Middle/ Thoracic Spine

The thoracic spine joins the cervical spine and extends down past the bottom of the shoulder blades, where it connects with the lumbar spine. The thoracic spine made up of twelve vertebrae is built for stability, holding the body upright and protecting the vital organs in the chest.

The most common cause of thoracic back pain is due to muscular irritation or other soft tissue problems, caused by poor posture, overuse injuries such as repetitive motion, or trauma.

Some common ailments that contribute to mid-back discomfort:

Strained or Irritated Muscles

Thoracic back pain may occur as a result of sudden injury, strain or poor posture over time, which aggravate muscle tissue and damages small blood vessels.

Joint Dysfunction

Pain caused by joint dysfunction, where the ribs attach to the spine at each level of the thoracic spine

Injured Discs

When a disc in the spine is injured, the nucleus may seep through the weakened point in its hard outer casing, placing a strain on surrounding nerves, ligaments and tissues while also threatening the structure of the spine.

Fractured Vertebrae High impact accidents, as well as extreme spinal deterioration, can lead to a vertebral fracture.

High impact accidents, as well as extreme spinal deterioration, can lead to a vertebral fracture.


Osteoporosis happens when new bone is not created quickly enough to replace old bone, resulting in frail, brittle bones.


Arthritis in the spine can cause tenderness, pressure to the nerve, and limited range of motion. With age, the cartilages in the facet joints can become thin or disappear or can produce an overgrowth of bone spurs and an enlargement of the joints.


Infections can cause inflammation in the spinal joints and cause middle back pain.


Scoliosis, a sideways curvature of the spine, can cause pain as the proper weight distribution system of the spine is disturbed, and tissues, ligaments and nerves are disrupted.

Sometimes, the pain felt in the thoracic spine can be a symptom of a more serious underlying disease or problems such as a cancerous tumour, certain diseases of the heart, lungs, abdominal organs, or kidneys.

Middle Spine Pain Symptoms

  • Stiffness and tightness, especially in the morning • Muscle spasms • Tenderness • Numbness • Shooting pain • Bad posture • Weakness • Shoulder, neck or hip pain • Sleeping problems • Headache • Fatigue • Depression and anxiety may also accompany your middle back pain. • In the case of chest pain, difficulty breathing, jaw pain, loss of bladder control, severe abdominal pain or if paralysis in the leg occurs, seek emergency medical assistance as these complications may signify a life-threatening problem.

Treatment Approach

Spine surgery is typically recommended if nonsurgical treatments, such as medications and physical therapy have not relieved the painful symptoms and if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis.

Minimally Invasive Spine Surgery

In recent years, technological advances have allowed back and neck conditions to be treated with a minimally invasive surgical technique. Because minimally invasive spine surgery (MISS), does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.

Minimally invasive spine surgery (MISS) is sometimes called less invasive spine surgery. In these procedures, doctors use specialised instruments to access the spine through small incisions.

Although MISS holds advantages for many patients, it is important to note that some back and neck problems cannot yet be treated effectively with minimally invasive methods.

The doctor will evaluate to select the appropriate treatment based on various factors.

Dr Nishat Goda

Spine and Joint Replacement Surgeon

K J Somaiya Hospital Super Speciality Centre.

Associate Professor, K J Somaiya Hospital

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