Don’t blame your shoulder and neck for your pain. Your mid back could be the culprit.
New Yorkers spend a good part of their day staring down at their computer screens or smartphones. While those devices are essential to modern life, their constant use often leads to neck and shoulder pain. When the pain and stiffness starts, New Yorkers naturally think the discomfort lies in the neck and shoulders. But it might not.
A mid-back injury or condition may be the root cause of upper back pain in the neck and along the shoulders. Less well known than the lumbar (lower) or the cervical (neck) spine, the mid back or thoracic spine is just as important in supporting your body and helping you move. The solution to your neck and shoulder pain could be a stronger and healthier mid back.
What Is the Mid Back (Thoracic Spine)?
The mid back or thoracic spine extends from the base of your neck to the bottom or your rib cage (the thorax). It consists of 12 vertebrae numbered T1 to T12. Each vertebrae attaches to a rib. Wedged between each vertebrae is a shock-absorbing fluid disc. A network of nerves, muscles, and ligaments surround the thoracic spine.
Though not as mobile as the lower back or neck, the mid-back provides structure and support to the spine. It does that through a group of muscles connecting the mid back to the neck, shoulder, and lower back. Because of its unique anatomy, the mid back plays a vital role in keeping your spine healthy and aligned.
- Supports proper posture
- Maintains smooth neck movement
- Assists shoulder blade or scapular motions
- Distributes load evenly when completing daily tasks
Why the Mid Back Affects the Neck and Shoulders
Every part of the spine works together. When the muscles in the mid back are weak or lack flexibility, the neck muscles and the muscles controlling the scapula (shoulder blade) compensate and that leads to pain and tightness in those areas. You may experience difficulty moving your arms and neck.
Several orthopedic conditions can affect the thoracic spine, causing referred pain in the neck and shoulder. Lifestyle factors and poor posture are culprits, as well. Unfortunately, the mid-back is often overlooked because the pain centers in the neck and shoulder area. An orthopedist or physical therapist can determine if the mid back is the source of your pain.
Common Mid Back Injuries and Conditions
One study of more than 3,700 workers revealed that mid back pain struck 17 percent of the women and 9 percent of the men in the study. Though less prevalent than low back and neck pain, the study concludes 1 in 10 men and 1 in 5 women suffer from thoracic spine pain.
Mid back pain can affect anyone and be due to several orthopedic conditions.
- Muscle strain. Heavy lifting for work or a sudden wrenching of the back can hurt the muscles and ligaments of the mid spine.
- Facet joint arthropathy. This type of arthritis affects the small facet joints in the mid spine that support and stabilize it. Bending or twisting movements worsen the pain.
- Poor posture. Hunching over your laptop, tilting down toward your smartphone, or slouching on your couch for long hours tenses the muscles of the upper and mid-back.
- Herniated disc. A disc cushioning the vertebrae in the middle spine ruptures and leaks fluid, which then irritates nearby nerves. Herniated discs in the mid back are less common compared to the cervical and lumbar spine.
- Myofascial pain syndrome. A chronic condition, myofascial pain syndrome affects the muscles and the thin connective tissue (fascia) around them. The condition typically centers in one localized area, causing a trigger point (or a small bump or nodule) in the muscle. A trigger point can develop in the upper back and shoulder area.
- Chronic or congenital conditions. Chronic conditions, such as osteoarthritis or spinal stenosis, or a congenital abnormality, such as scoliosis (an abnormal curvature of the spine), often cause mid back pain..
Symptoms of Mid Back Issues
A host of symptoms can be traced to a mid back condition or injury, even if the pain doesn’t always radiate in that region of the spine.
- Pain between the shoulder blades
- Tightness or stiffness in upper and mid back
- Radiating discomfort to the neck or shoulders
- Reduced mobility or rotation of the spine
- Muscle fatigue
More serious conditions may be the reason for mid back pain, too. If you experience numbness or tingling in your legs, bowel and bladder incontinence, or chest pain, seek immediate medical attention.
What Causes Mid Back Pain in Daily Life
Our tech-dependent lifestyle often causes mid back pain. But other factors are equally to blame.
- Poor posture. Bad habits, like hunching over your desk or bending your neck forward to see your phone, can throw your spine out of alignment and result in pain.
