Middle back pain can have several causes, including impact trauma, arthritis, herniated discs, muscle strains, scoliosis, and many more.

The term ‘middle back’ often refers to the thoracic spine — the region of the back between the rib cage and the base of the neck. This region has 12 spinal disks, several vertebrae, and many muscles and ligaments. Damage or irritation to these structures can lead to back pain.

Read on to learn more about the causes of middle back pain and discover techniques to find relief.

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There are many possible causes of middle back pain, ranging from injury to poor posture.

Potential causes include:

Arthritis

There are several different forms of arthritis, some of which can affect the back.

Osteoarthritis (OA) is a common degenerative joint disease that affects 32.5 million adults in the United States. OA causes the ends of bones to rub together, leading to pain, swelling, and stiffness.

Ankylosing spondylitis is a type of arthritis that affects the spine. Symptoms include pain and stiffness in the back. Over time, it causes the vertebrae to fuse, impacting posture and mobility.

Rheumatoid arthritis is a form of inflammatory arthritis that typically affects joints in the hands, feet, and legs. However, it can also affect spinal joints and other parts of the body. It occurs when a person’s immune system mistakenly attacks joint tissue.

Fractured vertebrae

A fracture or broken bone can occur in any vertebrae in the middle back due to a sports injury, automobile crash, or fall.

Extreme deterioration of the spine over time, such as from osteoarthritis, can also cause a fractured vertebra.

Symptoms include intense pain that gets worse with movement. If the injury affects the spinal cord, it can lead to tingling, numbness, and incontinence. Fractures require immediate medical treatment.

Herniated discs

Spinal discs are soft tissue formations between each vertebra. They contain liquid and act as shock-absorbing cushions, and aid in spinal mobility.

Discs can rupture or bulge outward. This is known as a herniated or slipped disc and puts pressure on the surrounding nerves.

A herniated disk in the middle back does not always cause symptoms, but it may result in pain, tingling, or numbness. Spinal discs can also rupture completely.

Kidney problems

The most common causes of kidney pain are infections and kidney stones. These may cause pain that feels as though it radiates through a person’s back.

Additional symptoms include:

Learn more about the differences between kidney pain and back pain here.

Lifestyle factors

A lack of exercise leads to weak muscles, which can contribute to pain. People who exercise improper lifting techniques can also experience pain in the back.

Research suggests that people who smoke tobacco also have an increased risk of developing chronic back pain.

Muscle strain or sprain

Repeatedly lifting heavy objects or carrying items improperly can cause the muscles and ligaments in the back to stretch or tear.

Overweight and obesity

Being overweight or obese puts additional strain on the back muscles, bones, and other structures.

Higher body weight and a lack of physical activity can increase a person’s risk of general back pain.

More specifically, obesity has strong associations with an increase in lower back pain.

Osteoporosis

Osteoporosis is a type of bone disease that results in brittle bones.

Osteoporosis can cause a decrease in bone mineral density and bone mass. It can also lead to a change in the quality of bone structure. These changes can cause bones to weaken, increasing the risk of fractures.

Approximately 10 million U.S. adults over 50 have osteoporosis. A further 43.3 million people have low bone density, which may put them at risk of the disease.

People with osteoporosis in the back can experience severe back pain due to strains or compression fractures.

Poor posture

Incorrect posture while sitting or standing is a leading cause of back pain. Slouching increases pressure on the spine and leads to strained muscles as they try to maintain balance.

Mental health conditions

People who experience depression or anxiety tend to be at increased risk of developing back pain.

Scoliosis

Scoliosis causes the spine to curve sideways. It leads to an uneven distribution of weight throughout the back and may cause middle back pain.

Living with scoliosis may cause muscle imbalances in the back, contributing to back pain.

Tumor

If a tumor grows in the middle back, it can affect spinal alignment and pressure the nearby nerves, muscles, and ligaments, resulting in pain.

The treatment for middle back pain will depend on the underlying cause. Doctors usually suggest home remedies first but may recommend medical and surgical interventions if needed.

Home remedies

At-home methods to treat middle back pain include:

  • Heat therapy: Alternating hot and cold compresses, or ice and heat, can provide relief from many types of middle back pain.
  • Over-the-counter pain relief: Ibuprofen (Advil) or naproxen (Aleve) may relieve pain and swelling.
  • Posture improvements: Poor posture should be corrected to alleviate back pain. Practice correct posture by standing tall with the shoulders back and minimizing not slouching.

Exercises

Several exercises may help to stretch and strengthen the muscles in the middle back to treat and prevent pain.

Beneficial stretches include:

  • Cat-Cow Pose: Position yourself on your hands and knees. Then, arch your back as far as comfortable (like a cat) before sinking your back toward the ground in a U-shape (like a cow).
  • Cobra Pose: Lying flat on the ground, use your arms to prop up the upper body, stretching the back.
  • Seated twist: Sitting cross-legged, twist your upper body to the right, placing your left hand on the right knee for support. Repeat on the other side.

Beneficial exercises include:

  • Low impact activities. Good options include yoga, swimming, and walking.
  • Core-strengthening exercises. Working the abdominal and back muscles using bridges and planks helps to support the back.

People should speak with a doctor or physical therapist before beginning any new exercise regimen.

Medical treatments

A person should see a doctor for back pain that persists for several days or does not respond to home remedies.

Possible medical treatments for middle back pain typically include prescription medications, including painkillers, muscle relaxants, or steroid injections, and physical therapy, such as exercises and massage.

Surgery

If medication or physical therapy do not alleviate middle back pain, surgery may be necessary. Types of surgery for the middle back include:

  • Discectomy: People with a herniated disk may need a discectomy to remove the injured part of the disk and prevent further damage.
  • Fusion: A fusion procedure involves joining two vertebrae and using a spacer to replace damaged disks.
  • Laminectomy: Used to decompress the spinal cord, a laminectomy removes the back wall of a vertebra (the lamina).
  • Laminotomy: In this surgery, a surgeon removes a portion of the lamina to treat a pinched nerve.

Not all cases of middle back pain are preventable, but the following steps may reduce the risk of injury:

  • reach or maintain a moderate weight
  • sleep on one side or on the back
  • practice proper posture
  • ergonomically optimize all workspaces
  • practice safe lifting techniques
  • try physical therapy

A person should see a doctor if they experience any symptoms for more than 3 days, especially if they do not respond to home remedies.

Symptoms of severe back pain that require prompt medical treatment include:

  • a tingling sensation in the arms, chest, or legs
  • chest pain
  • incontinence
  • numbness
  • weakness

People should seek immediate medical treatment for back symptoms following a fall, collision, or injury.

Middle back pain can have a great many causes. These can range from impact injuries to the spinal column, poor posture, muscle weakness, and chronic inflammatory conditions.

Treatment will typically vary depending on the underlying cause, and prevention may not always be possible.

However, maintaining a moderate weight, leading an active lifestyle, and minimizing stress placed on the back muscles can all be of benefit to overall back health.