Thoracic Back Pain (Mid / Upper Back Pain)

Overview

The thoracic spine is the middle section of your back: the twelve vertebrae that the ribs attach to, running from the base of the neck to just above the waist. Because the ribcage gives it extra support, it is naturally stiffer than the neck or lower back, and pain here is less common than in those areas. When it does occur, the usual cause is mechanical: the joints and muscles have been held in one position for too long.

Thoracic pain often feels like a dull ache or a band of tightness between the shoulder blades, sometimes with a sharp catch on twisting or taking a deep breath. It is strongly linked to desk work, long study sessions and slouched sitting, which flex the mid-back and leave the muscles working hard to hold the head and shoulders up.

Most episodes respond well to movement, posture changes and hands-on treatment. Because the ribs, heart and lungs sit close by, we always check for signs that pain may be coming from somewhere other than the spine.

Causes and risk factors

• Prolonged sitting, especially slouched over a laptop or phone
• A workstation where the screen is low or off to one side
• Weak mid-back and shoulder-blade muscles, with tight chest muscles
• Carrying a heavy rucksack or bag, or lifting with a rounded back
• Sudden increase in overhead sport or gym work, such as swimming or pressing
• Stress, which raises resting tension in the upper-back muscles
• Rarely, age-related change in the thoracic discs or joints

How we may be able to help

Assessment comes first. We look at how your thoracic spine bends, extends and rotates, check the rib joints, test the muscles around the shoulder blades and screen for any signs that suggest a non-spinal cause. A 3D posture scan can show how much your upper back rounds and whether one side is working harder than the other.

Treatment may include hands-on mobilisation and chiropractic manipulation for stiff thoracic segments, which many people find gives quick relief, along with IASTM or cupping for tight muscles between the shoulder blades. Kinesiology taping can act as a posture reminder during long study or work days. Every plan includes mobility and strengthening exercises for the mid-back, because evidence suggests that building endurance in these muscles may help reduce recurrence.

What you can do at home

• Stand up and extend your back over the top of your chair for 30 seconds every half hour
• Raise your screen to eye level and sit with your hips at the back of the chair
• Practise thoracic rotation and "open book" stretches a few times a day
• Use a foam roller gently along the upper back (not the lower back or neck)
• Strengthen your mid-back with rows, band pull-aparts and wall angels
• Try heat on the upper back after a long day at your desk