Middle Back Pain

Understanding Middle Back Pain

Pain in the middle of your back, also known as the thoracic spine, is different from pain in the upper (neck) or lower back. This part of your spine is connected to your rib cage, which protects vital organs like your heart and lungs. The thoracic spine has twelve segments and is often divided into two areas: the upper middle back (linked to neck and arm pain) and the lower middle back (linked to lower back and hip pain).

What Causes Lower Middle Back Pain?

Degenerative Disc Disease: This is a common condition where the discs between your spinal bones start to wear down, leading to pain and stiffness.

Slipped (Herniated) Disc: While rare in the thoracic region, a slipped disc can press on nerves, causing pain.

Facet Joint Syndrome: The small joints in your spine can become irritated or inflamed, causing pain.

Fractures: More common in older adults or those with osteoporosis, fractures in the thoracic spine can be painful and need medical attention.

Muscle Strains: Overuse or injury can lead to muscle pain and stiffness in this area.

Maigne’s Syndrome: This is a condition where pain radiates from the lower thoracic spine into the lower back and hip.

Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum (breastbone).

Myofascial Pain Syndrome: Trigger points or "knots" in muscles can cause pain in the middle back.

What Causes Upper Middle Back Pain?

Degenerative Disc Disease: As with the lower back, disc degeneration in the thoracic spine can cause pain and discomfort.

Slipped (Herniated) Disc: Though rare, a slipped disc can cause significant pain in the upper back.

Facet Joint Syndrome: Inflammation or irritation of the facet joints in the upper thoracic spine can lead to pain.

Thoracic Outlet Syndrome: This condition occurs when nerves or blood vessels in the neck and shoulder area are compressed, leading to pain in the neck, shoulders, or arms.

T4 Syndrome: This is a rare condition where dysfunction in the T4 vertebra (near the upper thoracic spine) causes pain that radiates into the arms.

Poor posture, especially a rounded back or increased spinal curve (kyphosis), is closely linked to upper middle back pain. This can also contribute to neck and lower back pain. Addressing posture through chiropractic care, exercises, and lifestyle changes can significantly reduce discomfort and improve overall spinal health.

Reference:

Wong, J. J., et al. (2017). "Clinical Practice Guidelines for the Noninvasive Management of Low Back Pain: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration." European Spine Journal, 26(9), 2430-2448. DOI: 10.1007/s00586-017-5223-1.

Common Treatments for Middle Back Pain

When it comes to managing mid-back pain, a combination of chiropractic care, exercises, myofascial therapy, and patient education is often effective. These approaches focus on relieving pain, improving function, and preventing future problems.

Chiropractic Care:

Chiropractic adjustments are a core treatment for mid-back pain. These gentle manipulations of the spine can help restore proper movement, reduce pain, and improve mobility. Chiropractors may also use mobilisation techniques, which involve slower, more sustained movements to ease stiffness in the thoracic spine.

Exercise Therapy:

Specific exercises tailored to your needs can help strengthen the muscles that support your mid-back, improve flexibility, and enhance overall posture. Regular exercise not only helps relieve pain but also prevents future episodes by stabilizing the spine and improving your range of motion.

Myofascial Therapy:

Myofascial therapy targets the connective tissues (fascia) that surround muscles. This hands-on technique helps release tight areas, known as trigger points, that contribute to pain. By applying sustained pressure on these areas, myofascial therapy can reduce muscle tension, improve blood flow, and decrease discomfort in the mid-back.

Patient Education:

Understanding the factors that contribute to mid-back pain is crucial for effective management. Chiropractors often educate patients on posture, ergonomics, and lifestyle changes to reduce the risk of recurrence. Learning how to maintain a healthy spine through proper posture and safe movement habits is key to long-term pain relief.

Common Exercises for Middle Back Pain

Engaging in the right exercises can significantly reduce mid-back pain and improve your overall spinal health. Here are some effective exercises that are commonly recommended for this area:

Thoracic Extension Exercises:

Sit on a chair with a backrest. Place your hands behind your head, elbows wide. Gently lean back over the backrest, extending your upper back. Hold for a few seconds and return to the starting position.

Benefits: This exercise helps improve the mobility of the thoracic spine and counteracts the effects of poor posture.

Cat-Cow Stretch:

Start on your hands and knees. Arch your back upwards (like a cat) while tucking your chin towards your chest. Then, dip your back downwards while lifting your head and tailbone (like a cow). Repeat slowly.

Benefits: This stretch increases flexibility in the spine and helps relieve tension in the mid-back.

Thoracic Rotation:

Sit with your feet flat on the floor. Cross your arms over your chest. Slowly twist your upper body to one side, keeping your hips stable. Hold for a few seconds, then rotate to the other side.

Benefits: Thoracic rotations enhance spinal mobility and reduce stiffness in the mid-back.

Foam Roller Extensions:

Lie on your back with a foam roller placed horizontally under your upper back. Support your head with your hands and gently roll back and forth, focusing on the thoracic spine. You can also pause and extend over the roller to increase the stretch.

Benefits: This exercise helps release tension in the thoracic spine and improves flexibility.

Regularly incorporating these exercises into your routine can help alleviate middle back pain and promote a healthier spine. However, it's essential to consult with a healthcare professional or chiropractor to ensure these exercises are appropriate for your specific condition.

References:

Wong, J. J., et al. (2017). "Clinical Practice Guidelines for the Noninvasive Management of Low Back Pain: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration." European Spine Journal, 26(9), 2430-2448. DOI: 10.1007/s00586-017-5223-1.

Oakley, P. A., & Harrison, D. E. (2019). "Evidence-Based Chiropractic Care of Musculoskeletal Disorders in the 21st Century." Journal of Clinical Chiropractic Pediatrics, 19(2), 1573-1578. DOI: 10.21307/jccp-2019-1573.

How Can We Help You?

At our clinic, we are dedicated to providing comprehensive care to help you find relief from your MSK pain and discomfort. Our approach to treatment is tailored to meet your individual health needs and includes a combination of Chiropractic Treatment, Exercise Therapy, Myofascial Therapy, Dry Needling and Patient Education (NRE).

What If We Cannot Help You?

While we strive to deliver the best possible outcomes utilising our specialist services, we understand that some cases may require additional intervention. If your condition does not improve as expected or if we believe that another approach might be more appropriate, we can:

• Refer You to Your GP: We will coordinate with your General Practitioner to ensure you receive the appropriate medical evaluation and care.

• Recommend Diagnostic Imaging: If necessary, we may suggest diagnostic imaging, such as X-rays or MRI scans, to get a clearer understanding of your condition and inform the next steps in your treatment.

• Refer You to a Specialist: In cases where specialised care is needed, we will refer you to a trusted specialist to ensure you receive the most effective treatment.

Our commitment is to your health and well-being, and we will guide you every step of the way to ensure you receive the care that’s right for you.