- Repetitive movements. Constant heavy lifting, twisting, or overhead activities like throwing a ball can over-stress the muscles in the mid back and shoulders.
- Weak core and upper back muscles. The muscles surrounding the mid back and abdomen weaken and cannot support the thoracic spine.
- Lack of activity. Your muscles lose their strength when you stay in one position for too long or are sedentary.
- Muscle tension. Prolonged stress from poor posture or other spinal conditions often leads to a dull ache and tightness in the mid-back area.
How to Prevent Mid Back Injury
Mid-back discomfort isn’t an inevitable part of a fast-paced, technology centric New York City lifestyle. Prevention is key to not letting mid-back pain be a cramp in your daily routine.
Improve your posture
- Strengthen your core muscles
- Stretch tight hip flexor, chest, and neck muscles
- Do posture correcting exercises like chin tucks and wall angels
Change your workstation
- Choose a chair with good lumbar support
- Place your computer screen at eye level to avoid looking down
- Place your keyboard and mouse so your elbows rest at a 90-degree angle
- Use a standing desk
- Take frequent breaks from your desk
Mobility Exercises
- Seated twists
- Bridge pose
- Cat-cow stretch
- Foam rolling
Strength Training
- Light to medium dumbbell lifts
- Face pull with resistance bands
- Scapular squeeze
Activity Modification
- Adapt movements to avoid repetitive strain
- Lift heavy items using your legs
- Perform dynamic stretches to warm up your neck, shoulders, and upper back before exercising
- Do static stretches following a workout to maintain flexibility
Treatment Options for Mid Back Pain
The good news is, conservative therapy effectively treats mid-back pain. And you have plenty of options to choose from.
Conservative Treatments
- Physical therapy to ease pain and increase mobility.
- Strengthen the back and abdominal muscles with light weights and resistance band techniques.
- Stretch the muscles in the upper back and neck with neck and shoulder rolls.
- Manual techniques such as massage and trigger point release.
Pain Management
- Ice to reduce pain and inflammation
- Heat to loosen tight muscles
- Over-the-counter pain relievers (ibuprofen, acetaminophen) and nonsteroidal anti-inflammatories (naproxen, aspirin); remember to check with your physician before taking any medication.
When to Seek Medical Care
Mid back pain typically diminishes within a few days with rest and at-home care. In some instances, however, mid-back pain may signal a more serious underlying condition. Consider making an appointment with an orthopedic physician if you experience prolonged and unusual symptoms.
- Persistent pain lasting more than a few weeks
- Pain follows a fail or blow to the back
- Neurological symptoms (weakness, numbness, and tingling in one or both legs)
- Unable to perform routine tasks
- Bowel and bladder problems
- Fever
How Physical Therapy and Orthopedic Care Helps
The physicians and physical therapists at New York Bone & Joint have advanced training in treating spinal conditions. We prioritize joint and muscle preservation, so 90 percent of our patients are treated conservatively with our comprehensive approach:
- Movement and posture assessment
- Correcting muscle imbalances
- Improving mobility and strength
- Preventing recurrence
We see many patients with neck and shoulder pain related to common mid back injuries and conditions. Let us help you overcome your mid back pain and get back to your life. Contact us today.
FAQs
What is the mid back?
The mid back or thoracic spine consists of 12 vertebrae stretching from the base of your neck to the bottom or your rib cage. Its main function is to provide stability to the spine.
How does the mid back support the neck and the shoulders?
A network of muscles connect the mid back to the neck, shoulder, and lower back. You’re able to move your neck and shoulders because of the mid back muscles. But weakness in the mid back muscles force the neck and shoulder blade to overcompensate, which can lead to pain and stiffness in those regions.
What can cause mid back pain?
Muscle strains from overuse, herniated discs, and chronic conditions like arthritis can all cause mid-back pain. A major culprit is poor posture, slouching at your desk, and looking down at your phone. Those positions pull your spine out of proper alignment.
How is mid-back pain treated?
Physical therapy and exercises to strengthen the core muscles and stretch the mid back muscles successfully resolve the pain and stiffness. Medication and ice/heat therapy are effective, too. You can also improve your posture and re-arrange your workstation to an ergonomic setup. A physical therapist can assist you in making those changes.
