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Mid Back Pain Symptoms and Common Causes

What Causes Thoracic Spine Pain — And How to Recognize It

Mid back pain — also called thoracic back pain — is more common than many people realize. While neck and low back pain tend to receive more attention, the thoracic spine can become a significant source of discomfort, particularly for people who sit for long periods or perform repetitive movements throughout the day.

If you are experiencing stiffness, aching, or sharp pain between your shoulder blades, understanding the common causes and symptoms of mid back pain is the first step toward finding effective relief. At Fredericton Family Chiropractic, we see patients dealing with mid back pain every day, and most cases are caused by mechanical factors that respond well to conservative chiropractic care.

This page is part of our comprehensive Mid Back Pain Guide.

Understanding the Thoracic Spine

The thoracic spine is the longest section of the spinal column, made up of 12 vertebrae labeled T1 through T12. It spans from the base of the neck to the bottom of the rib cage.

Unlike the cervical spine (neck) and lumbar spine (lower back), which are designed primarily for mobility, the thoracic spine is built for stability and protection. Each thoracic vertebra connects to a pair of ribs, forming the rib cage that protects your heart, lungs, and other vital organs.

This inherent stability means the thoracic spine does not move as freely as the neck or lower back. However, it still requires a healthy range of motion — particularly rotation and extension — to function properly. When the thoracic spine becomes too stiff, it can cause local pain and also create compensatory problems above and below. Learn more about why thoracic spine mobility matters for your whole body.

The key structures that can contribute to mid back pain include:

  • Thoracic facet joints — the small joints that connect each vertebra and guide spinal movement
  • Costovertebral joints — the joints where each rib attaches to its corresponding vertebra
  • Costotransverse joints — additional rib-to-spine connections at the transverse processes
  • Intervertebral discs — the cushions between each vertebra that absorb load
  • Muscles — including the rhomboids, middle and lower trapezius, erector spinae, and multifidus
  • Ligaments — the connective tissues that support the spinal joints

Because several of these structures can become irritated simultaneously, mid back pain often presents as a diffuse aching sensation rather than a single sharp point.

Common Causes of Mid Back Pain

Most mid back pain develops gradually from repeated mechanical stress rather than a single injury. At Fredericton Family Chiropractic, the following are the most common causes we see in our patients:

Postural Strain and Prolonged Sitting

This is by far the most common cause of mid back pain we treat. When you sit for extended periods — especially with a rounded upper back and forward head posture — the thoracic spine stays in a flexed position. Over time, the joints stiffen, the muscles between the shoulder blades fatigue, and pain develops.

This is particularly common among government employees, university students at UNB and STU, and desk-based professionals throughout the Fredericton area. If your mid back pain gets worse as the day goes on or feels better on weekends and holidays, postural strain is likely a major contributor. Read our detailed guide on how desk work affects your thoracic spine.

Thoracic Joint Restriction

The facet joints of the thoracic spine can become stiff or restricted from prolonged positioning, lack of movement, or minor strain. When a joint loses its normal range of motion, the surrounding muscles tighten to compensate. This creates a self-reinforcing cycle: the joint stays stiff, the muscles guard, and pain persists or worsens.

Joint restriction is one of the primary targets of chiropractic treatment. A spinal adjustment can restore normal motion to a restricted joint, helping to break this cycle. Learn more about how we treat mid back pain at our Fredericton clinic.

Costovertebral and Rib Joint Dysfunction

Each thoracic vertebra connects to a rib on each side. These costovertebral joints can become irritated from coughing, sneezing, twisting, reaching overhead, or even sleeping in an awkward position.

Rib joint dysfunction often produces a distinctive pattern of symptoms: a sharp or catching pain with deep breathing, pain that wraps around the rib cage, or a localized tender spot beside the spine. Some patients describe it as a feeling that something is “out of place” or “stuck.” This type of pain can be alarming because it sometimes mimics chest or cardiac-related discomfort, but it is usually mechanical and responds well to treatment.

Muscle Tension and Trigger Points

The muscles of the mid back — particularly the rhomboids, middle trapezius, and erector spinae — are prone to developing trigger points. These are hyperirritable areas within a taut band of muscle that produce localized tenderness and often refer pain to nearby areas.

Common triggers include sustained posture, emotional stress, repetitive arm movements, and overuse. Trigger points between the shoulder blades are one of the most frequent complaints we see at our Fredericton clinic, and they often accompany underlying joint stiffness.

Stress and Emotional Tension

Many people unconsciously carry stress in their upper and mid back. Chronic emotional tension causes the muscles between the shoulder blades to tighten, the shoulders to elevate, and the thoracic spine to stiffen. Over time, this pattern can produce persistent mid back pain that seems to come and go with stress levels.

Addressing the physical component of stress-related mid back pain through chiropractic care, massage therapy, and movement can help break this pattern.

