Upper and middle back pain occurs 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. Disks reside between them.
The spinal column protects the spinal cord. The spinal cord is a long bundle of nerves that allows the brain to communicate with the rest of the body. There are a number of ways the bones, muscles, ligaments, and disks in the spine can irritate or injure the nerves, causing back pain.
Causes
Though it is less common than lower back pain or neck pain, a study posted to Occupational Medicine indicated that 1 in 10 men and 1 in 5 women might suffer from upper back pain. Doctors call upper back pain thoracic spine pain or TSP. Common causes include the following:
Muscle deconditioning and poor posture: People can condition their muscles over time to be stronger or more enduring through exercises and weight training. The reverse is also true. Humans may decondition their muscles over time by not using them correctly. In some muscles, including back muscles, deconditioning is as easy as sitting at a desk with incorrect posture for too long. A person may do this while at work.
Muscle overuse: Overusing back muscles is another common cause of upper back pain. This typically occurs due to repeating the same motions over time.
Traumatic injury: A traumatic injury can also lead to back pain. This may be the result of situations that include:
car accidents
slipping and falling
work-related accidents
lifting incorrectly
working out too hard
The injury is sometimes obvious, and pain appears just after the incident. At other times, the pain may not develop until later or the next day.
Herniated disc: Herniated discs are more common in the lower back but may sometimes happen in the upper back too. Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine.
Osteoarthritis: The source of back pain is sometimes not the muscles, but a problem in the bones and joints. The cartilage that cushions and protects the bones may wear down as a person ages. The term for this is osteoarthritis. It is the most common form of arthritis among older adults, according to the United States National Institute on Aging.
Myofascial pain: Pain may also stem from problems in the connective tissue in the back, which doctors call the fascia. Myofascial pain may begin after an injury or overuse, but chronic myofascial pain may last long after the initial injury. It is still uncertain why myofascial pain continues in some cases. Doctors may recommend physical therapy and myofascial release therapy to enable a person to work the fascia and relieve the pain.
Spinal infection: Rarely, an infection may be the cause of upper and middle back pain. A spinal epidural abscess is a collection of germs and pus that form between the spinal cord and bones of the spine. The abscess can grow and swell, leading to pain. Early diagnosis is critical, and doctors will treat a spinal abscess quickly to avoid serious complications.
Treatment
Treatment for middle back pain varies based on the cause of the pain. Because back pain is fairly common, most people first attempt to treat it at home using simple, inexpensive, and noninvasive treatment methods. If home remedies don’t help your symptoms, medical treatments or surgery may be required.
Home remedies
There are several methods you can do at home to treat middle back pain:
Ice the area and later apply heat. This is one of the most common methods that can provide immediate relief.
Consider taking over-the-counter pain medications, such as ibuprofen (Advil) and naproxen (Aleve), to reduce swelling and pain.
Stretch and strengthen the back muscles by doing exercises such as yoga.
You can also work toward improving your posture to help ease back pain. Try these tips:
Avoid slouching.
Keep your shoulders back when standing.
Take standing breaks if you sit for long periods of time.
If you have a desk job, adjusting your chair and computer monitor height, keyboard, and mouse positioning can all enable good posture.
Medical treatments
If your back pain lasts more than 72 hours and home remedies aren’t alleviating the pain, see your doctor. They may recommend:
physical therapy
prescription pain relievers or muscle relaxers
chiropractic care
steroid injections
Surgeries
If these noninvasive treatments don’t help your middle back pain, your doctor may recommend surgery. There are a number of different procedures that could help your back pain, depending on the cause. Recovery from surgery can take several months.
Some possible surgeries include:
Laminectomy. This surgery removes the entire lamina, or the back wall of a vertebrae, to decompress the spinal cord.
Laminotomy. This procedure removes part of the lamina to alleviate a pinched nerve.
Diskectomy. This surgery removes part of a spinal disk to alleviate a pinched nerve.
Upper back and Middle back pain can stop you in your tracks, making it difficult to go about your typical day. The reasons behind this discomfort vary, but they all come down to how we hold ourselves while standing, moving, and — most important of all — sitting.
