Understanding Thoracic Pain: Causes, Symptoms, Diagnosis, Treatment, and Management

Thoracic Pain
Dr. Garrett Stroup. Physical Therapist in Roseburg Area.


Dr. Garrett C. Stroup

DPT, VRC - Owner and Founder

We help athletes and active adults regain control of their injury without expensive surgeries or medications, so they can keep going.


Thoracic pain, also known as mid-back pain, is a common complaint that affects many individuals at some point in their lives. The thoracic region, located between the cervical (neck) and lumbar (lower back) regions of the spine, plays a crucial role in supporting the upper body and protecting vital organs. However, the thoracic spine is also susceptible to various conditions that can cause pain and discomfort. In this comprehensive 3000-word article, we will explore the causes, symptoms, diagnosis, treatment options, and management strategies for thoracic pain.

Section 1: Anatomy of the Thoracic Spine

The thoracic spine is made up of twelve vertebrae (T1 to T12) and is situated between the cervical and lumbar regions. Each vertebra in the thoracic spine is connected to a rib on each side, forming the thoracic cage, which protects the heart and lungs. The thoracic spine is less flexible than the cervical and lumbar regions due to the presence of the rib cage. The intervertebral discs between the thoracic vertebrae act as shock absorbers, providing stability and cushioning for the spine.

Section 2: Common Causes of Thoracic Pain

Thoracic pain can arise from various factors, including:

  • Muscle Strain: Overuse, poor posture, or sudden movements can strain the muscles in the thoracic region, leading to pain and discomfort.
  • Poor Posture: Slouching or maintaining an improper posture for extended periods can put strain on the thoracic spine and surrounding muscles.
  • Herniated Disc: A herniated disc in the thoracic region can compress nearby nerves, causing pain and radiating symptoms.
  • Osteoarthritis: Degeneration of the facet joints between the thoracic vertebrae can lead to osteoarthritis, causing pain and stiffness.
  • Fractures: Trauma, such as a fall or car accident, can cause fractures in the thoracic vertebrae, resulting in acute pain.
  • Scoliosis: A sideways curvature of the spine can affect the thoracic region, leading to pain and discomfort.
  • Kyphosis: An exaggerated forward rounding of the upper back can cause thoracic pain and stiffness.
  • Ankylosing Spondylitis: A form of arthritis that primarily affects the spine, leading to pain and limited mobility.

Section 3: Symptoms of Thoracic Pain

Symptoms of Thoracic Pain


Thoracic pain can present with various symptoms, which may vary depending on the underlying cause. Common symptoms include:

  • Pain: Dull, aching, or sharp pain in the mid-back region, which may worsen with movement or certain activities.
  • Stiffness: Reduced flexibility in the thoracic spine, leading to difficulty in bending or twisting.
  • Muscle Tension: Tightness and muscle spasms in the back muscles.
  • Radiating Pain: Pain that radiates to the chest, abdomen, or arms in some cases.
  • Numbness and Tingling: Sensations of numbness or tingling in the chest, arms, or hands if nerve compression is involved.
  • Difficulty Breathing: In severe cases, thoracic pain may cause difficulty in taking deep breaths or breathing deeply.

Section 4: Diagnosis of Thoracic Pain

Accurate diagnosis of thoracic pain is essential for determining the underlying cause and guiding appropriate treatment. The following methods are commonly used for diagnosis:

  • Medical History: The healthcare provider will inquire about the patient’s symptoms, medical history, and any recent injuries or activities that may have contributed to the thoracic pain.
  • Physical Examination: A thorough examination of the back, assessing posture, range of motion, tenderness, and signs of inflammation.
  • Imaging Studies: X-rays, MRI, or CT scans may be conducted to visualize the thoracic spine’s internal structures and detect any abnormalities or signs of joint degeneration or herniated discs.
  • Bone Scan: A bone scan may be used to detect fractures or inflammation in the thoracic vertebrae.
  • Electromyography (EMG): EMG tests can evaluate nerve function and identify nerve compression or damage.

