Characterized by symptoms that might include dull pain, burning sensations, sharp, stabbing pain, and muscle stiffness or tension, back pain felt between the neck and lower ribcage (T1 to T12 vertebrae) is referred to as middle back pain. While a lot of attention is given to the neck and lower back, discomfort in the mid-back area (thoracic spine) can be just as disruptive to daily life. For this reason, it helps to have a better idea of what could lead to middle back pain. Here are some of the common causes and contributing factors.
1. Posture Issues
The muscles and ligaments that support your mid-back are going to have to work harder if you routinely slouch or bend excessively forward while using handheld devices or performing certain tasks. Make an effort to sit and stand straight with your head and shoulders aligned to avoid overstressing middle spine muscles.
2. Excess Weight
There’s plenty of research suggesting a link between carrying around too many pounds and back pain, and this also applies to the middle part of the spine. As your weight increases, so does the pressure placed on your spine and its discs, vertebrae, joints, and supporting muscles.
3. Soft Tissue Sprains and Strains
Improperly lifting something heavy or excessively twisting or turning beyond your normal range of motion are among the common ways the soft tissues that support your spine may become sprained or strained. Specifically, sprains involve the tearing or stretching of back-supporting ligaments, and strains affect muscles and tendons. This type of middle back pain is usually temporary and treatable with rest, activity modification, and the use of anti-inflammatory and pain medications.
4. Falls and Other Unexpected Injuries
When you fall or experience a hard impact, you’re more likely to injure your lower back or neck, since these areas aren’t as well protected and stable as the mid-back is. Still, falls and other injuries can affect the thoracic spine under certain circumstances. Your mid-back may also become injured from:
• Car accident impacts
• Sports-related injuries
• Falls down steps or off of ladders
• Forceful impacts
• Slip-and-fall accidents on sidewalks
If you experience a traumatic back injury that doesn’t improve with time and self-care, see your Santa Monica spine surgeon right away. Early diagnosis of issues such as fractures and muscle tears is crucial for getting treatment that prevents long-term damage.
5. Spinal Disc Damage/Herniation
When inner disc material pushes through the harder exterior part of a spinal disc, the result is what’s referred to as a herniated (“bulging”) disc. This type of disc damage may irritate nerves within the middle back area enough to cause pain, numbness, tingling sensations, and general weakness in the thoracic spine or nearby areas along the affected nerve’s pathway.
6. Osteoarthritis (OA)
Often referred to as “wear-and-tear arthritis,” osteoarthritis slowly breaks down the cartilage that covers spinal joints. This deterioration sometimes leads to increased bone friction and middle back pain. OA isn’t entirely preventable, although its progression may be slowed with improvements to diet and exercise habits.
7. Age-Related Wear
Middle back pain linked to age-related spinal changes is most likely to begin occurring between the ages of 30 and 50. Over time, thinning bones, a reduction in muscle mass, and a loss of natural spinal disc “sponginess” can increase the odds of experiencing mid-back pain.
As is the case with OA, the most effective way to minimize issues linked to age-related spinal wear is to be mindful of diet and exercise habits. It can also be helpful to increase your intake of certain nutrients, especially calcium and vitamin D.
8. Spinal Fractures
Bone-thinning disease (osteoporosis), not wearing sufficient protective gear while playing sports, and injuries sustained during a hard fall or car accident are just some of the possible causes of spinal fractures that may affect the middle back.
Thoracic spine fractures tend to be affected by movement and may produce symptoms that include pain, numbness, and tingling sensations. Vertebrae, discs, spinal joints, and the spinal cord may all be affected by fractures. Treatment, which will depend on the severity of the fracture, may involve:
• Analgesic pain medicines and/or bed rest
• Wearing a back brace
• Physical therapy
• Surgery that may include special cement and/or the use of a surgical balloon (vertebroplasty or kyphoplasty)
Middle back pain is normally diagnosed with a combination of results from a physical exam, image tests, and specialized tests that may include neurological evaluations. Since the mid-back area can present certain surgical challenges because of its proximity to organs and the ribcage, treatment usually starts with conservative efforts (e.g., medication, steroid injections, physical therapy, and/or alternative options like chiropractic care). If symptoms are severe or persistent, it may be time to consider disc removal (discectomy), removal of part of a vertebral bone (laminectomy), fusion surgery, or spinal fusion alternatives. Santa Monica patients should see a specialist as soon as possible if pain in the middle back is intense or doesn’t respond to conservative treatment.
If you’re experiencing pain in your middle back that doesn’t go away with rest and/or over-the-counter medication, see a physician to make sure you don’t have a serious underlying cause that needs more specialized treatment. The industry-leading spinal health experts at The Spine Institute have years of experience treating pain in every area of the back and neck. Schedule an appointment today by calling one of our friendly representatives at 310-828-7757.