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This topic provides an overview of upper and middle back pain. If
you have low back pain or neck pain, see the topic
Low Back Pain or
Upper and middle back pain can occur anywhere from the base of
your neck to the bottom of your rib
Your ribs attach to a long, flat bone in the center
of the chest called the sternum and attach to and wrap around your back. If a
nerve in this area is pinched, irritated, or injured, you may also feel pain in
other places where the nerve travels, such as your arms, legs, chest, and
The upper and middle back (called the thoracic spine) has:
See a picture of the
middle back pain is not as common as low back pain or neck pain, because the
bones in this area of the back don't flex or move as much as the bones in your
lower back or neck. Instead, they work with the ribs to keep the back stable
and help protect vital organs, such as the heart and
Upper and middle back pain may be caused by:
In rare cases, pain may be caused by other problems, such as
cancer, or an infection.
Common symptoms of upper and middle back pain are:
serious symptoms that need to be treated right away include:
Your doctor will first ask you about your past
health, your symptoms, and your work and physical activities. Then he or she
will do a physical exam.
Your doctor may also order an imaging test, such as an
X-ray or an
MRI, to find out if
something such as a broken bone or a herniated disc is causing your
You may need more tests to check for other
possible causes for your pain.
In most cases, people with mild to moderate back pain can
manage their symptoms with:
But if your
pain gets worse and you're having a hard time doing your daily activities, you
may need to take a prescription pain medicine. Surgery is seldom used to treat
upper and middle back pain.
There are several things you can do at home
to help reduce your pain. For example:
Health Tools help you make wise health decisions or take action to improve your health.
Learning about upper and middle back pain:
upper and middle back pain:
In most cases, upper and middle back
pain is caused by:
For example, some people hurt their backs when
Conditions that put
pressure on the spinal
nerves also can cause pain. These include:
cases, upper and middle back pain may be caused by other problems, such as
cancer, or an infection.
In general, symptoms of upper and middle
back pain may:
More serious symptoms that need to
be treated right away include:
In most cases, back pain gets better with
home treatment. So unless you have signs of a severe illness, injury, or heart
attack, you can give your back pain some time to work itself out before you
call your doctor.
Call 911 or other emergency services
Call your doctor
Watchful waiting is a wait-and-see approach. If you get better on your own,
you won't need treatment. If you get worse, you and your doctor will decide
what to do next. If your back pain is mild to moderate, it probably will get
better on its own. You can try home treatment to relieve your symptoms. If you
don't feel better in 1 to 2 weeks, call your doctor.
Be sure to call
your doctor right away if you start to have other symptoms or you have:
Health care professionals who often diagnose the cause of
back pain include:
If your back pain is severe or
long-lasting, health professionals who can treat you include:
You can also
get care from:
Your doctor will first ask you about your
past health, your symptoms, and your work and physical activities. Then he or
she will do a physical
exam. Your doctor may also order an imaging test to find out if
something such as a broken bone or a herniated disc is causing your pain.
The type of imaging test you have depends on what kind of problem your
doctor suspects. You may have one or more tests, such as:
More tests may be done to check for other possible causes for your
There are many treatments for upper and
middle back pain. What works for someone else may not help you. Work with your
doctor to find what is best for you.
Treatment for upper and middle back
pain is based on:
In most cases, people with mild to moderate upper and
middle back pain can manage their symptoms with:
If your back pain doesn't get better or it gets worse, your
doctor may recommend:
some cases, a back brace may be used to support the bones in the spine after a
Surgery is seldom used to treat upper and middle back pain. If
your doctor recommends surgery, the type will depend on the problem you have.
Before you decide to have surgery, it's a good idea to get a second opinion
from a different doctor. Surgery choices may include:
There are several things you can do at
home to help reduce your pain. For example:
Here are some other things you can do to feel better:
Esses SI, et al. (2011). The treatment of symptomatic osteoporotic spinal compression fractures. Journal of the American Academy of Orthopaedic Surgeons, 19(3): 176–182. Also available online: http://www.aaos.org/research/guidelines/guide.asp.
McIntosh G, Hall H (2011). Low back pain (acute), search date December 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Other Works Consulted
Hanson TJ (2008). Thoracic compression fracture. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 2nd ed., pp. 213–217. Philadelphia: Saunders Elsevier.
Mercier LR (2008). The back. In Practical Orthopedics, 6th ed., pp. 143–184. Philadelphia: Mosby Elsevier.
ByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency MedicineSpecialist Medical ReviewerRobert B. Keller, MD - Orthopedics
Current as ofJanuary 13, 2015
Current as of:
January 13, 2015
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Robert B. Keller, MD - Orthopedics
How this information was developed to help you make better health decisions.
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