Mid-back pain is commonly caused by poor posture, muscle strain, or a herniated disc. See a doctor if it comes with chest pain or numbness.
Common causes
- Poor posture and slouching.
- Muscle strain or overuse.
- Herniated thoracic disc.
- Osteoporosis or a compression fracture.
- Scoliosis or arthritis.
Home care
Rest briefly, use heat or ice, stretch gently and strengthen your core.
See a doctor
If pain follows an injury, is severe, wakes you at night, or comes with numbness, fever, or unexplained weight loss.
Emergency
Mid-back pain with chest pain, shortness of breath or sweating can be a heart attack. Call 911.
Where the pain comes from
The middle back is the thoracic spine, with 12 vertebrae attached to the ribs. It is more stable and less mobile than the neck and lower back, so injuries are less common but still occur.
Muscle and posture causes
- Poor posture while sitting at a desk.
- Overuse in lifting, sports or repetitive work.
- Sleeping in an awkward position.
- Carrying a heavy backpack.
Spine causes
- Herniated thoracic disc.
- Osteoarthritis of the spine.
- Osteoporosis causing compression fractures, especially in older women.
- Scoliosis.
- Ankylosing spondylitis, an inflammatory arthritis.
Non spine causes
- Gallbladder disease (pain between the shoulder blades or right side).
- Peptic ulcer or pancreatitis.
- Kidney stones or infection.
- Pneumonia or pleurisy.
- Shingles, which causes a burning rash on one side.
- Aortic aneurysm or dissection (severe, sudden).
- Heart attack, where pain can radiate to the back, in particular in women.
Home care
- Alternate heat and cold.
- Gentle stretches such as cat cow and thoracic extensions.
- Over the counter pain relief.
- Keep moving, since bed rest can slow recovery.
Prevention
Strengthen the core and back, adjust the workstation, lift with the legs and not the back.
Emergency signs
Call 911 for sudden severe back pain with chest pain, trouble breathing, sweating, fainting or a tearing sensation. Seek urgent care for leg weakness, numbness in the groin or loss of bladder or bowel control.
Anatomy and typical causes
The thoracic spine has 12 vertebrae that connect to the ribs, and it is more stable and less mobile than the neck and low back, so pain here is less common than low back pain. Typical causes include muscle strain from lifting or poor posture, rounded shoulders from long sitting, rib joint irritation, scoliosis, a herniated disc and osteoporosis fractures. Pain between the shoulder blades can also come from outside the spine, including acid reflux, gallbladder disease, pancreatitis, kidney problems, lung conditions and, importantly, heart problems.
Self care and emergency signs
Heat or ice for 15 to 20 minutes, gentle stretching, short walks and ergonomic changes help most cases. Strengthening the back and core muscles and improving posture reduces recurrences. Call 911 for mid back pain with chest pressure, shortness of breath, sweating, nausea or pain spreading to the arm or jaw, since it could be a heart attack. A sudden tearing pain in the chest or back can signal aortic dissection, another emergency. See a doctor if pain follows a fall, is worse at night, comes with fever or weight loss, or causes leg weakness or numbness.
Based on data from the Cleveland Clinic and the American Heart Association
