Middle Back Pain Causes and Treatment

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Middle back pain, also known as thoracic spine pain, can be a persistent issue that affects many a lot of people, especially during activities like lifting and working on a computer.  But before you make a decision on how to treat your middle back pain, it’s important to know the causes for the pain in the first place.  Here, we help you understand three common causes of middle back pain and discuss the best treatments to decrease and prevent pain in your thoracic area, or middle back.

Degenerative Conditions in the Neck:

One common cause of thoracic spine pain is degenerative conditions in the middle to lower part of the neck.  Arthritic conditions such as degenerative disc disease (also known as spondylosis) and cervical stenosis can refer pain into the thoracic region.  Other conditions like rheumatoid arthritis can also affect the thoracic spine, leading to inflammation, stiffness, and pain.  Although both the cervical and thoracic areas are less prone to disc herniations compared to the lumbar spine, they can still occur.  When a disc in the cervical or thoracic region bulges or ruptures, it can put pressure on nearby nerves, causing radiating pain into the middle back, and sometimes down the arm.

While you may not always notice your neck pain, ask yourself if the pain worsens when moving your neck in specific directions, like looking side-to-side and upward, or when you adopt certain neck postures. This self-evaluation can offer insights into the potential cause of your pain.

Treatment Approach:

Pain caused by this reason often responds well to exercises and movements that target the neck and surrounding areas.  Strengthening, mobility and postural exercises for your neck can alleviate referred pain to the thoracic spine.  It’s also important to emphasize practicing proper neck posture daily to prevent and manage degenerative conditions.

Postural Overloading:

Prolonged stooped or slouching positions or sitting for extended periods of time without back support can often strain the muscles and ligaments in the thoracic spine, leading to middle back pain.  Overexertion or sudden/awkward movements that stress your middle and upper back can result also result in pain. This can happen during activities such as resistance training, sports, lifting heavy objects or engaging in repetitive motions without proper support.

To test if this is related to your middle back pain, assess your posture standing or sitting sideways to a mirror– are you slouched forward?  Is it reproducing your middle back pain or discomfort?  Does it feel natural to sit in a slumped posture?  Then correct your posture by lifting your collar bones upward and notice if this helps reduce your pain.  If it does, your middle back pain may be related to postural overloading.

Treatment Approach:

In mild to moderate acute pain, rest, ice and/or heat can help the painful muscles to settle down and reduce any inflammation.  It is also important during this initial phase to avoid any activities that may worsen or aggravate the area.

Once settled down, a typical approach would be to work on developing your muscle endurance to improve posture that keeps you out of positions that aggravate your pain.  Instead of pressing into painful end ranges of motion, you should be encouraged to “go tall” in both sitting and standing positions.  Specific exercises such as these help to target the upper back and neck muscles to maintain a more upright posture and reduce the risk of postural overloading.

Osteoporosis-Related Fractures:

Although Osteoporosis has traditionally been seen in older female patients, an increasing number of men and younger, especially athletic, females are being diagnosed.  Bone mineral loss specifically leads to a weakening of the thoracic vertebrae, making them more susceptible to compression fractures, that often happen without being noticed.  These fractures can also occur after lifting, bending, twisting, or stooping.  Once acute symptoms settle down, emphasis shifts to developing muscle strength and endurance, particularly in the back extensor muscles.

To learn more about how to manage and reduce the risk of osteoporosis fractures, read our updated article on the newly-improved BoneFit certificate program from Osteoporosis Canada, that has been designed to help health professionals stay on top of the latest available evidence for their practices.

Treatment Approach:

Rehabilitation therapists can design tailored exercise programs focusing on strengthening the back extensor muscles while avoiding dangerous movements such as spine flexion or bending forward. These exercises should be performed diligently and initially supervised to ensure proper technique. The goal is to enhance muscle strength and posture, promote overall spinal stability and prevent further fractures.

When to Seek Professional Help:

While self-treatment is often effective for many causes of middle back pain, it’s essential to recognize when professional intervention is necessary. Consult your healthcare professional if:

  1. Pain persists or worsens despite self-care efforts.
  2. Pain is accompanied by numbness, tingling, or weakness in the arms or legs.
  3. Pain is the result of a traumatic injury, accident, or if you felt a sudden pain during a movement
  4. You are having trouble breathing or chest pain associated with thoracic spine discomfort.

Understanding the causes of middle back pain is crucial for effective treatment.  If you’re experiencing thoracic spine pain, consult with your rehabilitation professional for a thorough evaluation as the first step towards a pain-free and healthy back.  They play a pivotal role in addressing the root causes so you can make the best choices when managing symptoms.  Remember, taking charge of your posture and engaging in targeted exercises can make a significant difference in managing and preventing middle back pain.

For more information or to speak to a professional about your specific needs, please don’t hesitate to contact us by phone or email!  One of our expert therapists would be happy to help you find relief quickly!

This service pro­vides gen­eral infor­ma­tion and dis­cus­sion about therapy, health and related sub­jects. It is not meant to replace advice and/or treatment from your health care professional.