Middle back pain: Causes, symptoms, and treatment options

Middle Back PainPain in the middle of the back can put a damper on your day and affect your ability to complete simple tasks. The middle of the back is made up of 12 thoracic vertebrae and their interlocking facet joints and discs, as well as the different muscles, tendons, and ligaments that allow movement. Because this section of the back is attached to the ribs, it is much more rigid and unable to bend and stretch in the way the upper and lower back can, meaning the discs of the middle back do not experience the same level of degradation as those in other areas. Instead, middle back pain is often a result of strained muscles or stressed joints between the ribs and vertebrae.

Causes of middle back pain

What are some of the most common causes of middle back pain and when should you be concerned? Read on to learn more about why you may be experiencing discomfort in the middle of your back.


Poor posture: One of the most common causes of middle back pain is poor posture, especially if you sit at a desk for long periods of time. Hunched posture can cause tightness in the muscles of the middle of your back, so if you have a desk job, it is important to be mindful of how you are sitting. Try to sit up straight and stretch your shoulders often to keep the muscles in your back loose.

Muscle strain: Whether your job involves heavy lifting or you practice weight-lifting in the gym, ensuring you do so using correct form is crucial to preventing middle back pain. The pain experienced in the middle back associated with lifting improperly is due to muscle strain that can make your job or fitness routine extremely difficult and painful. Be sure to use the proper lifting technique to prevent this—bend at the knees and use your legs to help lift the weight, and carry the heavy mass close to your body to reduce the risk of painful muscle strain.

Vertebral fractures: More common in elderly persons, these fractures often occur in those with the bone-weakening disease osteoporosis. Prevent vertebral fractures by eating a calcium rich diet and taking the appropriate medications to help strengthen your bones.

Herniated spinal disk: Herniated disks can press on spinal nerves and result in pain in the middle of the back. These bulging disks sometimes require surgery to remove.

Myofascial pain: Fascia is the tissue that connects the muscles, and when strained, it can cause a burning or tingling pain in the middle back. Knotty “trigger points” are also common with myofascial pain and they can be relieved through physical therapy, massage, trigger point therapy, or trigger point injections.

Heart attack: Women who are experiencing middle back pain along with chest pain, dizziness, shortness of breath, and/or nausea may be experiencing a heart attack and should seek medical attention immediately.

Aortic aneurysm: Pain in the middle of the back can also be a symptom of an aortic aneurysm, which occurs when abnormal or damaged tissue in the aorta expands and bursts, resulting in severe chest pain and extensive blood loss.

Pleurisy: The inflammation of the lining of your lungs, Pleurisy is characterized by sharp chest pain that can cause middle back pain, and while it is not serious by itself, it could be a warning sign for pneumonia or even lung cancer.

Kidney pain: Pain in the kidneys can feel as though it is coming from the middle back and may indicate an infection that could cause potential damage to your renal system.

Middle back pain symptoms

Some of the symptoms of middle back pain include:

  • A dull, sharp, or burning pain in the middle of the back
  • Muscle stiffness or tightness
  • Sudden middle back pain or gradual middle back pain
  • Pain worsening with specific activity and movement
  • Loss of bowel and/or bladder control
  • Numbness in your arms, legs, chest, or abdomen
  • Weakness in the arms or legs

While most cases of middle back pain can be treated at home, it is important to contact a doctor if you are experiencing any of the last three symptoms listed, or are also experiencing symptoms of a heart attack, serious illness, or injury.

Other symptoms that can accompany middle back pain

Along with the symptoms mentioned above, middle back pain may also be joined with separate symptoms that include anxiety, depression, fatigue, fever, and headaches. Redness, warmth, or swelling in the back is also associated with middle back pain, as well as sleeping problems, stiffness of the back in the morning, and shoulder, neck, and hip pains.

Risk factors and complications of middle back pain

While middle back pain can happen to nearly anyone at any age, it is most prevalent in those between the ages of 30 and 50, as the combination of lifestyle changes that occur around this time and the weakening and aging of the spine and tissues put this age bracket at higher risk. Some risk factors of middle back pain are:

  • Older age
  • Congenital or acquired back problems such as scoliosis and kyphosis
  • Poor posture
  • Pregnancy
  • Obesity and a sedentary lifestyle
  • Smoking
  • Higher levels of stress and anxiety
  • Weak core muscles

These risk factors may lead to complications such as chronic pain, disability, permanent nerve damage or paralysis, and a reduced quality of life.

Other causes of middle back pain

Middle back pain can range in severity and be explained by a number of things, ranging from tight muscles to cancer. Some of the more frequent causes of pain in the middle of the back are:

  • Weak muscles that hinder movement and do not support the back properly
  • Frequent and incorrect use of knapsacks that are too heavy or weighted improperly
  • Trauma from a fall or car accident
  • Long periods of poor posture
  • Slipped or herniated disks
  • Repeated heavy lifting
  • Injuries due to sports

If your pain is not related to a known cause such as injury, poor posture, or improper use of a knapsack, it is important to speak with your doctor about potential causes, as middle back pain can be associated with more serious conditions such as osteoporosis, scoliosis, and some cancers.

Treatment for middle back pain

Depending on the severity of your middle back pain, it is possible to treat it at home. Some easy remedies to soothe your pain are:

Movement: Keeping active despite the pain can actually help improve how you feel. Try walking around your home at an easy pace rather than staying in bed all day, and work your way up to short neighborhood walks. Stretching can also help to ease back pain caused by muscle tightness, and with your physician’s approval, relief can be found by practicing yoga or Pilates. These stretching techniques can also help relieve middle back pain caused by weak muscles and poor posture, as they gently build muscle while keeping your body loose.

Stress reduction: While reducing stress may not be the easiest feat to accomplish, especially if your middle back pain is associated with work, it has proven to be beneficial for relieving muscle tension and reducing back pain. Meditation before bed is a great way to soothe your mind and can help you get a good night’s sleep in order to better recover.

Massage therapy: Middle back pain caused by a sports-related injury may be best treated by a registered massage therapist who specializes in back issues. Getting a massage not only helps to reduce stress, but it can relieve muscle tension and strains, aiding in a speedier recovery.

Heat: For immediate relief of middle back pain, try using a heat compress or spray to help loosen the muscles.


Pain medication: On the recommendation of a doctor or pharmacist, using over-the-counter medications as detailed on the label can be helpful to gain relief from persistent middle back pain.

Middle back pain can affect anyone, though particular age groups are more at risk than others. While muscle strains, poor posture, and injuries are some of the more common causes of this discomfort, pain in the mid-back can also be attributed to more serious conditions and you should always seek the advice or your doctor if you experience any troubling symptoms.

Related: Back pain: Common causes and tips for treatment

Author Bio

Devon Andre has been involved in the health and dietary supplement industry for a number of years. Devon has written extensively for Bel Marra Health. He has a Bachelor of Forensic Science from the University of Windsor, and went on to complete a Juris Doctor from the University of Pittsburgh. Devon is keenly aware of trends and new developments in the area of health and wellness. He embraces an active lifestyle combining diet, exercise and healthy choices. By working to inform readers of the options available to them, he hopes to improve their health and quality of life.



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