Mid Back Pain

Mid back pain is pain that is felt between the bottom of the neck and top of the lumbar spine. Mid back pain is also called middle back pain or thoracic pain. Mid back pain can be acute, sub-acute or chronic in duration. With Chiropractic treatment, the symptoms of mid back pain can show significant improvement within a short period of time.


Anatomy of the Mid Back


The thoracic spine contains 12 medium sized vertebrae all of which form articulations (joints) with 2 opposing ribs. Like the other spinal vertebrae, the thoracic vertebrae act as attachments for muscles and ligaments in the mid spine and also encase and protect the median aspect of the spinal cord and thoracic nerve roots.


Because the thoracic vertebrae form relatively strong articulations with the ribs, the mobility of the thoracic spine is less than that of the cervical and lumbar spines. However, this same characteristic also protects the thoracic spinal discs and facet joints from the wear and tear experienced by these structures in the other areas of the spine.


Causes of Mid Back Pain


Mid back pain is most commonly caused by irritation or injury to the muscles and ligaments of the thoracic spine. The high incidence of poor postural habits, lack of adequate exercise and muscle conditioning, as well as the ever more popular “seated” lifestyles of desk workers are all major contributors.


  • Incomplete rehabilitation of past injuries
  • Improper lifting techniques
  • Improper workstation setup
  • Poor posture
  • Prolonged sitting
  • Prolonged use of non-ergonomically designed equipment
  • Excessive repetitive torsal motions
  • Scoliosis (lateral deviation of the spine)
  • Physical inactivity


Symptoms of Mid Back Pain


Middle back pain symptoms involve a variety of signs that point toward the cause of the pain, such as a torn muscle or ligament, or injury to the spine. Different types and severity of pain is felt by middle back pain sufferers, including a dull or achy pain anywhere in the middle back region, a burning feeling, sharp or stinging pain that radiates throughout the back, or a combination of any of these types of pain.


Some of the more common symptoms of middle back pain are sharp, dull or burning pain, stiff muscles and joints, weakness in the arms or legs. Many middle back pain sufferers also experience stiffness or pain in the shoulders or neck as well as other areas of the back, like the upper or lower back.


Middle back pain symptoms may be constant no matter what activity the pain sufferer is doing, or it may become more severe while participating in certain activities, such as walking, running, playing sports, or even sitting or laying down. The pain may be in one single point on the back or felt in different areas of the back for a more broad type of pain. It is not uncommon for middle back pain to start suddenly or to gradually become more severe without proper treatment.


Additional symptoms associated with middle back pain include fatigue, headaches, fever, insomnia, anxiety or depression, and redness, swelling, or warmth in the middle back area.


Types of Injury in the Mid Back


The thoracic spine is unique in that each of its’ vertebrae attaches to a pair of ribs. There are 12 thoracic vertebrae and thus, 24 ribs (12 on the left and 12 on the right). Just like vertebrae can biomechanically malfunction, so too can the thoracic vertebrae and it’s adjacent ribs. When ribs “go out” or misalign in relation to their connecting vertebrae, the individual will often experience sharp pains in the area of the misaligned rib head, especially on twisting movements of the torso.


The facet joints in the thoracic spine allow for considerable amounts of flexion and extension. The facet joints can become injured with excessive amounts of rotation and extension. Golfers are prime candidates for facet joint injury due to their repetitive twisting motions as they swing their golf clubs. When injured, pain is often sharp and localized to the area of the affected facet joint.


The discs of the thoracic spine are less likely to become injured compared to those of the cervical and lumbar spines, making up only 2% of intervertebral disc herniations. This is because of the rib articulations made by the vertebrae which significantly increases the stability of the thoracic spine. This does not mean that the discs of the thoracic are immune from damage, rather, statistically less likely to become injured.


The paraspinal muscles of the thoracic spine are numerous. They are responsible for the majority of trunkal movements as well as a number of upper extremity movements and are a common source of injury and pain. Over exertion of the muscles from lifting and pulling and poor posture are the major contributors in mid back strains. Pain originating from these muscles characteristically produces a dull generalized ache.


Symptoms of Serious Mid Back Pain


Some middle back pain symptoms are considered to be more serious and may point to serious medical conditions. If any of the following symptoms associated with middle back pain is felt, consult a professional immediately:


  • Tingling or numbness in your arms, legs, abdomen, or chest
  • Loss of bladder or bowel control
  • Weakness in the arms or legs
  • Jaw pain
  • Shortness of breath
  • Pain, tightness or pressure in the chest
  • Severe abdominal pain