What Is Middle Back Pain A Symptom Of? 

what is middle back pain a symptom of?

Have you got a mysterious pain right in the middle section of your back?

Discomfort below your shoulder blades and above your tailbone? 

Understanding Middle Back Pain

Understanding middle back pain

We refer to middle back pain as any pain between the lower part of your ribcage and just below the start of your neck. That part of your spinal cord is called your “thoracic spine.” There are 12 vertebrae in this region of the back (T1 – T2), with spinal disks inside them. 

Your spinal cord itself is a large stretch of nerves inside your spinal column that connects your brain to the rest of your body.

Think of it like a telephone wire that sends messages, movement instructions, and sensory information to and from your brain. Communicating with your hands, feet, fingers, and every other cell and organ inside your body. 

The causes of all types of back pain can be numerous, including:

  • Injuries
  • Overexertion
  • Strain
  • Damage to the discs, muscles, ligaments, connective tissue, or spinal bones

But what exactly is middle back pain a symptom of?

What Are The Symptoms of Middle Back Pain?

What Are The Symptoms of Middle Back Pain?

The symptoms we link with middle back pain are subject to the specific medical condition and/or cause. For example, your other presenting symptoms may include urinary incontinence if your middle back pain relates to a pinched nerve. If you have middle back pain related to arthritis, your symptoms may also include pain in your other joints and pain in the middle section of your back. 

Other varying symptoms that accompany middle back pain could be: 

  • Waking up with back stiffness 
  • Swelling and redness of the back 
  • Neck, shoulder, or hip pain
  • Depression with feelings of anxiety
  • Fibromyalgia/Chronic fatigue
  • Headache accompanied by fever 
  • Sleep issues and insomnia
  • Excessive fatigue 

In some instances, other symptoms might occur with middle back pain that could be serious and require immediate medical attention, e.g., a heart attack.

Some of the signs that your middle back pain might be severe and need swift medical attention include:   

  • Acute abdominal pain
  • Shortness of breath or difficulty breathing
  • Pressure or pain in the chest
  • Any incontinence
  • Feeling severe numbness/ weakness in the limbs
  • Severe pain in the jaw 

What Causes Middle Back Pain?

What Causes Middle Back Pain?

Your middle back is made up of the thoracic spine, which encases the spinal cord nerves. Within each vertebra in the middle back are cartilage sacs known as discs that provide cushion-like support and help in the spine’s mobility.

In addition, there are ligaments, tendons, and muscles that offer additional support. If any of these structures within the middle back get inflamed due to any damage, it can cause various medical conditions, including some serious ones.  

One of the more common causes of mild to severe middle back pain is any sudden or awkward movement while active or playing sports like twisting or over-extending.

However, this type of injury is more likely to occur if you have a sedentary lifestyle. When your bones lack support and stabilizing muscle tone, making you more susceptible to middle back pain injuries. 

Certain severe medical conditions can also cause middle back pain. These conditions include spondylitis, a herniated disc, or fibromyalgia.

In addition, any disc within the spinal cord that is “bulging” can cause the buildup of spinal pressure upon the nerve roots that leads to severe middle back pain.  

Other parts of your body, like your digestive system or heart, can also be the underlying cause of middle back pain.

We call this type of pain referred pain because although you may feel the pain in your middle back – the actual root cause is a different part of your body. 

Some of the other causes of middle back pain that we see are related to connective tissue or bone disorders, such as:

  • Spinal stenosis causes a buildup of pressure on nerves and the spinal cord
  • Loss of bone tissue or malformation due to Paget’s disease
  • Osteoarthritis 
  • Degeneration of the spine spondylosis  
  • Weakening of the bones – known as “Osteoporosis.” 
  • Having a herniated disc 
  • Osteomyelitis: leads to inflammation and infection in the bones
  • Spondylitis: inflammation in the joints of the spine 

You could also have some underlying structural issues that could be causing your middle back pain, like: 

