What is Upper and Middle Back Pain?


The middle back or thoracic spine is an intricate construct of bones, connective tissues, nerves, muscles, spinal segments, and joints. While most people think only of the back, the shoulders, arms, and ribs are integral to function in that area. While the thoracic spine has a more solid construction and is relatively stable due to the ribs, it can also have many a sources of pain:


Sprains and strains from injuries from an auto accident or sports.


Muscular problems. Upper back pain is most commonly caused by muscle irritation or tension, also called myofascial pain. The cause may be poor posture or any type of irritation of the large back and shoulder muscles.


Joint Dysfunction. Pain caused by joint dysfunction, where the ribs attach to the spine at each level of the thoracic spine, can cause pain.


Herniated or degenerative discs. While less common in the thoracic spine, degenerative disc disease or a thoracic herniated disc can be a source of pain.


Arthritis. Swelling due to arthritis in the spine can cause tenderness, pressure to the nerve, and limited range of motion. Often due to wear and tear of the aging process, the cartilage in the facet joints can become thin or disappear or can produce an overgrowth of bone spurs and an enlargement of the joints. Facet joint disorders of the thoracic spine can result from osteoarthritis.


Kyphosis (hunchback). In addition to vertebral fractures, kyphosis  can be caused by many factors, such as poor posture or a deformity, such as ankylosing spondylitis or Scheuermann's kyphosis. While kyphosis is primarily a deformity, it can also be a source of pain.


Scoliosis. Scoliosis is a condition in which the spine abnormally curves sideways and can sometimes produce upper back pain.