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Chiropractors – Middle Back Pain

Middle back pain or mid back pain is not as common as neck pain or low back pain but can be annoying or even disabling in rare cases. Further information about middle back pain can be accessed at Backpainexpert and


Middle Back Pain – Spine

The spinal area involved in the mid back is what I have defined as the lower half of the thoracic spine, running from the sixth thoracic vertebra to the twelfth, a part of the vertebral column just above the lumbar spine.

The thoracic spine in this region is specialised for the movement of rotation, with relatively limited amounts of extension and flexion (backward and forward bending). This may be to restrict cramping of the internal organs such as the lungs and heart.

Facet joints, small flat joints formed from part of the vertebra above and below, are present at each level on each side and are known to be a potential source of pain. The lower ribs also attach at two small joint sites at each side at each level and again are a potential pain source. Physiotherapists and other manual therapists believe in some cases a small joint like this causes middle back pain.

Middle back pain symptoms can vary greatly from sharp jabbing pains related to an overstrain of a joint or pulled muscle in lifting or twisting to a persistent ache related to postural maintenance. In worse cases the pain can be very troublesome and flare easily on activity.


Middle Back Pain – Neck Involvement

The lower neck joints have been shown to refer pain down to the base of the shoulder blade when stimulated but they do not appear to refer further down into what I have set as the middle back are unlikely to be important in this kind of pain. Chest pain however can be generated by thoracic problems or be referred from the rib joints and then be mistaken in some cases for heart problems.


Chiropractors and physiotherapists assess and treat people with middle back pain on the symptoms present and the normality or otherwise of the anatomical structures in the area and nearby areas. Typical treatment techniques include manipulation, mobilisation techniques, postural advice and correction, general fitness and middle back pain exercises. Chiropractic assessment and techniques may be relatively specific to their profession, as are their diagnostic labels.

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