Many people have back pain at some point in their lives. Middle right back pain involves the area of the back between the base of the neck and the rib cage. Pain can sometimes affect one side more than the other.

This article examines some potential causes of middle right back pain.

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The middle back is also called the thoracic spine.

The area includes 12 spinal vertebrae — T1 to T12 — along with muscles and ligaments.

Damage or irritation to any of these areas can lead to middle back pain. The pain may sometimes affect one side more than the other, leading to pain on the right side.

Learn more about the anatomy of the back here.

There are many possible causes of middle and middle right back pain, including injury and poor posture.

Aging

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), people 45 years and older are more likely to develop back pain.

Learn more about middle back pain here.

Lifestyle factors

Various lifestyle factors may increase a person’s risk of developing back pain. These include:

  • Obesity: Excess body weight puts more strain on the back, which can cause pain.
  • Exercise: Back pain is common in people who have not exercised for a while or ramp up their workouts too fast after an extended break.
  • Occupational hazards: Some jobs that require a lot of lifting, pushing, twisting, and pulling can increase a person’s risk of developing back pain. People who sit and slouch all day are more likely to have bad posture, which can also contribute to back pain. This type of pain can occur on either side of the back.

Learn how exercise and diet can help treat back pain.

Arthritis

Most back pain is temporary. However, arthritis-related back pain is a chronic condition. According to the Arthritis Foundation, people often experience arthritis of the lower back, but it can occur in the middle back area.

There are many forms of arthritis, so the treatment depends on the type of arthritis a person has.

An example of a type of arthritis that can affect the spine is ankylosing spondylitis (AS). The pain usually starts in the lower back, but a person with AS may also have middle back pain.

AS causes a dull and diffuse pain instead of sharp, localized pain. It can occur on only one side of the body, sometimes alternating.

Learn about different types of arthritis here.

Injury

While it is possible to injure the thoracic spine, the American Association of Neurological Surgeons (AANS) indicate that it is an unlikely spot for an acute injury because it is much more rigid than other spinal areas.

Herniated disk

However, injuries do happen. For instance, a herniated disk in the middle of the back can press on a nerve, causing pain in the middle back, along with weakness and numbness.

Other symptoms of a herniated disk in the thoracic spine include:

  • chest pain
  • pain upon taking a deep breath
  • pain around the rib cage

Learn about what causes a herniated disk and how to treat it here.

Sprains and strains

Most mild injuries, such as sprains and strains, will heal on their own. Rest, physical therapy, and over-the-counter (OTC) nonsteroidal anti-inflammatories (NSAIDs) can help speed recovery.

Learn the differences between a sprain and strain here.

Spinal injuries

Serious spinal injuries, such as those resulting from a car accident, may require surgery. Severe spinal injuries may even leave individuals paralyzed.

Learn more about different types of paralysis here.

Muscles and soft tissue

Muscular or soft tissue issues of the middle back may cause the following sensations:

  • sharp pain
  • aching
  • throbbing
  • weakness
  • muscle fatigue
  • spasms

If the problem is nerve-related, a person may feel the following:

  • burning
  • shooting pain
  • weakness because of nerve impingement
  • tingling or numbness

Learn how a pinched nerve can cause back pain here.

Kidney pain

People sometimes mistake pain in the kidneys as back pain. The kidneys are under the rib cage on both sides of the spine.

Pain due to a kidney infection or kidney stones can sometimes feel like back pain in the middle back. The pain may occur on one side or both.

Other symptoms of a kidney infection include:

People with kidney stones may experience the following in addition to back pain:

  • strong urge to urinate
  • frequent urination
  • painful urination
  • blood in urine
  • nausea and vomiting

People who suspect they have a kidney infection should seek immediate medical care.

While some kidney stones may pass easily, larger stones can be unbearably painful and may require surgical intervention.

Learn the differences between back and kidney pain here.

Scoliosis

People with scoliosis have abnormal spinal curvature. According to the AANS, about 2–3% of people in the United States live with this condition.

Not everyone with scoliosis develops back pain. The site of the pain depends on the degree of severity of the curvature.

Other symptoms of scoliosis include:

  • uneven shoulder height
  • protruding shoulder blades
  • head off-center
  • unusually high hips
  • asymmetrical rig cage height
  • abnormal skin texture along the spine
  • leaning to one side

Treatment for scoliosis may involve a wait-and-see approach in children and teens. Other treatment options include bracing and surgery.

