Middle back pain or thoracic back pain, is pain located in your back that is felt in the area of the thoracic vertebrae, between the base of the neck and top of the lumbar. It has many possible causes, including muscle pull to failure of a vertebra or uncommon serious disorders. The upper spine is very good and stable to support the weight of the upper body, along with anchoring the rib cage offering a cavity allowing one’s heart and lungs to function and shield them.
Generally, the pain is likely to be self-limiting; in that case no testing is required to provide diagnosis, and straightforward pain relief is sufficient. More intense and protracted cases may demand more specific pain management strategies and sometimes investigations for underlying disorders. All forms of back pain can lead to loss of wages, lower quality of life and handicap.
Signs and symptoms
Your thoracic spine begins at the bottom of the neck and extends to the middle of the torso. Any pain in this region is considered “middle back pain”.
The precise symptoms associated with middle back pain will be based upon the underlying cause. Most middle back pain is not serious in nature. Nonetheless, it will tend to have more serious pathology related to it than pain in your neck and that in the low back. Symptoms can include pain, either locally close to the backbone or sent along place the similar nerve dermatome. Symptoms can also include numbness or a sensation of pins and needles when nerve irritation or compression is included. Weakness in the legs or loss of bowel or bladder control in the clear presence of thoracic back pain can signal spinal cord compression and needs to be investigated.
Thoracic spinal pain has been associated with: concurrent musculoskeletal pain; growth and physical; lifestyle and societal; backpack; postural; emotional; and environmental factors.
Special risk factors identified in teenagers comprised age (being old) and poorer mental health.
The most frequent factors behind upper back pain are unknown but theorized to start with muscle annoyance, intervertebral discs, spinal facet joints, ribs or soft tissue (e.g. ligament/fascia) difficulties. Generally intra-scapular pain is sent from the low cervical spine. Contributing factors to harm contain; lack of strength, bad posture, overuse injuries (like repetitive motion), or a trauma (like a car crash or sports injury). Often thoracic pain can be aggravated by wriggling, side bending and with prolonged bent spinal bearings.
A compression fracture of the vertebra can also cause acute and/or continual pain in the upper back. Injury can cause a fracture, but in women over age 50 without major injury or someone known to have osteoporosis, a spontaneous vertebral compression fracture is possible.
Other, less common reasons for thoracic back pain add a spinal disc herniation which regularly may have radicular pain (wrapping around the ribs linked with numbness and burning pain), spinal tumors and rib fractures may mimic thoracic pain/radicular pain. Other possible sources of referral pain to the thoracic area contain visceral organs like: lungs, gallbladder, stomach, liver duodenum, pleura and cardiac.
Middle back pain is definitely considered a “red flag” to alert healthcare professionals to the likelihood of cancer (metastasis or spread to the backbone). That is not a sensitive or particular occurrence and will consequently not be relied upon in isolation.
The word “thoracic” means pertaining to the chest, and the thoracic spine comprises the upper portion of the back that corresponds to the chest region. The upper spine includes twelve vertebrae, and each of the upper nine vertebrae in this section attach into a rib on either side of the back. All the ribs then curves around the side of the body and attaches to the breastbone in front. This forms a sturdy structure (the throracic cage) that supports and protects the internal organs — the heart, lungs and liver.
Comprehensive physiologic testing showing what percentage of pain in the thoracic spine is brought on by disc, facet, rib or muscle are yet to be finished so the response to the question what’s the reason for the pain frequently is left unanswered.
If thoracic pain presents with weakness or numbness of the legs, bowel or bladder incontinence, and/or dropping immediate MRI imaging is signaled.
Non specific thoracic spine pain is generally treated by one or a variety of the following:
Exercise/Active and passive physical therapy
Heavy massage or massage treatment
Ice and/or heat therapy
Analgesics such as non-steroidal anti-inflammatory drugs
Joint manipulation, as commonly performed by physical therapists, chiropractors or osteopathic doctors (D.O.).
If there’s a specific tender area, then trigger point massage or injections can be helpful.
A painful vertebral compression fracture may be treated with pain medication and rest, or with vertebroplasty or kyphoplasty operation. In case the reason is believed to be osteoporosis, oral or intravenous bisphosphonates could possibly be administered to reduce additional fracture risk.