Upper and middle back pain – also called thoracic back pain – can occur anywhere from the bottom of your rib cage up to the base of your neck. Around 15-30% of people experiencing it during their lifetime.
Upper and middle back pain can range from aching and stiffness to a sharp or burning sensation.
What causes upper and middle back pain?
Upper and middle back pain may be caused by:
- Overuse of, or injury to, the muscles, ligaments and discs that make up the thoracic spine
Examples include a fall or jolting from a car accident, being hit hard in the back, lifting or carrying something too heavy, reaching to put objects on a high shelf, and carrying a heavy backpack over one shoulder. Repetitive throwing, bending or twisting or even forceful coughing or sneezing can also cause back pain.
- Poor posture
Slumping or slouching when you sit or stand, especially when using a computer for a long time.
- Weak muscles
This could be as a result of not doing enough exercise.
- Pressure on the spinal nerves
Conditions like a herniated disc could cause this.
- A fracture of one of the vertebrae
This can cause long-term back pain if rehabilitation is not properly performed.
- Osteoarthritis from the breakdown of protective cartilage
This is usually caused by the discs degenerating. As a result, the vertebrae grind and wear down.
- Myofascial pain or muscular irritation
Often caused by overuse or deconditioning of these muscles.
- Medical conditions
For example, lung problems, indigestion, and pregnancy.
Symptoms of upper middle back pain
Upper middle back pain symptoms often vary due to the underlying cause, meaning pain could be mild, severe or somewhere in the middle. You may feel a sharp pain that’s focused on one spot or experience a more general dull ache.
Other symptoms include:
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- Tight or stiff muscles
- Tingling, numbness or weakness
- A pain that radiates along a nerve
How is pain in the upper middle back diagnosed?
If you’re finding it difficult to do daily activities, you should consult your doctor. You may need to take prescription medicine or have diagnostic tests to determine the cause of your back pain.
Your doctor will ask questions about when the discomfort started, where it hurts and if you’ve found anything that helps your symptoms.
Potential physical tests include:
- Spinal X-Ray to look at the bones in your spine
- MRI scan to create pictures of your bones, tendons and muscles
- CT scan to create 3D images of the bones and soft tissues in your spine
- EMG test to look at the nerves and muscles in your spine, specifically to check for nerve damage
- Blood test to look for any genetic conditions that could be causing pain in the upper middle back
11 ways to relieve pain in the upper middle back
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Exercises for Upper Middle Back Pain
As upper back pain is related to large muscles in the shoulder area, exercises to stretch and strengthen these muscles are largely recommended.
Exercise will also strengthen the muscle groups that support your mid-back to help relieve back muscle pain.
Some of the best exercises for upper middle back pain include swimming, walking, cycling, yoga and Pilates.
Exercising regularly will help keep weight gain and obesity at bay which can cause strain on the back and ultimately lead to back pain.
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Stretches for Upper Middle Back Pain
As well as general exercise, there are specific stretches you can do to help alleviate your upper back pain. They include:
- Cat cow pose
- Opposite arm/leg raise
- Corner stretch
- Prone cobra
Back stretches when done on a regular basis can help prevent back pain. They support you in maintaining back mobility, joint health, sustaining good posture and keeping your discs moving.
Stretching exercises are best after a workout when your muscles are warmed up. You should take a break from exercise and stretching if your back hurts a lot but try not to let too much time pass before you get moving again.
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Over-the-Counter Medication
Over-the-counter medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, can reduce pain and swelling. Topical NSAIDs like Voltarol may help too.
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Prescription Medication
If the pain persists after you’ve tried over-the-counter medicine, your doctor may prescribe a stronger painkiller or a muscle relaxant.
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Ice or Heat
Heat can reduce pain and stiffness while ice can reduce swelling. You may find an ice pack provides targeted relief, or a bath may help relax your muscles and reduce stiffness.
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Manual and Physical Therapy
Manual therapy, such as massage or spinal manipulation, helps reduce muscle tension in the upper and middle back.
Your physiotherapist may use specific exercises combined with massage to relieve your discomfort. They will also advise you on exercises and stretches to do at home.
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Acupuncture
Acupuncture involves putting tiny needles into your skin at certain points on the body to promote healing and pain relief. It can help relieve upper and middle back pain by releasing trigger points.
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Good Posture
Try to stand or sit tall and balance your weight evenly on both feet. Don't slump or slouch.
When sitting, keep your shoulders rolled back and be sure to adopt suitable positions when using computers and driving. For example, if you spend a lot of time at a computer, make sure the screen is at eye level, never below and not so far away that you have to reach to it.
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Ergonomic Adjustments
If you spend a long time sitting at a computer for work, making a few adjustments can have a big impact. Invest in an ergonomic office chair that supports pelvic and lumbar regions to take the weight off your back. Shifting your position on your chair to improve your posture can also help.
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Improve Your Sleeping
Try to find a comfortable sleeping position and use pillows to maintain this position whilst you’re asleep if needed. A relatively firm mattress may also be beneficial to give your back proper support. According to the Sleep Council a mattress should be changed every 7 years³.
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Reduce Your Stress
Learning ways to reduce your stress may result in reduced pain. You could try deep breathing and relaxation exercises or meditation.
Taking time away from your desk while working to stretch and get outside can work wonders too. Both for your mood and your back pain.
Back and Spinal Treatments at Ramsay Health Care
Ramsay Health Care offers a comprehensive range of diagnostic assessments and treatments for upper and middle back pain including radiology services, osteopathy, physiotherapy, pain management clinics, rheumatology, injection therapies and surgery.
Our experienced health professionals, including Chartered Physiotherapists, offer one to one advice and tailor your treatment plan to your needs.
Some of the highest qualified and experienced orthopaedic, rheumatology and pain management consultants in the UK work with Ramsay Health Care to provide the best individual healthcare for your needs.
Upper Middle Back Pain FAQs
What causes upper middle back and chest pain?
The two pains together may just be a coincidence, but it could also be a sign of a condition that needs treatment quickly, such as a chest infection, angina, pericarditis, or a pulmonary embolism. If you are experiencing upper middle back and chest pain, speak with your doctor.
What causes upper middle back pain when breathing?
If you get back pain when you’re breathing, it could be a sign of a condition that needs medical attention. Possible causes include:
- Asthma
- Angina
- Chest infection
- Chronic obstructive pulmonary disease (COPD)
- Lung cancer
- Pneumonia
It may also be a symptom of anxiety and stress.
What causes upper middle back pain after eating?
Upper middle back pain after eating may be caused by gastroesophageal reflux disease (GERD).
This is a chronic condition where stomach acid flows back into the oesophagus, causing irritation and often heartburn. Sometimes you feel pain in your upper middle back with GERD as swelling and irritation in your oesophagus can affect the surrounding nerves and cause pain elsewhere.
Your pain could also be caused by pancreatitis - inflammation of the pancreas. Whilst pain is most common in the upper left side of your stomach, you can also feel it in your back too.
What causes upper middle back pain during pregnancy?
An increase in hormones that affect spinal ligaments, an altered centre of gravity that places excessive strain on back tissues, additional body weight, poor posture and increased stress are all risk factors for back pain during pregnancy.
References¹ http://www.acatoday.org/pdf/BackPainExercise.pdf² https://backcare.org.uk/news/myth-exercise-is-dangerous-for-back-pain³ http://www.sleepcouncil.org.uk/⁴ http://www.nhs.uk/conditions/Back-pain/Pages/Introduction.aspx