Understanding your middle back pain


Upper to middle back pain is pain or discomfort that occurs anywhere from the bottom of the neck (cervical spine) to the bottom of the ribcage, just above your lumbar spine. The cause of or best treatment for middle back pain is not always easy to identify. Fortunately, although back pain is one of the most common medical complaints in the world, there are both physician-approved and home treatments available.

Understanding the Anatomy of the Spine

A brief summary of the spine’s anatomy can help you recognize upper to middle back pain symptoms. The back is made up of five areas, cervical, thoracic, lumbar, sacrum, and coccyx. Middle back pain occurs in the upper and lower portions of the thoracic spine.

Within the thoracic spine, there are 12 vertebrae, each of which attaches to the rib cage. In between each of the vertebrae are gel-like discs that cushion the joints when we move. Over time, these discs wear down, putting more pressure on the spine. Additionally, there are also muscles and ligaments that hold each part of the spine together.

While upper and middle back pain is not as common as lower back pain, it is an important condition to monitor. The purpose of the upper and middle backbones is to protect the vital organs while stabilizing the rest of the body. This means that pain within the middle back can result from a muscular problem, or worse.

The upper and middle back is also more resistant to movement, meaning it is less likely to become injured. When it does, though, identifying the cause and following a treatment plan is crucial in preventing your middle back pain from getting worse.

Causes of Mid Back Pain

Many of us attribute back pain to getting older. While this is definitely the case for some, there are many potential causes of middle back pain, including:

  • Muscle strain
  • Injuries/accidents
  • Disc degeneration, osteoarthritis or degenerative disc disease
  • Poor posture or wearing the wrong shoes
  • Herniated disc
  • Structural problems with the spine, including scoliosis
  • Bad quality mattress
  • Bad sleeping position
  • Spinal stenosis
  • Obesity
  • Lack of exercise
  • Fracture or compression fracture
  • Autoimmune condition
  • Gallbladder disease
  • Infection
  • Cancer
  • Pressure on the spinal cord
  • Kidney infection
  • Heart attack

As you can see, some causes of middle back pain are expected, like the gradual wear down of the discs in between the vertebrae. However, others are more serious and require immediate evaluation to rule out medical conditions like an infection or a heart attack. While most causes of middle back pain that are serious come on abruptly versus slowly over time, it is important to seek medical care if you have symptoms that you are unfamiliar with. When middle back pain is due to kidney or heart problems, it is often described as severe pain that comes on suddenly and sharply.

Back pain can affect anyone, regardless of their age, gender, nationality, or race. However, certain risk factors can increase your chances of middle back pain, including:

  • Older age
  • Birth deformities
  • Obesity
  • Poor posture
  • Genetics
  • Pregnancy
  • Lack of exercise
  • Smoking
  • Frequent stress and anxiety
  • Poor foot care
  • Improperly fitted footwear

These risk factors can lead to certain conditions, like osteoarthritis, or they can worsen already existing symptoms of middle back pain.

Because of the body’s unique design and how each structure correlates with other parts, middle back pain can also come from different areas of your body, including your feet. Foot problems, like hammer toes or foot deformities, can cause nerve damage, which can be felt in different areas of the back. Conversely, problems in the spine can lead to other bodily pains, including the feet. If a disc slips or you get a herniated disc, it could be felt in the feet.

Good-fitting shoes that have the appropriate cushion are important when dealing with any type of back pain. Additionally, the right pair of shoes can prevent a worsening of your symptoms. While it might be tempting to wear shoes that match an outfit or that are on sale, these purchases are not always the best idea. You may end up paying for it in the long run.

Signs and Symptoms of Mid Back Pain

The symptoms of middle back pain will vary, depending on the cause. Symptoms can also be acute or chronic. Acute pain begins suddenly and often has a specific cause, such as an injury or a fracture. Chronic pain is pain that lasts for longer than three months. It often has a long-lasting cause, such as osteoarthritis or an autoimmune condition.

A few common symptoms include:

  • Dull, burning pain
  • Sharp pains
  • Overall tightness of local muscles
  • Stiffness in the surrounding muscles
  • Foot pain
  • Numbness

If you notice any of the symptoms of middle back pain for more than three days, it is a good idea to schedule an appointment with your doctor. Other symptoms that could indicate a serious problem include:

  • Weakness in your arms or legs
  • Pain that radiates to different parts of the body
  • Loss of bladder control
  • Loss of bowel control
  • Chest pain
  • Abdominal pain
  • Difficulty breathing
  • Complete numbness, or a lack of sensation to feet or toes

If you have any of these more serious back pain symptoms, it is vital to seek medical care immediately. They could indicate a medical emergency.

