Middle Back Pain: Symptoms, Causes, Treatment, and Home Relief

Dr Philip Altieri

What is middle back pain? This is pain that occurs below the neck (cervical spine) and above the lower back (lumbar spine). This area is called the thoracic spine, commonly referred to as the middle back. The middle back is comprised of 12 vertebrae and is unique in that it articulates with all the ribs. The spine and ribs in the middle back also consist of the spinal cord, intervertebral discs, muscles, ligaments, and nerves. The middle back spinal area has an extremely important function in that it protects and controls vital organs such as the heart, lungs, stomach, liver, pancreas and gallbladder.

What are common middle back pain symptoms? There are several different symptoms that encompass middle back pain and to varying degrees of severity. Symptoms and severity will ultimately depend on the cause or origin of your pain. Some of the most common mid back pain symptoms include:

  • Muscle spasm and aches
  • Muscle tightness or stiffness
  • Burning sensation- especially along ribs
  • Sharp or stabbing pain- can be felt along ribs or chest
  • Dull achy pain
  • Numbness or tingling
  • Difficulty or increased pain with a deep breath
  • Increased pain with a sneeze or cough

Other more serious signs or symptoms would include:

  • Loss of bowel or bladder control
  • Severe chest pain that doesn’t subside
  • Prolonged weakness in arms or legs
  • Tingling or numbness in chest, abdomen, arms, or legs
  • Shortness or inability to breathe
  • Nausea or unstoppable vomiting

Middle back pain doesn’t always have to be of serious origin, and most of the time it’s not but it should not be ignored. Have your symptoms examined by a qualified physician like a chiropractor. Why a chiropractor you might say? A chiropractor is an expert in the field of diagnosing and treating middle back pain and can determine the origin of the symptoms. Chiropractors can help to differentiate if your mid back pain is of musculoskeletal origin or a more serious condition such as heart disease, cancer, ulcer or gallbladder problems to name but a few.

So, what are some of the more common causes of middle back pain?

  1. Muscle strain or sprain. Strains happen when muscles or tendons sustain tearing or have been over stretched beyond its limits. Sprains happen the same way but affect ligaments.
  2. Nerve pain. Thoracic spinal nerves can become compressed or irritated by subluxated vertebrae, discs disorders, lesions, or other conditions.
  3. Poor posture. Imbalances in the spine can cause vertebrae to misalign and put pressure on the nerves. Improper biomechanics cause the back muscles, tendons, and ligaments to overwork trying to prevent slouching. All this causes pressure on the spine.
  4. Bulging or herniated disc. When the disc weakens or starts to degrade they tend to form a bulge outward. If this continues, than the inner gel-like core pushes through the bulge causing mechanical pressure on the nerve and inflammation.
  5. Osteoarthritis (OA). This is degenerative joint disease, commonly referred to as arthritis. It occurs when the cartilage or joint space begins to breakdown and deteriorate, lipping and spurring on the bones and joints can form.  
  6. Facet syndrome. Similar to OA, except the synovial lining that covers the spinal joints deteriorate or breakdown, not allowing proper smooth movements to occur.
  7. Myofascial pain syndrome. This is considered a chronic pain disorder affecting connective tissue or muscle bundle groups. Muscle restriction and sensitivity occurs, trigger points typically form and is common in people with Fibromyalgia.
  8. Aging. Yes, unfortunately the older we get the natural breakdown process wears on the body. This normal aging process causes thinning bones, reduction in muscle mass, joint deterioration, spinal joints fluid reduction, degenerative disc disease, and loss of overall flexibility.
  9. Fall or injury. This can be due to a blunt force trauma, sports injury, car accident, slip and fall, or any abnormal eventful situation.
  10. Fractures. These are breaks or cracks in the vertebrae. They can be minor or of serious origin and caused by trauma, accident, a fall, or reduced bone density as seen with severe cases of osteoporosis.

There is however good news for the successful treatment of middle back pain! As with any painful condition, you or your doctor should not just treat the symptoms. What do I mean? Painkillers, anti-inflammatories, or over-the-counter medications may mask the underlying problem, give a false sense that the condition is better, and have unwanted side effects associated with taking them! Safe, gentle, effective chiropractic care can get to the root cause of your middle back pain and devise a personalized treatment plan to alleviate the pain naturally. Chiropractors are highly educated and trained in the differential diagnosis of mid back pain conditions. The beauty of receiving chiropractic care is three-fold, it can alleviate or reduce the symptoms, address and correct the underlying cause, and prevent the painful mid back condition from returning by maintaining your health and promoting optimal function. This can all usually be accomplished in a timely manner in a chiropractor’s office by implementing effective treatment protocols. Doctors of chiropractic not only adjust the spine to correct vertebral subluxations (misalignments) and reduce nerve interference, but, they also use such techniques as electro-muscular stimulation, ultrasound, cold laser therapy, myofascial release techniques, trigger point therapy, kinesiology taping, and physical therapy techniques to reduce pain, muscle spasm and inflammation. Other advanced treatment techniques such as decompression, flexion-distraction, computerized instrument assisted adjusters, neuromuscular re-education, biomechanical postural balancing, and musculoskeletal bracing all may be instituted in a chiropractor’s office such as mine to treat middle back pain.

What are some home remedies for middle back pain and how can you care for yourself? There are several things you can do for the short term relief of pain as well as the future prevention of it.

  • Rest. If the pain is persistent and hurts a lot, take a break. Be sure to not stay imobile too long though as you may become stiffer and tighter overall.
  • Heat. This can reduce pain, muscle spasm and stiffness, as well as increase blood flow to the area to promote healing. Be sure that it’s not too hot to prevent skin burning and don’t leave on for more than 20 min. at a time. This can be done several times per day.
  • Ice. This can reduce muscle spasm, pain, and inflammation. Wrap the ice in linen so not directly in contact with the skin, use for 15 min. on the hour until swelling has gone down and pain reduced.
  • Stretch. Light stretching type movements are suitable even while in acute pain as it can reduce stiffness, muscle spasm, and pain while promoting healing (as long as there’s no fracture or dislocation).
  • Exercise. Once the condition has resolved, exercises that stretch and strengthen the back muscles, spinal ligaments, shoulders, and abdomen can be instituted. It’s vital to strengthen your core and postural stabilization muscles in most musculoskeletal conditions.
  • Proper posture. Don’t slump or slouch while sitting or standing, stand tall and keep your shoulders back. Keep your head and neck centered over shoulders, especially while at a desk or computer. Have good ergonomics at your desk or workstation to prevent fatigue, repetitive work related injuries, and chronic pain syndromes.
  • Stress reduction. Try deep breathing techniques and relaxation exercises such as yoga. Learn mental coping techniques and stay away from negative people or situations. Read positive affirmations daily and find hobbies that heal your mind and body.
  • Sleep. Change your sleeping position. Try side sleeping in a fetal position using a pillow between your knees, hold another lightly against your chest, and place a third behind your mid back for support and relief.

As always, drink plenty of water, eat a well balanced diet, have a positive mental attitude, and institute good healthy habits. Chiropractors are great resources to help guide and coach you to better health and well-being as well as treat your painful conditions!

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