Section 5: Treatment Options for Thoracic Pain

Treatment for thoracic pain depends on the underlying cause and the severity of the symptoms. Common treatment options include:

  • Rest and Activity Modification: Resting the back and avoiding activities that exacerbate pain can help promote healing and prevent further strain.
  • Physical Therapy: Targeted exercises and stretches can help strengthen the muscles around the thoracic spine, improve flexibility, and reduce pain.
  • Heat and Cold Therapy: Applying heat packs or cold compresses can help reduce inflammation and alleviate pain.
  • Medications: Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can provide short-term relief from pain and inflammation.
  • Epidural Steroid Injections: In cases of nerve compression, injections of corticosteroids can help reduce inflammation and relieve pain.
  • Spinal Manipulation: Chiropractic adjustments or osteopathic manipulations may provide relief for certain conditions causing thoracic pain.
  • Posture Correction: Proper ergonomics and postural training can help correct poor posture and alleviate thoracic pain caused by

Section 5: Preventative Techniques to Avoid Thoracic Pain

Back Shoulder Pain

Maintain Proper Posture

One of the fundamental preventative measures for thoracic pain is maintaining proper posture. Poor posture can place excessive stress on the thoracic spine, leading to muscle imbalances and discomfort. To maintain good posture:

  • Sit and Stand Tall: Keep the shoulders back and down, with the ears aligned over the shoulders and hips. Avoid slouching or hunching forward.
  • Use Ergonomic Furniture: Utilize ergonomically designed chairs and desks that support the natural curvature of the spine and promote proper alignment.
  • Adjust Computer Setup: Position the computer monitor at eye level, and maintain a neutral wrist position while typing to reduce strain on the mid-back.

Engage in Regular Exercise

Regular exercise is essential for maintaining a strong and flexible mid-back. Specific exercises that target the back muscles and promote thoracic spine mobility can help prevent pain and discomfort. Some beneficial exercises include:

  • Thoracic Extension: Sit or stand tall, interlace your hands behind your head, and gently arch your upper back backward. Hold for a few seconds and return to the starting position. Repeat several times.
  • Cat-Cow Stretch: Begin on all fours, inhale as you arch your back and lift your head (Cow Pose), and exhale as you round your back and tuck your chin (Cat Pose). Repeat for several breaths.
  • Shoulder Blade Squeezes: Sit or stand tall, squeeze your shoulder blades together as if trying to hold a pencil between them. Hold for a few seconds and release. Repeat several times.
  • Swimming: Lie face down on a mat with arms extended overhead. Lift your right arm and left leg off the ground, lower them, then lift your left arm and right leg. Continue alternating for a few repetitions.

Incorporate Stretching Into Your Routine

Stretching is an essential component of maintaining thoracic flexibility and preventing pain. Incorporate regular stretching into your daily routine to keep the mid-back supple. Some effective stretches include:

  • Thoracic Rotation Stretch: Sit on a chair with feet flat on the ground. Hold a towel or resistance band with both hands, and gently twist your torso to the right and then to the left, feeling a stretch along the thoracic spine.
  • Child’s Pose: Start on all fours, then sit back on your heels while reaching your arms forward. Allow your forehead to rest on the ground, feeling a gentle stretch in the mid-back.
  • Chest Opener: Stand tall, clasp your hands behind your back, and lift your arms slightly to open the chest. Hold for a few seconds and release.

Lift Properly

Improper lifting techniques can strain the thoracic spine and lead to pain and injury. Whether lifting heavy objects at work or performing household chores, follow these guidelines for safe lifting:

  • Bend Your Knees: Avoid bending from the waist; instead, bend your knees and keep your back straight when picking up objects.
  • Hold Objects Close: Hold heavy objects close to your body, distributing the weight evenly and reducing strain on the back.
  • Use Your Legs: Engage your leg muscles to lift objects, keeping the back straight and avoiding twisting motions.

Take Breaks and Move

Sitting or standing in the same position for prolonged periods can strain the thoracic spine. Taking regular breaks to move and stretch can prevent stiffness and discomfort. Incorporate short walks or gentle stretching into your work routine to promote blood flow and maintain spine health.

Support Your Sleep

A supportive mattress and pillow can make a significant difference in preventing thoracic pain. Invest in a mattress that provides adequate support for the spine’s natural curvature and a pillow that aligns the head with the neck and thoracic region.

Manage Stress

Stress can contribute to muscle tension and exacerbate thoracic pain. Practicing stress-relief techniques such as meditation, yoga, or deep breathing exercises can help relax the back muscles and promote overall well-being.


Preventing thoracic pain is essential for maintaining a healthy and pain-free mid-back. By incorporating proper posture, regular exercise, stretching, safe lifting practices, and stress management into your daily routine, you can protect your thoracic spine and reduce the risk of discomfort and pain. Remember that prevention is always better than cure, and taking proactive steps to care for your thoracic spine can lead to a more active, pain-free, and enjoyable life.

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