Fixing Poor Posture and Other Prevention Techniques

Some causes of upper and middle back pain can be prevented, while others cannot. However, even if you cannot avoid the cause of your middle back pain, you may be able to prevent your symptoms from getting worse.

Follow these important prevention techniques:

  • Follow up with your doctor with any new symptoms
  • Learn fitness and stretching techniques with a physical therapist
  • Be aware of your posture
  • Invest in a good pair of shoes
  • Maintain a healthy weight
  • Avoid smoking
  • Invest in a good mattress
  • Focus on ergonomics in your workspace
  • Be careful when lifting heavy objects
  • Posture plays a key role in preventing back pain symptoms. Posture is not only important when sitting at a desk, but also when walking. Poor posture can put additional pressure on your muscles and ligaments and cause misalignment of your hips, knees, and ankles, worsening your middle back pain symptoms. Choosing the right pair of shoes with good support can help you maintain good posture throughout the day.

    Treating Middle Back Pain and Pain Management

    Finding the cause of your middle back pain is essential to determine a treatment plan that will work for you. You may need to see a doctor who specializes in diagnosing thoracic pain. First, your doctor will complete a physical exam. They may also ask questions about your occupation and physical activities to determine the cause of the pain. They may order imaging, like x-rays or an MRI, to get an in-depth look at the discs and ligaments in your back. Neurological tests are sometimes used to evaluate the brain’s signaling and how well it gets messages to other parts of the body.

    Treatment for middle back pain might include:

    • Massage therapy
    • Physical therapy
    • Chiropractic adjustments and regular chiropractic care
    • Prescription pain medications
    • Muscle relaxers
    • Non-steroidal anti-inflammatories (NSAIDs)
    • Steroid injections
    • Nerve blockers
    • Diskectomy

    Treatment of upper and middle back pain is important to prevent further complications from occurring. Additionally, back pain can impact other areas of your life, like increasing your stress, which can lead to insomnia. Back pain can even make it difficult to complete your work or household duties.

    Surgery is less likely to be an option for upper to middle back pain because of its close location to vital organs. The treatment of middle back pain is often decided based on the severity of the symptoms. Mild back pain is usually treated with over-the-counter medications and rest. Your doctor may also prescribe heat and ice therapy, as well as recommendations to improve your posture and choose the right pair of shoes.

    Moderate pain is often monitored by a physician for improvement. Depending on the cause of your pain, your doctor may prescribe short-term opioid pain medication and anti-inflammatories. They may also monitor your condition for a while and then order more tests if the pain does not go away.

    Your doctor will usually prescribe medication treatment for more severe types of pain, depending on the cause. Finding the cause of the pain is crucial to prevent further damage.

    Home Remedies and Finding Pain Relief

    While following your doctor’s treatment plan is important, you can also work on improving your middle back pain and finding relief with these home remedies:

    • Middle/upper back stretches: Stretching elongates the spine and improves posture while also relieving muscle tension.
    • Well-fitted shoes with ample support: Painful feet due to foot conditions or improperly fitted shoes with poor support can cause, or worsen, back pains. However, shoes that provide cushioned support will not only help alleviate foot pain but also help keep your ankles and rest of your leg in proper alignment.
    • Exercise: Exercise can reduce weight, taking pressure off the spine. It can also release hormones like dopamine and norepinephrine, the body's natural pain relievers.
    • Over-the-counter medication: Over-the-counter medications, like Tylenol, can temporarily relieve pain.
    • Hot baths: Hot baths stimulate blood flow to the injured area, promoting healing.
    • Ice packs: Ice restricts blood flow and can temporarily reduce inflammation.
    • Rest: Rest is often needed following an acute muscle injury that leads to middle back pain. Rest gives your body time to heal, so you can later begin working on your treatment plan.
    • Reduce stress: Stress exacerbates pain of all types. While a stress-free life may not be realistic, techniques like yoga or meditation can help you manage it.

    Treating pain at home allows you to take control of your middle back pain. Don’t let the symptoms of back pain keep you up at night anymore. Don’t let it affect your ability to enjoy the outdoors or take that hike you always planned. With prevention and a few lifestyle changes, you can learn to manage your back pain.



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