Learn about exercises and stretching for scoliosis here.

Pancreatic cancer

According to the American Cancer Society, abdominal pain that turns into or radiates to the middle back pain is a possible symptom of pancreatic cancer. Depending on the location of the tumor, pain may have various possible locations.

Other symptoms of pancreatic cancer include:

  • jaundice
  • dark urine
  • itching
  • pale-colored stools
  • poor appetite
  • unexplained weight loss
  • diabetes

Often doctors do not diagnose pancreatic cancer in its early stages, and according to the American Cancer Society, it has a low 5-year survival rate. Possible treatments include surgery, ablation, radiation therapy, chemotherapy, and immunotherapy.

However, the cause of these symptoms is usually something other than pancreatic cancer.

Learn more about back pain and cancer here.

A doctor may prescribe medications or, in more severe cases, recommend surgery.

A person can also use several home remedies for middle right back pain, including:

  • using hot or cold therapy
  • taking OTC NSAIDs
  • stopping or limiting activities or exercises that worsen the pain
  • maintaining proper form and posture throughout the day
  • switching positions frequently
  • avoiding sitting too long
  • using supportive seating when working
  • changing sleeping position and avoiding sleeping on the stomach
  • avoiding lifting heavy objects or carrying heavy loads

Learn more about home remedies for back pain here.

The following videos show how to do some stretches and exercises to help strengthen and stretch the back muscles and prevent and treat pain.

Knee-to-chest

This stretch involves lying down on the back with feet positioned flat on the floor. The person can also sit in a chair.

Pull one knee into the chest and hold the position for about 5 seconds, then change sides. Keep the spine pressed to the floor.

Cat-Cow Pose

Start on all fours in the tabletop position. Then, arch the back upward like a cat and then lower it, bringing the belly toward the floor.

Repeat with each leg several times.

Child’s Pose

This easy yoga pose helps elongate and stretch the spine.

Kneel with the buttocks resting on the lower legs and feet. Place the knees apart in a comfortable position.

To perform the stretch, fold forward and lower the chest down to the knees.
If possible, bring the forehead to the floor, but this is not a requirement.

Stretch the arms long in front of the body with the hands on the floor. Hold the pose for 20–30 seconds before returning to a sitting position.

Bridge Pose

To perform the Bridge, lie on the back on the floor with the knees bent and feet flat. Gently raise the buttocks off the floor while squeezing the bottom and abdominal muscles.

Hold the position for several seconds, then release and slowly lower the buttocks down to the floor.

If performing specific movements causes a person’s pain to worsen, they should stop immediately. A medical professional can help an individual determine which exercises are safe and appropriate.

If performing specific movements causes a person’s pain to worsen, they should stop immediately. A medical professional can help an individual determine which exercises are safe and appropriate.

Learn how to do six yoga poses that help with back pain here.

Doing regular exercises to strengthen the muscles in the back and abdomen can help prevent back pain. A healthful diet is vital to help maintain a healthy weight and a strong spine.

People can also work on their posture and try to avoid slouching when sitting or standing.

Another way to avoid back pain is to use proper form when exercising and when lifting heavy objects. Always use the legs and abdominal muscles rather than the back when lifting to prevent injury.

Learn about exercises to improve posture here.

A doctor will ask about family and medical history to determine whether an acute injury or medical condition is causing a person’s back pain.

A doctor may also ask about the specific location of the pain. A physical exam will help a doctor reach a diagnosis.

They may also order blood tests, X-rays, and other imaging tests to confirm a diagnosis.

People should see a doctor if their back pain does not improve after several weeks.

A person should also visit a doctor if they experience the following symptoms with back pain:

  • tingling and numbness
  • pain that does not improve after they take medication or change position
  • pain that occurs after an acute injury or fall
  • difficulty urinating
  • numbness, weakness, or pain in the lower extremities
  • fever
  • unintentional weight loss
  • severe stiffness in the spine

Back pain is an incredibly common ailment. Middle right back pain can happen for various reasons, including injury or issues affecting internal organs.

Being specific about the location and type of pain can help a doctor diagnose the issue.

People can often find relief from back pain with home remedies, such as OTC pain relievers and rest.

If the middle right back pain does not go away or worsens, a person should see a doctor.