Pathophysiology

The upper back (thoracic spine) is made up of 12 vertebrae and it’s role is mainly to provide stability for the flexible neck and lower back as well as protecting the internal organs.

Symptoms

• Pain in the middle area of the back, can be vague
• Can refer around towards the ribs
• Pain can be worse with extremes of movement e.g twisting movements
• May be restricted or stiff in twisting and arching from the thoracic spine
• Often worse in those with desk based jobs and static postures

Management

• Activity modification and pacing
• Ice or heat
• Pain relief
• Physiotherapy including range of movement exercises and a graded strengthening programme

Investigations

Generally not indicated

Downloads

Download “For pain in the middle of your back”