  • Muscle spasms
  • A spinal fracture 
  • A condition called Scoliosis (curved spine) 
  • The curvature of the upper spine due to “kyphosis.” 
  • Strain or sprain of the back due to injury or exertion
  • A benign or malignant tumor

Finally, but more rarely, middle back pain can occur due to several other underlying medical conditions that could lead to back pain like: 

  • Fibromyalgia
  • Gastric ulcers
  • Inflammation of the pancreas known as pancreatitis
  • Multiple myeloma
  • Severe indigestion or GERD
  • Malignant tumor in the abdomen
  • Kidney stones
  • Having a heart attack
  • An aortic aneurysm 

Who Is At Risk From Middle Back Pain?

Who Is At Risk From Middle Back Pain?

While middle back pain can afflict people of all ages, some people are more prone to experiencing it in their lifetime. Generally, we see middle back pain more often in people aged 30 – 50. Aging combined with lifestyle and activity levels plays a crucial role in middle back pain. It can happen to anyone, but those most at risk of middle back pain are:

  • Those with an acquired or congenital deformity are more susceptible to middle back pain.
  • The elderly as the bones and tissue weaken because of wear and tear.
  • Those maintaining a sedentary lifestyle with little or no physical activity.
  • Those who maintain a poor posture and have weak core muscles.
  • People undergoing excessive anxiety or stress.
  • Smokers (if you smoke, you’re at high risk of this and many other conditions).
  • The obese: obesity is one of the top causes of middle back pain because of the extra weight on the spinal cord.
  • Pregnant women often experience middle back pain.
  • Those with a family history of back-related medical conditions. 

What Is The Treatment For Middle Back Pain?

What Is The Treatment For Middle Back Pain?

The most effective treatments for middle back pain tend to vary depending upon the underlying condition and/or cause since it is a common pain complaint like lower back pain.

Most people initially resort to treating it conservatively at home – preferring not to seek professional treatment.

However, this strategy is a false economy in most cases and only serves to delay healing. Plus, ignoring middle back pain could worsen the problem and cause the pain to become more severe. 

DIY treatments for middle back pain: 

  • The most convenient at-home method for treating mild middle back pain is hot/cold packs to relieve the inflammation and reduce pain. 
  • You can take over-the-counter pain medicines and anti-inflammatories for pain and swelling (but only for a limited number of days).
  • Doing stretching movements and exercises that strengthen weak back muscles can sometimes help mild middle back pain.
  • You can also work on maintaining the correct posture to prevent middle back pain in the following ways:
    • Get up from your seat every 15-30 minutes and avoid sitting for extended durations.
    • Do not slouch while sitting.
    • Choose a suitable desk if you have a sedentary job to maintain the correct posture while working.
    • Push your shoulders back when you stand upright 

Professional treatments for middle back pain

Professional treatments for middle back pain
Discus Hernia manual massage treatment. Physical therapist massaging lower back.

If the pain and swelling in your middle back persist for more than three days without relief from any of the above DIY remedies, it is essential to seek medical help – either from a trained physical therapist or medical doctor.

Your doctor might recommend any of the following to help with middle back pain:

  • Using prescription drugs to relieve pain and relax muscles
  • Taking steroid injections
  • Undergoing Physical Therapy
  • In severe cases that do not respond to conventional treatment, your doctor may also consider the option of surgery. However, the recovery period (back surgery especially) can be lengthy and take several months, so surgery should be an absolute last resort. 

Physical Therapy First 

Physical Therapy First 

There are numerous drugs and invasive treatments available to treat middle back pain. However, we always recommend physical therapy first for middle back pain and all other types of chronic pain.


Because we can usually find and treat the root cause quickly and prevent the need for pain pills, injections, and surgery altogether.

Pain pills and anti-inflammatory drugs only mask the pain. They do not resolve the condition. It is likely to come back with a vengeance as soon as you stop taking them.

So, let us find the source of your pain and protect your future health from the negative health consequences of chronic pain medication. Book your free consultation now. 

Andrew Vertson