Diagnosing the Cause of Thoracic Pain

Because there are a number of cervical spine conditions that can cause neck pain and each can be associated with similar symptoms, an accurate neck pain diagnosis requires significant skill and expertise from a spine specialist.

How is Thoracic Pain Diagnosed?

Physicians will perform a series of examinations in order to properly diagnose neck pain and its causes. These will include a thorough history, physical and medical exam, during which a trained spine specialist will check for signs of acute neck pain, muscle weakness, tenderness or numbness in the area of the cervical spine that is affected. Additional neck pain imaging or injection studies may be ordered to arrive at an exact neck pain diagnosis.

Thoracic Pain Diagnosis

Diagnosing pain in the mid- or upper-back requires skilled spinal expertise and a physician who has considerable experience in treating thoracic spine conditions. There are a number of conditions that can cause thoracic pain. Diagnosis based on a thorough analysis of symptoms and examinations is crucial to helping patients find the treatment plan that is right for their specific concern.  Often, this requires “ruling out” certain conditions in order to narrow the list of potential causes of a person’s mid-back pain. When it comes to accurate thoracic pain diagnosis, the team at BASIC continues searching until we are confident we have determined the cause of the pain.

The History and Physical

In order to arrive at a particular thoracic pain diagnosis, the most experienced spine experts will first conduct a complete history and physical examination. During the history portion of this evaluation, the patient is asked a series of questions regarding their thoracic pain symptoms which often include when the pain began, whether there was an injury to the mid-back or other part of the spine that caused the pain, a precise explanation of where the pain is located and how intense it is, whether the pain radiates to the extremities or other parts of the body, any previous spine surgery and family history of conditions affecting the thoracic spine.

Upon completion of this discussion, the physician will then perform a physical examination aimed at pinpointing an accurate thoracic pain diagnosis. The physical exam helps the doctor rule out certain causes of thoracic pain, while honing in on others in order to properly diagnose the source of the patient’s mid-back pain. While the mid-back will be a feature of the physical exam, other parts of the body may also be examined depending on the thoracic pain symptoms that are being experienced by the patient.  Some of the characteristics the physician is evaluating include muscle weakness, pain or tenderness in certain areas, sensory changes, reflex changes, motor skills and other special signs.


After a thorough physical and history have been conducted in order to learn more about a patient’s mid-back pain symptoms, the next logical step in thoracic pain diagnosis is called an imaging examination. These types of tests are usually ordered once your physician has a suspicion as to what is causing the neck pain, based on the history questions and physical exam. Often, the MRI (Magnetic Resonance Imaging) is a preferred thoracic pain imaging exam because its detailed images can show any changes to the soft tissues surrounding the vertebrae in a way that x-rays, historical pain discussions and external physical exams simply can’t. For this reason, MRIs are frequently used to visualize whether there is damage to a thoracic disc, spinal stenosis, nerve problems or spinal tumors.

Thoracic Epidural Steroid Injection

During a thoracic epidural steroid injection, a local anesthetic medication is injected into the thoracic joint suspected to be causing the patient pain. If the injection causes the pain to subside, then physicians can be relatively sure that the thoracic spine joint in question is the cause of the mid-back pain and a confirmed thoracic pain diagnosis can then be made.

Accurately pin-pointing the root cause of mid-back pain is crucial to a precise thoracic pain diagnosis and effective treatment plan. While this diagnosis may require multiple steps in order to determine exactly what’s causing the mid-back pain, it is important to seek help from a spine expert who is skilled and experienced in effectively diagnosing thoracic pain and then expertly treating it using the least invasive methods first.

Health Tips For Mid Back

  • 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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