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Middle Back Pain: Where It Comes from and How to Get Relief

The body is an amazing machine. But we must remember machines can break down and be out of commission for repair. One of the most troublesome malfunctions we experience is middle back pain. Experts say back pain is the most common reason people miss days at work, and the third most common ailment that drives people to see a doctor. In fact, 80 percent of adults will experience back pain at some point in their lives.

Although we can experience middle back pain at any age, it is usually felt between 30 and 50 years of age, as the body ages, the spine is more prone to injury and often begins to show signs of wear and tear. That “machine” is not able to bounce back from activities as it once did.

There are different types of back pain. The upper back, the neck and shoulder area is where we commonly feel stress and tension. The lower back is where we feel strains from over-exertion. But the middle back can also be the source of pain and discomfort. The location we are focusing on is below the neck and above the bottom of the rib cage, in an area called the thoracic spine. There are 12 back bones — the T1 to T12 vertebrae — located in this area. In this location, you have the spinal cord, nerves, discs, muscles, blood vessels, ligaments, and tendons. Anatomically, the thoracic spine does not move as much as the spine in the lower back and neck because it is attached to the ribs, however it can become irritated or inflamed in response to a variety of mild to serious conditions.

Symptoms of Middle Back Pain

It’s important to seek the diagnosis of a pain management specialist for serious or prolonged middle back pain. Symptoms can be mild to severe and be a sign of a bigger health issue to be addressed. You may feel muscle ache, dull pain, a burning sensation, sharp or stabbing pain, muscle tightness or stiffness.

Causes of Middle Back Pain

While there may be many causes of middle back pain, healthcare professionals are conducting on-going studies which show a correlation between mental health issues and back pain. Question is, can stress cause back pain? The answer is, yes. According to the American Psychological Association, being in a state of constant stress or chronic stress produces chemical and physical reactions in your body to try and protect you from harm. It’s the release of the hormones, cortisol and adrenaline, which causes muscles to involuntarily tighten. If those muscles remain tense for a period of time, you are left with back pain and headache. The mind-body connection goes both ways. While anxiety and depression can cause back pain, on the flip side, chronic back pain can lead to a patient being depressed dealing with the discomfort.

Additionally, specialists classify middle back pain into three categories: disease and disorders, structural issues, and systemic issues.

Contact National Spine & Pain Centers to schedule an appointment with an affiliated pain specialist today.

Structural Middle Back issues include:

Poor posture

Slouching causes the muscles in your back to be overworked because they are being placed in unnatural positions. The repeated pressure on the spine is overworking the muscles and ligaments that are trying to keep the body in balance.


Extra weight on the spine puts undue strain on the muscles.

Muscle sprain or strain

Sudden or awkward movements or lifting heavy objects improperly can tear or stretch ligaments and muscles.

Fall or other injury

The middle back is more structured and rigid and less likely to get injured. However, injury from sudden force like taking a hard fall, car accident, blunt force trauma or sports-related injury, can be damaging and should be examined immediately by a pain management specialist.


As we age, the loss of muscle mass, thinning bones and loss of fluid in the joints can make us more prone to back injuries.

Disease and other disorders leading to middle back pain include:

Herniated disc

A herniated disc also referred to as a slipped or ruptured disc occurs when the inner, gel-like core of a disc in your back pushes against the outer ring of cartilage, putting pressure on a nerve. That pressure may cause pain, tingling or numbness in the middle back.

Pinched nerve

This is when there is pressure put on a nerve by the surrounding tissues like cartilage, muscles and bone. You may feel pressure on one side of your back.


This is a degenerative joint disease. It occurs when the cartilage covering your joints breaks down, causing bones to rub together.


This is a condition usually seen in older adults when bones become weak and brittle.


This is inflammation of a bone or bone marrow, usually caused by infection.

Spinal stenosis

This is the narrowing of the spinal canal. That movement puts pressure on the spinal cord and nerves causing middle back pain.


An infection or inflammation of the spinal joints.


A disorder characterized by widespread musculoskeletal pain which can affect the middle back.


Vertebrae fractures often occur following trauma, such as a fall, car accident, or sports injury, but can also occur with activity as simple as bending or twisting.

Fractures can cause severe middle back pain that gets worse if you move or even take a deep breath. If you’re also experiencing incontinence (inability to control your urine), tingling, or numbness, your fracture may be impacting the spinal cord as well.

Systemic Issues Causing Middle Back Pain

Other body systems may cause middle back pain, these issues can be concerning and life threatening. See a healthcare specialist immediately if you have any of the following: pain on one or both sides of your back, pain that radiates down one or both of your legs, neck pain, arm or leg pain, tingling, numbness, or weakness in your arms, legs or chest, chest pain, loss of bowel or bladder control.

These are danger signs of potential problems like:

Aortic aneurysm- life-threatening bulging and weakening of the wall of the aortic artery that can burst and cause severe hemorrhage.

Gastric Ulcer- erosion of the stomach lining which can send radiating pain to the middle back.

Heart attack - occurs when part of the heart muscle doesn’t receive blood. It can send shooting pain to the arms and middle back.

Indigestion- Discomfort in the abdomen caused by food eaten, may cause gas which puts pressure on the back.

Kidney Stones- Kidney stones are small pieces of hard, crystallized material that form in the kidney. As the stones pass through the urinary tract, they can cause debilitating pain through the middle back. There may be other symptoms you experience with kidney stones like nausea, painful or discolored urine and pain through the urinary tract.

Multiple myeloma- bone marrow cancer.

Pancreatitis- inflammation of the pancreas.

How to Get Relief

If you are experiencing prolonged or chronic middle back pain, a pain management specialist from the National Spine and Pain Centers will give you a physical exam along with a neurological test as an indicator of any possible spinal cord or nerve issues. You will likely also receive imaging tests, like X-ray, CT scan, MRI or ultrasound, to check for fractures, bone degeneration or misalignment which may be the source of your pain. Results will determine the best course of action for pain relief.

Home remedies for middle back pain include: ice and heat, over-the-counter pain medications, stretching, or physical therapy.

To prevent further problems, you may try to avoid slouching and improve posture. Remember to keep your shoulders back when standing. If your job requires you to sit for long periods of time, try to get up and move, stretching when you can. Strengthen your core, that is key to a strong back. Be aware of your sleeping position, to prevent middle back pain, avoid sleeping on your back. Instead, sleep on your sides with a pillow between your legs to alleviate back strain.

Most importantly, if you are concerned about middle back pain you are experiencing, book an appointment with a pain management specialist from the National Spin and Pain Centers.

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