Middle back pain can have several causes, including impact trauma, arthritis, herniated discs, muscle strains, scoliosis, poor posture, and more. Depending on the cause, medical treatments, home remedies, and exercises may help.

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 discs, 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, knees, or ankles. 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 disc 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

Having overweight or obesity puts additional strain on the back muscles, bones, and other structures.

Indeed, a 2023 study found that weight gain leads to a greater risk of back pain.

More specifically, obesity has a modest but significant association 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 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. However, these tend to be a rare occurrence.

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: A person should position themself on their hands and knees. Then, they should arch their back as far as comfortable (like a cat) before sinking their back toward the ground in a U-shape (like a cow).
  • Standing Forward Bend Pose: Standing with their knees slightly bent, a person should bend forward from the waist as far as they can comfortably go – all the while keeping their weight evenly distributed and letting their arms hang down towards the floor. They should come back up one vertebra at a time.
  • Seated Spinal Twist: Sitting with extended legs, a person should bend their right knee up. Placing their right foot on the outside of their left leg, they should sit up straight and tall. They should gently twist to the right from the hips, looking over their right shoulder. 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 a few weeks or does not respond to home remedies.

Possible medical treatments for middle back pain typically include prescription medications, including:

A doctor may also recommend physical therapy, such as exercises and massage.

Surgery

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

  • Discectomy: People with a herniated disc may need a discectomy to remove the injured part of the disc and prevent further damage.
  • Spinal fusion: A fusion procedure involves joining two vertebrae and using a spacer to replace damaged discs.
  • Laminectomy: A laminectomy removes the back wall of a vertebra (the lamina) and is used to decompress the spinal cord.
  • 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 back pain that does not improve within a few weeks despite home treatment.

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

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

Why would the middle of a person’s back hurt?

The middle of a person’s back can hurt for various reasons, ranging from muscle strain and poor posture to more serious medical conditions such as osteoarthritis, scoliosis, or kidney stones.

A person should seek medical advice if they have middle back pain that does not resolve within a few weeks of at-home treatment.

How can a person relieve middle back pain?

Middle back pain relief can be achieved initially through home remedies such as heat therapy, over-the-counter pain relief, and posture corrections.

Engaging in targeted exercises like stretches and low-impact activities may also strengthen and stretch middle back muscles.

If a person has persistent pain, they may require prescription medications, physical therapy, or even surgery if necessary.

What is a strain in the middle of the back?

A strain in the middle of the back refers to an injury to the muscles or tendons in the area between the shoulder blades and the lower back.

It typically occurs due to overuse, sudden injury, or poor posture.

Symptoms may include pain, stiffness, and limited range of motion in the affected area. It often resolves with rest, gentle stretching, and over-the-counter pain relief.

Middle back pain can have 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.