Thoracic back pain is a common ache or discomfort in the area of the middle and upper back. The thoracic region of the spine runs from the base of the neck to the bottom of the chest area that is below the breastbone.
The back has many small bones, muscles, and soft tissues that surround and protect the spinal cord. Nerves also leave the spinal cord in the back. Pain may be caused by stress, strain, or injury to any of these structures, such as:
Gradual wear and tear of tissue
Fractures of vertebra (spinal bones)
Nerve compression—pressure on nerves that exit the spine may be caused by problems with muscles, bones, or disc between vertebra
Herniated disc—damage to cushions that sit between the vertebra
Imbalance of muscles that support the spine
Rarely, thoracic back pain is associated with more serious problems like an infection in the spine, heart or lung problems, or cancer.
You will be asked about your symptoms and medical history. A physical exam will be done, which will include an assessment of the spine and muscles. Your strength, flexibility, sensation, and reflexes may be tested.
Imaging tests may be done if the pain is severe or is not going away as expected. Images of the spine and surrounding structures may be taken with:
Physical therapy may be recommended for pain that is limiting daily function or pain that is recurring. A therapist can provide stretching and strengthening exercises to help regain muscular and postural balance. Instruction may also be provided on irritating factors like sitting posture or lifting techniques.
Therapy may also include heat, cold, massage, or ultrasound treatments for more immediate pain relief.