Overview

The thoracic spine is the middle twelve vertebrae in the back that supports the neck, rib tissue, rib cage, soft tissues, flexible joints, blood vessels, and nerves. You may feel pain in your bones, muscles, ligaments, or spinal discs when experiencing pain in the middle of your back. While pain in the middle of the back is common, it is often short-lived and not the result of a serious health issue. Rarely thoracic spinal pain results from a spinal infection, cancer, or heart or lung problems. Pain in this area typically resolves itself over time. 

Some risk factors for developing pain in your thoracic spine are:

• Lifestyle habits such as poor posture, sedentary lifestyle, and sitting too much 
• Smoking 
• Underlying medical conditions, such as obesity, spinal stenosis, osteoporosis, osteoarthritis, and degenerative disc disease
• Age: As you age, you become more likely to experience some form of back pain
• Carrying too heavy of a backpack or purse

Treatment options 

Your treatment will depend on the underlying cause of your thoracic spinal pain, but some common treatment options include: 

• Yoga, functional mobility training, and exercise
• Acupuncture 
• Heat or ice therapy
• Physical therapy
• Massage or chiropractic therapy 
• Pain medication: Over-the-counter pain medication, such as acetaminophen and naproxen, or prescription painkillers, muscle relaxants, anti-inflammatories, and opioids
• Steroid injections 
• Surgery: laminectomy, percutaneous thoracic intervertebral disc nucleoplasty, spinal fusion, laminotomy

Your healthcare professional may ask you to lose weight if you are overweight or obese. Weight loss programs are often used in conjunction with other non-surgical options. Many causes of back pain may be alleviated or completely resolved through weight loss, while others cannot be. 

Symptoms

• Back or neck pain
• Chest pain
• Decreased mobility in thoracic spine
• Dull pain in your back
• Muscle aches
• Muscle spasms occurring when resting or with activity
• Pain in rib cage that worsens with physical activity or taking a deep breath
• Sensations of burning, tingling, numbness, or weakness
• Sharp pain
• Stiffness in thoracic spine
• Throbbing or aching pain

Diagnostic tests

If pain in your thoracic spine does not subside after several weeks or you sustained a recent trauma to your back, you should schedule an appointment with a medical professional. They will inquire about the duration, frequency, and severity of your symptoms before conducting a physical exam. Your medical professional will look for any visible spinal deformities and test the tenderness and sensitivity of your back. They will also inspect your head, pelvis, abdomen, arms, and legs. They will inquire about your medical history and any familial history of back pain.  

Your healthcare professional may order diagnostic tests, such as:

• X-ray
• MRI
• CT Scan
• Electromyography or nerve conduction velocity test
• Bone density scan
• Nuclear bone test

Causes

• Ankylosing spondylitis: arthritis of the spine
• Joint dysfunction 
• Herniated disc
• Kyphosis: causes spine to become too hunched forward 
• Muscular weakness, tightness, strains
• Myofascial pain: affects connective tissue of muscles or a group of muscles
• Nerve compression caused by problems with muscles, bones, or discs between the vertebrae 
• Osteoporosis 
• Overuse, muscle strain, or other injury to muscles, ligaments, and discs surrounding your spine
• Scoliosis: abnormal side-to-side spinal curvature 
• Sedentary lifestyle 
• Sitting or standing for prolonged periods of time
• Thoracic stenosis 
• Trauma to thoracic vertebrae
• Vertebral compression fracture
• Wearing heavy backpacks