Repetitive Strain and Overuse

Activities that involve repeated bending, lifting, twisting, or reaching can gradually overload the structures of the mid back. This is common in trades, manual labour, and certain sports. Even repetitive arm movements — such as prolonged computer mouse use or overhead reaching — can strain the muscles and joints of the thoracic region over time.

Motor Vehicle Accidents and Trauma

The forces involved in a motor vehicle accident can cause significant strain to the thoracic spine, even when the primary injury appears to be in the neck or lower back. Whiplash injuries can affect the mid back, and the bracing or impact forces during a collision can irritate thoracic joints, muscles, and rib attachments.

If you are experiencing mid back pain after an accident, early assessment is important. Learn more about our motor vehicle accident rehabilitation services.

Thoracic Disc Irritation

Although much less common than in the cervical or lumbar spine, thoracic disc problems can occur. Thoracic disc bulges or herniations can produce local mid back pain and, in some cases, pain that radiates along the rib cage. Because thoracic disc issues are relatively rare, other causes are usually investigated first.

Degenerative Changes

Like all areas of the spine, the thoracic region can develop age-related changes including disc degeneration, facet joint arthritis, and osteophyte formation. These changes are often visible on imaging but may or may not be the actual source of pain. Many people with degenerative changes on X-ray or MRI experience no symptoms at all, while others may develop stiffness or discomfort over time.

Common Symptoms of Mid Back Pain

Mid back pain can present in different ways depending on the underlying cause. Recognizing your symptoms can help your chiropractor identify the most likely source and develop an appropriate treatment plan.

Dull, Aching Pain Between the Shoulder Blades

This is the most common presentation we see. It is often related to postural strain, muscle fatigue, or joint stiffness and tends to worsen with prolonged sitting or desk work. The pain may feel like a deep, persistent ache that is difficult to pinpoint to one exact spot.

Stiffness and Reduced Mobility

A stiff mid back — particularly first thing in the morning or after sitting for a long time — is a hallmark of thoracic joint restriction. You may notice difficulty rotating your trunk, reaching overhead, or taking a deep breath.

Sharp Pain with Breathing or Movement

Sharp, localized pain that occurs with deep breathing, coughing, or twisting is often associated with costovertebral (rib) joint dysfunction. The pain may be felt beside the spine or along the rib cage, and it can sometimes wrap around to the front of the chest.

Muscle Spasm and Tightness

The muscles of the mid back may go into spasm in response to joint irritation, overuse, or acute strain. This can produce a feeling of tightness, tension, or a visible “knot” in the muscle.

Referred Pain

Pain from the thoracic spine can refer to other areas, including around the rib cage, into the chest wall, or between the shoulder blades. Trigger points in the mid back muscles can also refer pain to the shoulders, arms, or the front of the chest.

Pain That Worsens with Posture or Activity

Mid back pain that increases with prolonged sitting, standing, bending, or specific work activities is usually mechanical in nature. This pattern suggests that the pain is related to how the spine moves, loads, and responds to physical stress — and it generally responds well to chiropractic treatment and postural correction.

When Mid Back Pain Needs Urgent Attention

Most mid back pain is mechanical and not dangerous. However, because the thoracic spine is located near vital organs, certain symptoms warrant prompt medical evaluation:

  • Sudden, severe mid back pain after significant trauma
  • Mid back pain accompanied by chest pain, shortness of breath, or difficulty breathing
  • Pain with numbness, tingling, or weakness in the legs
  • Loss of bladder or bowel control
  • Unexplained weight loss with persistent thoracic pain
  • Fever or signs of infection with back pain
  • A history of cancer with new or worsening mid back pain

If you experience any of these symptoms, seek medical attention immediately. A chiropractor should always screen for red flags as part of a thorough initial assessment.

How Fredericton Family Chiropractic Can Help

Understanding the cause and symptoms of your mid back pain is the first step. The next step is getting a proper assessment from a qualified healthcare provider who can identify what is driving your pain and develop a plan to address it.

At Fredericton Family Chiropractic, Dr. Scott Brayall and our team take a thorough, evidence-based approach to mid back pain. We assess your posture, spinal mobility, joint function, and muscle tension to determine the most appropriate course of care.

If you are dealing with mid back pain in Fredericton or the surrounding New Brunswick communities, we are here to help.

Book an appointment or call us at (506) 472-7000 to get started.

Continue Reading: Mid Back Pain Guide

See all conditions we treat in Fredericton

References

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors. A Systematic Review. BMC Musculoskeletal Disorders. 2009.

Heneghan NR, Rushton A. Understanding Why the Thoracic Region Is the “Cinderella” Region of the Spine. Manual Therapy. 2016.

Southerst D, Marchand AA, Côté P, et al. The Effectiveness of Noninvasive Interventions for Musculoskeletal Thoracic Spine and Chest Wall Pain. Journal of Manipulative and Physiological Therapeutics. 2015.

Walser RF, Meserve BB, Boucher TR. The Effectiveness of Thoracic Spine Manipulation for the Management of Musculoskeletal Conditions. Journal of Manual and Manipulative Therapy. 2009.

Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins. 1999.