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Middle Back Pain Exercises

Middle back pain is not defined strictly and I have defined it as back pain from around the sixth thoracic vertebra down to the twelfth where the thorax meets the lumbar spine. It is also referred to as mid back pain and is not well differentiated from upper back pain or thoracic pain.

Further information about middle back pain can be accessed at Backpainexpert and

Middle Back Pain – Spine

The spine in the middle back is the lower half of the thoracic spine. The thoracic vertebrae in this area are designed to allow rotation of the body but little forward and back movement (flexion and extension) as this might cramp the lungs and heart.

The ribs are attached to the back of the thoracic vertebrae by two small joints which can be sources of middle back pain symptoms or chest pain.

Middle Back Pain – Neck

The neck is not usually involved in pain in the middle back although the low neck joints can refer pain right down to the tip of the shoulder blade which is close to this area.

Causes – Middle Back Pain

The main causes of middle back pain appear to be the joints in the area, including the facet joints and the costovertebral joints which are between the ribs and the vertebrae. Disc related pain is extremely uncommon in this area and a disc prolapse can give serious problems as there is little room in the spinal canal for a protrusion. This can lead to symptoms that the spinal cord is being compressed.

As the thoracic spine is the site of serious conditions more commonly that the lumbar or neck areas it is important to discuss any unusual symptoms at once with your doctor. These could include difficulty walking, loss of muscle power in a leg or both legs and any problems with bladder and bowel control.

Treatment of Middle Back Pain

Physiotherapists – middle back pain treatment could include assessment and treatment with mobilisation techniques, postural correction and range of movement exercises.

Chiropractors – middle back pain management would cover assessment and similar treatment with perhaps more emphasis on manipulation to restore normal joint mechanics.

Exercises for Middle Back Pain

The mid back is a difficult area to get at in terms of exercises, particularly if flexion and extension are desired as an exercise. Typical exercises might be:

  • Thoracic rotations – sitting with the arms crossed the person rotates the whole upper body round to one side and then slowly around to the other, pushing a little at the end of the movement if it is stiff or uncomfortable.

  • Slumping and arching the thoracic spine – sitting and allowing the body to adopt a full slump position then straightening right up. This is difficult to do without using the lumbar spine to fulfil the movement so it's important to hold the lumbar spine still particularly when arching up and back.

  • Lying on the back over a rolled up towel cross-wise under the area of discomfort which can force the joints into arch to some degree. Raising the arms above the head can increase the stretch.

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