What Causes Thoracic (Mid-Back) Pain?

While thoracic pain can be common at various stages of life, its causes can vary widely. These conditions can directly affect the thoracic vertebrae themselves, the soft tissues including the ligaments, muscles and thoracic discs or the nerves in the mid-back.

Causes of Mid-Back Pain

Much like the causes associated with neck pain, mid-back causes can vary depending on the condition that is present.  Additionally, the causes of thoracic pain can be primary – as is the case with a traumatic injury, or secondary – as the result of another degenerative process that has occurred elsewhere in the spine – like that of degenerative disc disease or osteoarthritis.

The causes of thoracic pain can result from conditions or injuries that affect what are known as the “soft tissues” of the mid-back (nerves, muscles and ligaments) or in the hard or fixed structures of the thoracic spine including the vertebrae and joints. In less common cases, a tumor, infection or congenital abnormality may be the thoracic pain cause.

Bulging Disc

A common cause of thoracic pain is the result of a bulging disc. This condition involves one or more of the discs between the vertebrae that swell outside of the space they should normally occupy. While a bulging disc may not always cause pain in the mid-back, in severe cases the disc can swell so much that it presses on surrounding nerves or results in a narrowing of the spinal canal in the thoracic spine. When this occurs, it causes thoracic pain symptoms in the part of the body served by the nerve being pressed upon by the bulging disc.

Herniated Disc

A herniated disc in the thoracic spine is one potential cause of mid-back pain. This condition is typically caused either by an injury to the spine or to daily wear-and-tear of a disc or discs between the vertebrae in the thoracic spine. Most herniated discs affect the lower part of the spine, but can affect the neck and mid-back.

Degenerative Disc Disease

Though rare in the thoracic spine, degenerative disc disease is one potential cause of pain in the mid-back. Over time or due to injury, the cushions (discs) between the vertebrae in the thoracic spine can become worn and the bones can take on an irregular shape. From this irregularity, the thoracic vertebrae may develop bone spurs that can compress the space between them, thus pinching on surrounding nerve roots. As degenerative disc disease progresses in the thoracic spine, it can result in severe pain.

Facet Joint Syndrome

Thoracic facet joint syndrome is the result of inflammation in the facet joints located on the backside of the thoracic portion of the spinal column. One of the causes of pain in the thoracic region of the spine, facet joint syndrome can also be caused as a result of a traumatic spine injury, degenerative disc disease stress, or strains on proper spinal posture.

Spinal Stenosis

Thoracic spinal stenosis, also called cervical myelopathy, is a common cause of neck pain, especially among those who are over the age of 50 and in the elderly population. This condition involves the narrowing of the spinal canal in the neck area or upper part of the spine. The narrowing of the spinal canal in the neck causes pressure on the spinal cord and surrounding nerve branches. Often, cervical stenosis in the neck causes pain symptoms only when the nerves or spinal cord become squeezed. Some people with cervical stenosis have a history of some type of trauma to the neck. However, this trauma may have occurred many years before it causes neck pain symptoms to appear.


Also referred to as degenerative joint disease, osteoarthritis can be a progressive potential cause of thoracic pain if there is a breakdown in joint cartilage. Over time this damage to cartilage can extend to the vertebrae, causing painful thoracic bone spurs. In its final stages, osteoarthritis the cartilage can completely wear away, leaving thoracic vertebrae to painfully rub against one another.

Muscle Strain

Any of the muscles located in the back can be strained as a result of injury. When muscle strains occur in the thoracic spine, pain is caused by a spasm in the area where the injury occurred. Though the pain may subside after the initial injury, it can take several hours for thoracic pain caused by a muscle strain to reach its peak.

Muscle Spasm

A common cause of pain in the mid-back, thoracic muscle spasms involve what feels like sudden and incontrollable contracting of the muscles in the upper back.


Spondylolisthesis occurs when one vertebrae in the thoracic spine slips over another vertebrae. Though more common in the lumbar region of the spine, it can affect the thoracic portion of the spine, resulting in mid-back pain. In adults, the most common cause of spondylolisthesis is degenerative disease, such as arthritis. Other causes include stress fractures, traumatic fractures, and other bone diseases.

Nerve Compression

Anything that puts abnormal pressure on a spinal nerve near the thoracic spine can cause pain. This thoracic nerve compression is often due to degenerative disc disease, herniated discs, degenerative joint disease or a traumatic spine injury.

Thoracic Outlet Syndrome

This often painful mid-back condition is caused by compression of blood vessels or nerves that are located in the thoracic outlet of the spinal canal. This compression may be caused by trauma, a congenital defect, and weight gain or tumor growth. There are three types of Thoracic Outlet Syndrome: Vascular, Neurogenic and Disputed or Painful Form.

Slipped Rib Syndrome

This painful condition can cause pain in the thoracic spine when one of the ribs recurrently slips out of place. This causes the thoracic ligaments that support the ribs to stretch and weaken. The slipping of the ribs can result in severe thoracic pain, especially when coughing or breathing deeply.

If you or someone you know is experiencing the debilitating effects of thoracic pain, contact the expert spine team at BASIC to determine what is causing the mid-back pain so that you can get back to living a life free from pain as soon as possible.

Health Tips For Thoracic

  • Focus daily on exercises designed to increase spinal mobility
  • Practice good posture – no shoulder slumping!
  • Introduce some deep-breathing techniques to help oxygenate spinal muscles
  • Maintain a normal body weight – too much can put unnecessary pressure on the spine

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