middle of Your Back?

Symptoms of Middle Back Pain

Middle back pain symptoms will be dependent on the underlying cause of the pain. As a rule, and regardless of the contributing factors, the middle back pain have the following symptoms:

  • A dull throbbing pain over a small point or spread out over a larger area.
  • Sharp, needle-like pains that may disappear quickly or last over a longer period.
  • Back pain that appears once in a while or appears constantly.
  • Pain that is characterized by muscle stiffness or numbness.
  • Depression and anxiety, accompanied by general lethargy, low mood, light-headedness, chest pain and shortness of breath.
  • People with middle back pain will also experience feverish symptoms which include; headaches, nausea, vomiting, and photosensitivity.
  • Neck and shoulder pain.
  • Sleeping problems including abnormal sleeping patterns, sleeping too little or too much. Altered sleeping patterns may have adverse effects such as reduced motor skills, fatigue, problems concentrating at work and many others.
  • Severe symptoms which may be life-threatening include severe abdominal pain, chest pressure, incontinence and numbness in the legs and other lower extremities. All these symptoms are critical and require that you visit your physician for a thorough check-up to arrest whatever condition may be causing them.

Risk Factors For Middle Back Pain

While a large percentage of the population is susceptible to back pain, certain risk factors will make it more likely for you to suffer from this condition. The following are the most common risk factors for developing middle back pain:

  • Age: People over 50 years of age are more likely to develop middle back pain due to the wear and tear of the spinal cord and the onset of diseases such as osteoporosis and osteoarthritis as they grow older.
  • Sedentary lifestyle: People who sit in one position for long periods of time without taking any form of exercise have a high risk of developing middle back pain. This is due to the fact that a largely sedentary lifestyle causes muscle stiffness n results in a weakening of the spinal cord making it more susceptible to injury.
  • Being overweight: Carrying extra weight especially around the midsection causes great pressure on the spine and may result in herniated disks as well as pinched nerves which are more likely to get inflamed or infected.
  • Genetic factors: People who are born with spinal deformities such as spine curvature and humpback experience more back pain as their spine is forced to support misaligned torsos and weight is not as well distributed as in a person with a normal spinal cord.
  • Physically strenuous occupations: Jobs that require workers to do heavy lifting or twist into different positions can put extra strain on back muscles. Done consistently, they will result in increased wear and tear off back muscles and ultimately increase a person’s chances of developing middle back pain.

Treatment For Middle Back Pain

Treatment will typically depend on several different factors including the severity of your symptoms, their effect on your day to day lifestyle, any treatments you may have had in the past, medical history and the presence of other medical conditions such as osteoarthritis and osteoporosis. Before prescribing a course of treatment, a doctor will conduct a thorough physical examination during which the patient will be asked to do the following:

  • Sit, stand and walk around both barefoot and while wearing shoes.
  • Lift their legs and move them around while lying on a flat surface. Bend their knees as well as arms at the elbow.
  • Twist their torso from side to side while standing, and bend forward and backward.

The doctor will also do a sensitivity test by hitting the ankles and knees with a hammer. S/he will measure the strength of muscles in different legs as well as touch several points in the body to test for numbness.

Once the diagnosis is complete, the doctor will then prescribe a course of treatment that will include both home care and medications to help you manage your pain. The most common treatments for middle back pain include:

Physical therapy

Depending on whether the pain is mild or severe, your doctor may prescribe physical therapy as a way to help remedy the situation. Your therapist will work with you to determine the best exercises to increase the strength and flexibility of your spine as well as help in pain management. The therapist will also teach you a few exercises that you can use to treat middle back pain from the comfort of your home.

Over the counter painkillers

People suffering from mild middle back pains can often manage them with the use of simple OTC painkillers such as Advil, Tylenol, and aspirin. However, even if you feel that your back pain does not warrant a visit to the doctor, it is always important to consult a health professional before self-prescribing painkillers so that you can find out the ones which are safest for your use.

Muscle relaxants

If your back pain does not improve after using OTC painkillers or a round of physical therapy, your doctor will prescribe muscle relaxants to reduce tension in the muscle fibers in your back. The relaxants will also help to improve the mobility of your spine and reduce overall stiffness.


Legal steroids help to bring down the levels of inflammation in the back muscles, reducing swelling and taking pressure off the nerves. The result is diminished middle back pain which allows you to go about your day to day activities without having to worry about debilitating pains.

Stretching exercises

Exercise programs such as Pilates and yoga incorporate a lot of stretches and as a result, are ideal for people suffering from middle back pain. Stretching out your back muscles reduces their stiffness and makes them stronger so that you are less likely to tear them when performing strenuous physical activities.


As a last resort and in cases where the spine is severely structured, your doctor may prescribe a vertebroplasty, herniated disc removal, and spinal decompression. Back surgery is extremely rare as most but the most serious of fractures will heal themselves given time and proper rest. However, in cases where a fractured spine threatens to permanently disable the affected person, surgery may be the only viable option.

Home treatments

In addition to treatments prescribed by your doctor, there are several things you can do from the comfort of your home to reduce the occurrence and prevalence of middle back pain:

  • Rest: Taking a couple of days off and limiting physical activity can give your back the rest it needs to repair injured and worn out tissues. However, for this to be effective, you will need to get moving after two or more days to avoid doing, even more, damage by remaining sedentary for long periods of time. Incorporating gentle movements combined with small periods of rest will help to ensure that you reduce your back pain and manage to keep it off in the long run.
  • Heating pads and ice packs: Pressing hot and cold packs alternately on the affected part of your pack will help to contract and stretch muscles. This helps swellings go down as well as lengthening muscle fibers, ultimately reducing pain in your middle back.
  • Massage: Home messages are an inexpensive way to stretch out the muscles in the middle of your back and reduce middle back pain. You can enlist the help of a family member to do this important task several times a week. Not only will this help to reduce your back pain, but you will save time and money that you would have spent on finding a professional masseur.

Middle back pain can sometimes make your life unbearable and prevent you from taking part in the productive day to day activities. However, by learning how to recognize its symptoms, learning about its causes and seeking out the help of a health professional, you should be able to find a permanent solution to this problem and get rid of this painful condition for good.


As with any type of pain, prevention is always the best medicine.  Weight-bearing exercise and aerobic exercise are ideal to help strengthen all of the vital muscles, bones, and ligaments within the human body.

While walking or jogging may be great aerobic exercises, they do very little in working the muscles of the back.  Discuss with your doctor the fact that you wish to begin an exercise regimen that will include targeting the back muscles.

If you regularly attend a gym, schedule a session with a personal trainer who can not only prescribe a set of exercises for you to perform but also demonstrate how to do them safely. On your own at home, easy exercises are available that can get you well on your way to back health.

Remember to start slowly; muscles will take a little time to acclimate to the extra tasks assigned to them, and starting with just a few repetitions and building a little more each session will build them the safe and correct way.  Some great programs for back strengthening are yoga, Tai Chai, and Pilates, which concentrate on good posture and breathing to achieve muscle toning and strength.

These types of programs are best done in a class setting, to begin with, but many videos and television programs that are devoted to their instruction can be very beneficial as well as able to be performed in the privacy of one’s own home.

See also:

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