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Thoracic Back Pain

What is thoracic back pain, and how is it treated?

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Topic at a Glance

  • Thoracic back pain affects the upper and middle back, in the area between the cervical spine and lumbar spine.
  • Common causes include poor posture, muscle strain, injuries, degenerative changes, compression fractures, and nerve compression.
  • Symptoms can range from localized muscle pain and stiffness to numbness, weakness, or pain that travels along the ribs.
  • A thorough evaluation can help determine the cause and guide treatment, which may include physical therapy, medication, injections, or other advanced options.

Thoracic Back Pain

Thoracic back pain can make everyday activities, work, exercise, and even simple movements uncomfortable. This article explains what thoracic back pain is, how the thoracic portion of the spinal column works, and the common causes of thoracic pain.

If you are experiencing persistent, worsening, or severe pain in your upper and middle back, our specialists at OrthoNeuro in Columbus, Ohio, can help identify the cause and create a personalized treatment plan. Schedule an appointment today to take the next step toward lasting pain relief.

What is Thoracic Back Pain?

Thoracic back pain refers to discomfort that develops in the thoracic region of the spine. This area is located between the cervical and lumbar regions and generally includes the upper and middle back. Thoracic spine pain may feel dull and aching, sharp, burning, or tight, depending on its underlying cause.

Anatomy of the Spine

The spinal column is divided into several regions. The cervical spine forms the neck, the thoracic spine forms much of the upper and middle back, and the lumbar spine supports the lower back. Together, these regions protect the spinal cord while providing strength, stability, and mobility.

The thoracic spine contains 12 thoracic vertebrae. These bones are stacked to form the middle portion of the spine, with discs and other structures helping cushion movement between the vertebrae. Facet joints connect the vertebrae and help guide spinal motion.

One unique feature of the thoracic region is its connection to the rib cage. The ribs attach to the thoracic vertebrae and help protect important organs in the chest. Although this arrangement provides stability, it also means that problems involving the ribs, joints, muscles, or soft tissues can contribute to thoracic spine pain.

The spinal cord travels through the spinal column and gives rise to spinal nerves. When a nerve is irritated or compressed, it may cause pain, tingling, numbness, or weakness. In the thoracic region, nerve compression may sometimes lead to a condition called thoracic radiculopathy, which can cause pain that travels around the chest or rib area.

What Causes Thoracic Back Pain?

Thoracic back pain can have many causes. Some are related to everyday habits and muscle strain, while others involve injuries or changes within the spine.

Poor posture and muscle strain: One of the most common contributors to thoracic pain is poor posture. Sitting for long periods while hunched over a computer, phone, or desk can place extra stress on the muscles and soft tissues of the upper back. Over time, this may lead to muscle tension, stiffness, and muscle pain. Repetitive activities, strenuous lifting, or sudden movements can also strain muscles and ligaments.

Injuries: Falls, sports injuries, motor vehicle accidents, and other trauma can damage the muscles, joints, ribs, or thoracic vertebrae. An injury may cause sudden pain immediately or symptoms that develop over time.

Degenerative changes: Age-related wear can affect spinal discs and facet joints. Arthritis and other degenerative changes may contribute to stiffness and thoracic spinal pain. Bone spurs can also develop and, in some cases, narrow spaces around nearby nerves.

Nerve compression: A disc problem, bone spur, injury, or other structural change can irritate or compress a spinal nerve. Thoracic radiculopathy is less common than similar conditions in the cervical and lumbar regions, but it can cause sharp, burning, or radiating pain around the chest or ribs.

Fractures: Compression fractures and vertebral compression fractures can occur after significant trauma or when bones have become weakened. These fractures can cause severe pain, changes in posture, and reduced mobility. Thoracic vertebrae are a common location for these types of spinal fractures.

Other spinal conditions: Less commonly, infections, tumors, inflammatory conditions, or problems affecting the spinal cord may cause thoracic back pain. Pain specialists and orthopedic specialists can help determine whether symptoms may be related to a more serious cause.

Thoracic Back Pain Symptoms

Symptoms can vary depending on the cause of thoracic back pain.

Common symptoms may include:

  • Aching, sharp, burning, or stabbing pain in the upper and middle back
  • Muscle tension, spasms, or tenderness
  • Muscle pain that worsens with certain movements or activities
  • Stiffness or a limited range of motion
  • Pain around the ribs or chest
  • Pain that becomes worse after prolonged sitting or poor posture
  • Numbness, tingling, or weakness
  • Pain that travels along the path of a nerve
  • Difficulty performing work, exercise, or other daily activities

Prompt medical evaluation is especially important for severe pain following trauma, unexplained weight loss, fever, progressive weakness, and difficulty walking.

