Back pain between your shoulder blades can be nagging, sharp, or downright alarming, especially when you’re not sure what’s causing it. The upper middle back is known as the thoracic region.
In the thoracic region, 12 vertebrae connect to your ribs, forming the protective rib cage around organs like your heart and lungs. This area of the spine is different from your neck and lower back because it is generally more stable and moves less. The middle back has a limited range of motion, which makes it less prone to injuries. But it can still suffer from strains, disc problems, fractures, or other health issues that cause pain.
What Causes Upper Middle Back Pain?
Pain in the thoracic region can happen for different reasons:
- Muscle and ligament strains can occur when the soft tissues supporting your spine are overstretched. Actions like improper lifting or repetitive movements can lead to inflammation, stiffness, or spasms.
- Although more common in the neck or lower back, bulging and herniated discs can still happen in the thoracic spine. When discs are damaged, they can irritate nearby nerves and cause pain, numbness, and tingling.
- Poor posture from hunching over a desk or staring down at a phone can strain the muscles and ligaments in your upper back. This can lead to chronic discomfort.
- Trauma from an impact can fracture the vertebrae.
- Scoliosis, a sideways curvature of the spine, can place uneven stress on the muscles and ligaments around the thoracic vertebrae. This leads to muscle fatigue, tension, and inflammation.
- Osteoarthritis can affect the small joints between vertebrae. This age-related wear and tear can cause pain and stiffness.
- Though less common, other conditions are important to consider if symptoms are unexplained. Rare causes of upper-middle back pain include infections or tumors.
Upper Middle Back Pain Symptoms
The symptoms you experience depend on what is causing it and can include:
- A dull ache, throbbing, or stiffness that worsens with certain movements
- A sharp, burning sensation in one specific spot
- Muscle tension and limited range of motion
- Radiating pain, numbness, or tingling in your arms, chest, or torso
If you feel weak, have balance problems, or struggle with daily tasks, these signs might mean there is a more serious issue. It’s important to get a medical check-up right away.
Diagnosing Upper Middle Back Pain
Your doctor may observe your posture and ask you to perform simple bending and twisting movements to see how they affect your pain. Checking muscle strength, sensation, and reflexes can help determine if there is any nerve involvement.
Imaging tests may also be done:
- X-rays offer a picture of the spinal bones to see fractures, arthritic changes, or alignment issues
- MRI scans produce detailed images of discs, nerves, and other soft tissues
- CT scans provide cross-sectional 3D images for a clearer view of bone and some soft tissue structures
Electromyography (EMG) may be done to test nerve and muscle function if there’s concern about nerve damage.
Finally, blood tests can check for inflammation, infections, and markers of certain arthritic conditions.
How is Upper Back Pain Treated?
In many cases, upper back pain responds well to simple self-care measures.
Over-the-counter pain relievers, such as nonsteroidal anti-inflammatories (NSAIDS), will help reduce inflammation. If these aren’t enough, your doctor may recommend a prescription option.
Applying a warm compress brings blood flow to tight spots, while cold packs can ease swelling. Additionally, massage therapy can loosen tight muscles and ligaments around the spine.
Gentle movements like light stretching can help keep the area flexible. Targeted exercises and posture training from a physical therapist may provide relief, too.
Good posture removes unnecessary stress from your thoracic spine. Focus on sitting and standing upright with your shoulders back. Making ergonomic adjustments, like raising or lowering your chair, can also help.
Should I See a Doctor?
Most upper-middle back pain improves with self-care, but some symptoms could signal a more serious issue, including:
- Worsening discomfort
- Severe pain
- Pain that starts suddenly or spreads to your chest or abdomen
- Pain following an injury
- Numbness, tingling, or weakness in your arms, legs, or torso
- Difficulty walking
- Trouble maintaining balance
- Loss of bladder or bowel control
- Unexplained weight loss, fever, or night sweats
When back pain fails to improve with self-care, a medical evaluation can help determine the best course of action.
Don’t wait for symptoms to get worse – schedule an appointment today!
