Thoracic Pain – Mid Back Pain

If you have ever had thoracic pain (mid back pain) and wonder how it could of happened….

Your thoracic spine, also known as your mid back, is made up of 12 individual vertebrae and has a pair of ribs associated with each segment. The primary purpose of your thoracic spine and rib cage is primarily structure and protection but is also responsible for your trunk movement. Pain through the mid back can present in a multitude of ways due to the huge number of structures including vertebrae, muscles, ligaments and organs. 

Most commonly we see complaints that are resulting in stiffness and aching pains, this is often from patients being in the same position too long, whether it be desk workers sitting for 8 hours or nurses on their feet for 8 hours. This is commonly a combination of overused and under-utilised muscles and joints. 

Some more acute injuries of the thoracic spine and rib cage are caused from every day activities, lifting something and twisting can cause facet sprains you can find out about  more via this link or rib sprains, this alternatively can occur from something as simple as coughing or sneezing. 

More seriously when aches and pains don’t fit into a musculoskeletal presentation the pain can be from the organs laying underneath. This can include kidney or gall stones, serious pathologies and infections, these are all quite rare but always a possibility. If you can’t explain your pain, if it is constant and unremitting your first port of call should be to the doctors.

Common Structures Injured

Facet Sprains is super common injury we see in the clinic, commonly presented as sharp pinching pains on movement and can have a dull ache when relaxing. This is often caused by lifting and twisting, sleeping in awkward positions and can be aggravated from contact sports such as football and basketball

Muscle Strains there are many muscles running throughout your thoracic spine, many include muscles supporting your scapula and shoulder, your intercostal muscles between your ribs and the large latissimus dorsi muscle which is commonly aggravated in cricket players and gym goers. Muscle injuries normally have a specific incident that caused the strain and will be frustrating with movement and daily activities, normally presents are a dull ache with weakness in the associated motion of the muscle. 

  • Rib sprains – a super painful injury. Often a rib sprain through 1-6 can cause such acute chest pain that patients have mistaken it for a heart attack. Rib sprains cause pain to breath and move in most directions. Commonly hurt with sneezing or coughing fits  
  • Costochrondritis – A pain usually at the front of the rib cage (costal cartilage) caused by inflammation in the joint. This can start due to a viral or bacterial infection, but in sports players it can present insidiously. This can take anywhere from days to months to get over and may require medication to manage the infection and inflammation. 
  • Disc injuries – Unlike the lumbar spine disc injuries are rarely seen in the thoracic spine, this is due to the changes in the curve of the spine and the weight transfer going through the joints. Disc injuries in the mid back are usually due to a more traumatic injury, potentially involving crush or lifting overhead, even car and bike accidents can create enough force.

Assessment and Management


Assessment of your injuries will be done by a thorough case history and palpation with some orthopedic testing which can help indicate or rule out subjects involved. 

Once we have a suspected tissue causing pain your management will be tailored to the injury. This will include manual therapy in the clinic combined with a series of stretches and exercises to help you get through your recovery. 

Times for healing are strongly dependent on the tissue involved and how many aggravating factors we can manage. Ligaments can take 2-12 weeks and muscles can take 4-8 weeks all depending on the aforementioned factors. 

If you have an injury please contact our clinic today so that one of our great osteopaths can assess and help you recover from your injury.

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