How is Thoracic Back Pain Diagnosed?

Diagnosing thoracic back pain begins with a detailed discussion about your symptoms, medical history, daily activities, and any recent injuries. Your orthopedic provider will ask when the pain began, whether it developed gradually or caused sudden pain, and what movements or activities make it better or worse.

A physical examination may evaluate posture, range of motion, muscle strength, sensation, reflexes, and areas of tenderness. The provider may also look for signs of nerve compression or conditions affecting the spinal nerves.

Imaging studies may be recommended when additional information is needed. X-rays can help identify fractures, alignment problems, and some degenerative changes. An MRI can provide detailed images of discs, nerves, the spinal cord, and soft tissues. A CT scan may provide additional information about the bones and spinal structures.

The goal is to identify the underlying source of thoracic spine pain rather than simply treating symptoms. Once the cause is understood, your provider can recommend the most appropriate treatment plan.

Thoracic Back Pain Treatment

Treatment depends on the cause, severity, and duration of your symptoms. Many patients improve with conservative care, while more advanced treatments may be appropriate for persistent pain or certain spinal conditions.

Physical therapy: Physical therapy is often an important part of treatment for thoracic back pain. A therapist can recommend exercises to improve strength, mobility, and posture. Treatment may also focus on reducing muscle tension, improving movement patterns, and helping reduce muscle pain.

Activity and lifestyle changes: Improving ergonomics and correcting poor posture can reduce strain on the upper and middle back. Taking regular movement breaks, adjusting a workstation, and learning proper lifting techniques may help prevent future episodes.

Heat or ice: Depending on the cause and timing of symptoms, heat or ice may provide temporary pain relief. Heat can help relax tight muscles, while ice may help manage discomfort after certain injuries.

Medications: Over-the-counter or prescription medications may be used as part of treatment when appropriate. Your provider can recommend options based on your medical history and the source of your pain.

Injections: For certain conditions, targeted injections may help relieve pain and inflammation. These can include epidural steroid injections or injections involving specific joints or pain-generating structures. Injections are typically considered when conservative treatment has not provided enough relief or when they may help confirm the source of pain.

Surgery is not necessary for most cases of thoracic pain, but it may be considered when there is significant nerve compression, spinal instability, certain fractures, or another condition that requires surgical treatment. OrthoNeuro can help determine the safest and most effective approach based on your individual needs.

Find Relief From Your Back Pain Today with OrthoNeuro

If you are dealing with persistent pain in your upper and middle back, do not wait to seek answers. Schedule an appointment with OrthoNeuro in Columbus, Ohio, today and take the next step toward meaningful pain relief.

Medically reviewed by Ying H. Chen, DO, FACOS

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References:

https://my.clevelandclinic.org/health/body/22460-thoracic-spine

https://www.treatingpain.com/news-updates/2024/august/middle-and-upper-thoracic-back-pain

https://orthoneuro.com/spine/thoracic-back-pain/

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FAQs About Thoracic Back Pain

Thoracic spine pain may feel like an ache, sharp pain, burning sensation, tightness, or stiffness in the upper and middle back. Some people also experience muscle pain, pain around the ribs, or symptoms that travel along a spinal nerve.

Yes. Poor posture can place ongoing stress on the muscles and soft tissues that support the thoracic spine. Over time, this may contribute to muscle tension, fatigue, stiffness, and discomfort.

Physical therapy can help many patients by improving strength, mobility, posture, and movement patterns. A personalized program may also help reduce muscle pain and support long-term pain relief.

You should consider medical care for pain that persists, worsens, interferes with daily activities, or develops after an injury. Seek prompt evaluation for severe pain, progressive weakness, numbness, difficulty walking, or other concerning neurological symptoms.

Spine Care Specialists

IF YOU LIVE WITH CHRONIC BACK OR NECK PAIN, CONTACT ORTHONEURO IN COLUMBUS, OHIO, FOR STATE-OF-THE-ART DIAGNOSIS AND PERSONALIZED SPINE CARE TREATMENT PLANS TO HEAL YOUR SPINE, RELIEVE YOUR PAIN, AND HELP YOU GET BACK TO YOUR REGULAR ACTIVITIES.