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  • Writer's pictureNashville PT

Common Causes of Thoracic (Mid/Upper Back) Pain

person pointing to pain in mid back thoracic area

Thoracic pain, or pain in the middle and upper back region, can significantly impact your daily life and restrict your mobility. Whether it's a dull ache or a sharp discomfort, thoracic pain can be a cause for concern. In this blog post, we'll explore the common causes of thoracic pain and discuss effective ways to find relief. Let's delve into the world of thoracic pain and discover how to alleviate it.

thoracic spine anatomy with ribs

Anatomy of Thoracic Spine

To comprehend the common causes of thoracic pain, it's essential to familiarize ourselves with the anatomy of the thoracic region. The thoracic spine is the middle portion of the spine, consisting of twelve vertebrae labeled as T1 to T12. This region forms the back of the chest and serves as the foundation for the rib cage, providing protection to vital organs like the heart and lungs.

Between each thoracic vertebra, there are intervertebral discs that act as shock absorbers and allow for flexibility. Surrounding the vertebrae are ligaments and muscles that provide stability and support to the spine.

The thoracic spine also houses the spinal cord, which carries nerve signals between the brain and the rest of the body. Nerves branching off the spinal cord exit through openings in the sides of the vertebrae, called intervertebral foramina, and extend to various parts of the body, including the chest, abdomen, and back.

The rib cage, consisting of twelve pairs of ribs, is connected to the thoracic vertebrae at the back, forming a protective enclosure for the vital organs. The ribs curve around the sides and attach to the sternum (breastbone) at the front, creating a sturdy framework for the chest cavity.

Within the thoracic region, there are also muscles involved in breathing, such as the intercostal muscles situated between the ribs. These muscles assist in expanding and contracting the rib cage during inhalation and exhalation.

Now, let's explore the potential causes of thoracic pain. Whether it's due to poor posture, muscle strain, trauma, or underlying conditions, understanding the root cause is crucial in finding appropriate treatment.

Common Causes of Thoracic or Mid/Upper Back Pain

1. Muscle Strain and Tension

One of the most prevalent causes of thoracic pain is muscle strain and tension. Prolonged poor posture, heavy lifting, or sudden movements can strain the muscles in your back, leading to pain and discomfort. If you've recently engaged in activities that may have strained your back muscles, they could be contributing to your thoracic pain.

2. Poor Ergonomics and Posture

Spending long hours hunched over a desk or engaging in activities that promote poor posture can lead to thoracic pain. Slouching, rounded shoulders, and improper lifting techniques can strain the muscles and ligaments in your thoracic region. Maintaining good posture and practicing ergonomic habits can help reduce the risk of developing thoracic pain.

3. Herniated Disc

A herniated disc in the thoracic region occurs when the soft cushion-like discs between your vertebrae become damaged or displaced. This can result in nerve compression and cause pain in the middle back area. If you experience persistent thoracic pain accompanied by radiating pain or tingling sensations, a herniated disc might be the underlying cause.

4. Osteoarthritis

Osteoarthritis, a degenerative joint disease, can affect the thoracic spine. Over time, the cartilage between the vertebrae wears down, leading to bone-on-bone contact and inflammation. This can result in thoracic pain, stiffness, and limited mobility. If you're over the age of 50 and experience chronic thoracic pain, osteoarthritis may be a contributing factor.

5. Postural Kyphosis

Postural kyphosis refers to an excessive curvature of the upper back, leading to a rounded or hunched appearance. This abnormal spinal curvature can cause thoracic pain and affect your posture and range of motion. If you notice a significant rounding of your upper back and experience thoracic pain, it's important to consult a healthcare professional for evaluation and guidance.

When to Seek Professional Help

While mild thoracic pain can often be managed with self-care measures, persistent or severe pain should be evaluated by a healthcare professional. A physical therapist or spine specialist can assess your condition, identify the underlying cause, and develop a tailored treatment plan to alleviate your thoracic pain.

Treatment Options

Treatment for thoracic pain may include a combination of therapies, such as physical therapy exercises to improve strength and flexibility, manual therapy techniques, postural correction strategies, pain management strategies, and lifestyle modifications. Your physical therapist will design a personalized treatment plan to address the root cause of your thoracic pain and promote healing.

Understanding the common causes of thoracic pain empowers you to take control of your well-being and seek appropriate treatment. If you're experiencing persistent thoracic pain or discomfort that interferes with your daily life, reach out to our team at Nashville Physical Therapy & Performance. We are committed to providing personalized care and effective solutions to help you find relief from thoracic pain and improve your overall quality of life.


- Mayo Clinic. (2021). Back Pain. Retrieved from

- American Academy of Orthopaedic Surgeons. (

2020). Thoracic Sprain. Retrieved from

- National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2020). Back Pain. Retrieved from

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