Mid back pain is a common condition that can result from poor posture, muscle tightness, joint stiffness, injuries, or referred pain from the neck. Physiotherapy can help reduce pain and restore mobility through manual therapy, posture correction, ergonomic advice, and targeted exercises. Learn about the causes, symptoms, treatments, and effective exercises to manage and prevent mid back pain.
What Is Mid Back Pain?
Mid back pain is pain or discomfort in the thoracic spine, the area between your neck and lower back. This region consists of 12 vertebrae (T1–T12) that attach to the ribs and provide stability while protecting the heart and lungs.
The pain may develop suddenly after an injury or gradually due to poor posture, prolonged sitting, repetitive movements, muscle strain, or age-related changes. It is commonly felt between the shoulder blades or along either side of the spine and may range from a mild ache to sharp pain during movement. The pain can be due to tightness in the joints and muscles in this mid back region but can also be caused by referred pain due to tension in the neck.
Most cases of mid back pain are mechanical and respond well to physiotherapy, exercise, and posture correction. Less commonly, the pain may be caused by conditions such as arthritis, thoracic disc injuries, rib dysfunction, scoliosis, or osteoporosis.
What Are the Symptoms of Mid Back Pain?
Mid back pain symptoms vary depending on the cause but commonly include:
- Dull aching pain between the shoulder blades.
- Sharp pain with twisting, bending, or reaching.
- Muscle stiffness or tightness.
- Pain that worsens with prolonged sitting or standing.
- Tenderness over the muscles or joints of the mid back.
- Reduced upper back mobility.
- Pain that wraps around the ribs or chest wall.
Seek medical attention if your pain occurs with chest pain, shortness of breath, fever, unexplained weight loss, numbness, weakness, or changes in bowel or bladder function, as these may indicate a more serious condition.
How is it treated?
Your physiotherapist will use manual therapy to massage the tight muscles in the mid back. Joint mobilizations will also be used to stretch the tight joints in this region. Often times mid back pain can be caused by poor posture and ergonomic affecting the neck. When your physiotherapist focuses on stretching and massaging your neck, your mid back pain will often resolve without direct treatment to the mid back. Your physiotherapist will advice you on how to improve your posture and ergonomics which would address the root cause of your pain to help you get better faster as well as avoid re-injury.
Other treatments can involve active release which would stretch muscles in the neck and back. Your physiotherapist may also perform gentle joint mobilizations or spinal adjustments to the mid back to relieve tension in the spinal joints. Acupuncture and dry needling would also be very effective at reducing pain and tension in this region. There are many different treatments that are effective at treating this issue. Your physiotherapist will work with you to decide the most effective treatment based on your individual case.
Common home exercises
Open Book Stretch
This exercise improves thoracic spine rotation and reduces stiffness between the shoulder blades.
- Lie on your side with your knees bent and stacked together.
- Extend both arms straight out in front of you with your palms together.
- Keeping your knees together, slowly lift your top arm and rotate your upper body until your chest opens toward the ceiling.
- Hold for 2–3 seconds.
- Return to the starting position and repeat 10 times before switching sides.
Thoracic Extension Over a Foam Roller
This exercise increases extension mobility of the mid back and helps counteract prolonged sitting.
- Lie on your back with a foam roller positioned across your mid back.
- Bend your knees and keep your feet flat on the floor.
- Support your head with your hands.
- Slowly lean backward over the roller until you feel a gentle stretch in your mid back.
- Return to the starting position and repeat 10–15 times, moving the roller slightly higher or lower as needed.
Cat-Cow Stretch
Learn how to perform the cat-cow exercise here.
