by EBSCO Medical Review Board
(Middle Back Pain; Mid Back Pain; Upper Back Pain)


Thoracic back pain is discomfort in the middle and upper part of the back.


The back has many small bones, muscles, and soft tissues that surround and protect the spinal cord. Nerves also leave the spinal cord in the back. Pain may be caused by stress, strain, or injury to any of these structures, such as:

  • Muscle strains
  • Ligament sprains
  • Gradual wear and tear of tissue
  • Fractures of vertebra (spinal bones)
  • Nerve compression—pressure on nerves that exit the spine may be caused by problems with muscles, bones, or disc between vertebra
  • Herniated disc—damage to cushions that sit between the vertebra
  • Imbalance of muscles that support the spine

Rarely, thoracic back pain may be caused by more serious problems like an infection in the spine, heart or lung problems, or cancer.

Herniated Thoracic Disc
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Risk Factors

Things that may raise the risk of this problem are:

  • Trauma
  • Activities or jobs that require sitting for long periods of time
  • Repetitive motion
  • Poor posture
  • Lack of activity

These health problems may also raise the risk of this type of back pain:


The symptoms a person has and how long they last depend on the cause. Problems may also be felt now and then or all the time.

Problems with muscle or soft tissue may cause:

  • Sharp pain
  • Spasms
  • Throbbing or aching pain
  • Weakness or fatigue

Nerve problems may cause:

  • Burning
  • Tingling/numbing feelings
  • Shooting pain
  • Weakness in an area affected by a nerve


The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the back.

Images may be taken for pain that is severe or not going away. This can be done with:


Any underlying causes will need to be treated. The goal of treatment is to ease symptoms to give the back time to heal. Treatments may include:

  • Resting the back for 1 to 2 days
  • Limiting activities that cause pain
  • Medicine to ease pain, such as over the counter pain medicine and muscle relaxers
  • Physical therapy to help with strength, flexibility, and range of motion

Most people are not helped by surgery.


To lower the risk of thoracic back pain:

  • Exercise regularly to keep the back strong and flexible.
  • Do not sit for long periods of time.
  • Practice good posture to ease pressure on the back.
  • Use proper methods when playing sports.
  • Use proper form when lifting objects.


American Pain Society 

Ortho Info—American Academy of Orthopaedic Surgeons 


Back Care Canada—Canadian Spine Society 

Canadian Pain Society 


Evaluation of neck and back pain. The Merck Manual Professional Edition website. Available at: Updated August 2019. Accessed May 14, 2020.

Examination of the spine. Patient UK website. Available at: Updated August 11, 2019. Accessed May 14, 2020.

Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of osteoporosis, ninth edition. ICSI 2017 Jul PDF.

Osteoporosis. EBSCO DynaMed website. Available at: . Updated February 28, 2020. Accessed May 14, 2020.

Thoracic back pain. Patient UK website. Available at: Updated September 29, 2016. Accessed May 14, 2020.

Revision Information