Types of Back Pain: Middle Back Pain vs. Thoracic Back Pain

When it comes to back pain, one size doesn’t fit all. Not only can pain occur anywhere along the spine or in the adjoining muscles, but it can vary drastically in intensity and frequency. Because the spine is the casing that protects the most important elements of the Central Nervous System, back pain of any kind can be a warning sign of damage that should be taken seriously. Left untreated, some causes of back pain can lead to permanent spine or nerve damage.

Types of Back Pain

Back pain of any kind can be either acute or chronic. If the pain is acute, symptoms are generally sudden and temporary. In chronic cases, however, the pain returns regularly, over time—sometimes unpredictably—and can make everyday activities difficult.

Back pain can occur for a variety of reasons, including the following:

  • Herniated disc(s)
  • Muscle strains (from overuse or poor posture)
  • Muscle injury
  • Pinched/compressed nerves
  • Narrowing of the spinal canal ( spinal stenosis)
  • Vertebral fracture(s)
  • Osteoporosis
  • The natural processes of aging
  • Spondylitis (a spinal infection that creates inflammation)
  • Scoliosis
  • Tumors
  • Degenerative disc disease

… and more

The regions of the back and spine can be separated into multiple sections: the cervical region (the vertebrae of the neck), the thoracic region (the vertebrae of the upper back), and the lumbar region (or lower back). The “middle back” is a somewhat generalized term that refers the area below the ribs and above the hips.

Middle and thoracic back pain are not as common as neck and lower back pain, of course, as the vertebrae in the middle regions of the spine do not typically flex as much as the vertebrae at the ends of the spine, which allow you to move your head and hips. For this reason, middle and upper back pain can often be a sign of something other than muscle stress.

Thoracic Back Pain

The thoracic spine comprises the twelve vertebrae to which the ribs attach and could, therefore, be described as the “upper back” region. When compared with neck (cervical) pain, middle back pain and lower (lumbar) back pain, pain in the thoracic region of the spine has a greater probability of being caused by a serious underlying condition. 1 Because of this, it’s important to keep an eye out for incidents and symptoms such as these:

  • Fever and/or chills
  • Unexplained/uncontrollable weight loss
  • Noticeable deformity
  • Nerve pain/numbness/tingling in the legs or lower body
  • Severe stiffness, particularly in the morning (which could be a sign of rheumatoid arthritis)
  • Physical trauma (e.g., from a recent car accident)
  • Onset of pain before the age of 20
  • Onset of pain after the age of 50
  • Constant, severe pain that is not helped by changing position

… and others


If you experience thoracic back pain after a recent trauma or develop any of these unusual symptoms at the same time, do not hesitate to see a doctor. Because this portion of the spine is connected to the ribs that keep your lungs and heart protected, damage to the thoracic vertebrae can affect your cardiopulmonary system as well.

Middle Back Pain

Although middle back pain is sometimes considered synonymous with thoracic back pain, it can generally be described as pain that occurs above the lumbar region of the spine but below the rib cage. In cases of middle back pain, the symptoms can be vague and difficult to diagnose, which can be especially frustrating in chronic cases.

There are a number of elements that can increase a person’s risk of developing middle back pain, including the following:

  • Pregnancy
  • Weight gain/obesity
  • Lack of physical activity
  • Stress and anxiety
  • Smoking

… and more


As with thoracic back pain, any sudden or unusual symptoms like fever, chills, dizziness, or weight loss can be a sign of something that goes beyond back pain. If you experience such symptoms, seek medical attention right away.

Treatment (and Prevention) of Back Pain

The treatment for a patient’s back pain depends strongly upon its cause and location; however, many conditions can be at least partially relieved by a combination of non-invasive techniques, including professional massage, physical therapy, and other treatments that can be performed by the patient at home.

For particularly severe spinal conditions that can’t be treated by non-invasive means, there are a number of surgical options that can be employed, some of which are minimally-invasive. For both thoracic and middle back pain, common surgeries include discectomy and/or vertebral fusion.

As its name suggests, a discectomy involves the removal of all or part of an injured spinal disc. Vertebral fusion, on the other hand, focuses on creating a strong structure from two adjacent vertebrae by physically joining them together (often also replacing the disc with an appropriate spacer). In some cases, these two procedures will be performed together.

The most important thing an individual can do is to protect his or her back before a painful condition can develop. To maintain good back and spine health, doctors recommend developing an appropriate diet and exercise regimen, using proper posture, sleeping on your side for good spinal support, quitting health-impacting vices like smoking or excessive drinking and generally reducing stress. 2

The following few exercises take only a few minutes a day to complete and are recommended by the Mayo Clinic for the prevention of back pain:

  1. Knee-to-chest stretch: Lie on your back with your feet flat on the floor and your knees bent. Pull one knee to your chest and hold it for five seconds, making sure your spine stays pressed to the floor. Return to the first position and repeat with the other leg for two to three repetitions.
  1. Bridge exercise: From the same starting position as the first exercise, tighten your abdominal and gluteal muscles and bring your hips up so that your body forms a straight line. Hold the position for three breaths, then return to the starting position. Repeat for five repetitions on the first day and work your way up to 30, over time.
  1. Cat stretch: Start on your hands and knees, then arch your back slowly upward. Next, arch your back slowly in the other direction, letting your midsection sag downward. Return to the first position. Repeat this exercise twice a day for three to five repetitions.
  1. Shoulder blade squeeze: Sit on a chair that does not have arms and assume proper posture. Without changing posture, pull your shoulder blades together and hold them for five seconds before returning to the starting position. As with the cat stretch, repeat this exercise twice a day for three to five repetitions.

Weill Cornell Medicine: Comprehensive Spine

If you’re experiencing back pain of any kind that preoccupies you, makes it difficult to accomplish everyday tasks, and/or is accompanied by other symptoms, it’s time to be seen by a spine specialist.

Weill Cornell Medicine: Comprehensive Spine in New York, NY is one of the nation’s foremost providers of minimally invasive spinal surgery and treatments. Our experienced neurological professionals will be able to diagnose your condition, determine its severity, and help you identify the best course of action with regard to back pain treatment and management.

Don’t let your back pain control your life; contact us today at 1-866-426-7787 to make an appointment to be seen by one of our expert physicians.

Sources

1. http://patient.info/doctor/thoracic-back-pain

2. http://www.everydayhealth.com/pain-management/back-pain/quick-tips-to-help-prevent-back-pain.aspx

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