Mid back pain and stiffness can make simple activities such as turning, reaching, sitting at a desk, exercising, or even taking a deep breath uncomfortable. While low back and neck pain tend to get more attention, problems in the middle portion of the spine are common and can significantly affect mobility and quality of life.
At The Healing Joint in Scottsdale, we frequently treat patients with pain, tightness, and restricted movement in the thoracic spine—the area between the neck and lower back.
What Is the Mid Back or Thoracic Spine?
The mid back is known as the thoracic spine. It consists of 12 vertebrae, labeled T1 through T12.
Unlike the neck and lower back, the thoracic spine connects with the ribs and helps form the rib cage. Because of this connection, stiffness in the thoracic spine can also affect the ribs, shoulders, neck, and surrounding muscles.
The thoracic spine is designed to allow rotation, bending, and extension while also providing stability and protection for the chest. When the joints and muscles in this region stop moving normally, patients can experience stiffness, aching, sharp pain, or a feeling that the middle of the back is “locked up.”
The thoracic spine connects with the ribs to form the rib cage. Image: OpenStax College, CC BY 3.0, via Wikimedia Commons.
Common Causes of Mid Back Pain and Stiffness
Poor Posture
Long hours sitting at a desk, working on a computer, driving, or looking down at a phone can gradually place stress on the mid back. Rounded shoulders and prolonged forward posture can cause the thoracic spine to become stiff while surrounding muscles become tight and overworked.
Restricted Thoracic Joints
The small joints between the vertebrae can lose normal movement. When this happens, patients may feel stiffness or localized pain when twisting, bending, or extending the spine.
Rib Joint Dysfunction
Each rib connects to the thoracic spine. If one of these joints becomes irritated or restricted, pain can develop near the spine, underneath the shoulder blade, or around the rib cage. Some patients notice the discomfort more when twisting or taking a deep breath.
Muscle Tightness and Trigger Points
Muscles that commonly contribute to mid back discomfort include the rhomboids, trapezius, thoracic paraspinal muscles, latissimus dorsi, erector spinae, and other muscles surrounding the shoulder blades. Trigger points and muscle tension can produce aching, burning, or tightness between the shoulder blades.
Prolonged Sitting
Sitting for many hours reduces movement through the thoracic spine. Over time, this can lead to reduced mobility, shortened muscles, stiffness, and discomfort—especially when standing up or trying to rotate the upper body.
Exercise or Sports Injuries
Weightlifting, golf, tennis, pickleball, swimming, and other activities involving rotation can irritate the joints and muscles of the mid back. Repetitive movement or sudden twisting can also strain the muscles surrounding the thoracic spine.
Car Accidents
The forces involved in a motor vehicle accident can affect more than just the neck and lower back. The thoracic spine, ribs, muscles, and shoulder blade region can also become irritated or restricted following an accident.
Symptoms of Mid Back Dysfunction
Mid back problems can feel different from person to person. Common symptoms include:
- Aching between the shoulder blades
- Stiffness after sitting
- Pain when twisting
- Difficulty extending or straightening the upper back
- Muscle tightness or spasms
- Sharp pain near a rib
- Pain underneath the shoulder blade
- Discomfort when taking a deep breath
- Reduced shoulder or upper-body mobility
- A frequent urge to stretch or “crack” the middle of the back
Some patients also develop neck or shoulder discomfort because the body begins compensating for reduced thoracic movement.
How the Thoracic Spine Affects the Neck and Shoulders
The thoracic spine plays an important role in the mechanics of the neck and shoulders. When the middle back becomes excessively stiff, the neck and shoulders often have to move more to compensate.
This can contribute to neck tightness, shoulder discomfort, headaches, reduced shoulder range of motion, tight upper trapezius muscles, and pain around the shoulder blades. Improving thoracic mobility can therefore be an important part of treating neck and shoulder problems as well.
If your symptoms are more focused around the shoulder blade, you may also want to read our article on shoulder-blade pain and the dorsal scapular nerve.
How the Abdominal Muscles Help Support the Mid Back
The muscles supporting the thoracic spine are not located only in the back. The abdominal muscles are also an important part of the support system for the trunk.
The rectus abdominis, internal and external obliques, and transversus abdominis work together with the muscles along the spine to control the position and movement of the torso. These muscles help the body resist excessive bending, extension, side bending, and rotation while we sit, stand, walk, lift, and exercise.
You can think of these muscles as forming part of a muscular cylinder around the trunk rather than simply a set of “abs” on the front of the body. When the abdominal muscles are not providing adequate support or endurance, the muscles along the back may have to work harder to maintain an upright position. This can contribute to fatigue and a feeling of tightness or stiffness through the middle of the back.
This is one reason our treatment approach at The Healing Joint does not focus only on the painful area. We also look at posture, thoracic mobility, rib movement, abdominal control, shoulder mechanics, and the surrounding muscles to determine what may be contributing to the problem.
The abdominal wall includes the rectus abdominis, internal and external obliques, and transversus abdominis. Image: OpenStax College, CC BY 3.0, via Wikimedia Commons.
Treatment for Mid Back Pain at The Healing Joint
At The Healing Joint, treatment is based on what we find during the examination rather than treating every patient the same way. Depending on the cause of the problem, treatment may include a combination of therapies.
Chiropractic Adjustments
Gentle chiropractic manipulation can help restore movement to restricted thoracic spinal joints. Improving joint mobility can reduce stiffness and make movements such as rotation and extension more comfortable.
Rib Mobilization
When rib joints are restricted, gentle mobilization or manipulation may be used to restore normal movement between the ribs and thoracic spine.
Active Release Technique
Active Release Technique, or ART, can be used to treat tight muscles and soft tissues around the thoracic spine and shoulder blades. Areas commonly treated include the rhomboids, trapezius, latissimus dorsi, and thoracic paraspinal muscles.
Massage Therapy
Massage therapy can help reduce muscle tension and loosen tight tissue surrounding the mid back and shoulder blades.
Cupping Therapy
Cupping therapy may be incorporated to help reduce muscle tension and improve mobility in areas of persistent tightness.
Acupuncture
Acupuncture can be used as part of a treatment program for muscular tension, pain, and restricted movement in the thoracic region.
Class IV Laser Therapy
Class IV laser therapy may be used to target irritated muscles and joints and support the healing process.
Therapeutic Exercise and Stretching
Restoring movement is only part of the solution. We may also provide exercises designed to improve thoracic extension, thoracic rotation, shoulder mobility, posture, upper-back strength, and core strength, endurance, and trunk control. These exercises can help maintain improvements between treatments and reduce recurring stiffness.
Simple Ways to Reduce Mid Back Stiffness at Home
Movement throughout the day can make a significant difference. Try getting up from your chair every 30 to 60 minutes rather than remaining in the same position for hours at a time.
Other helpful strategies include gentle thoracic rotation stretches, foam rolling the upper and mid back, doorway chest stretches, shoulder blade strengthening exercises, adjusting your workstation, avoiding prolonged slouched sitting, and regular walking or physical activity.
The correct exercises depend on the underlying cause of your discomfort, so persistent or worsening pain should be evaluated.
When Should Mid Back Pain Be Evaluated?
Many cases of mid back pain are related to muscles, joints, posture, or activity. However, unexplained or severe thoracic pain should not automatically be assumed to be musculoskeletal.
Seek appropriate medical evaluation if mid back pain occurs with symptoms such as significant trauma, fever, difficulty breathing, chest pain, unexplained weight loss, progressive weakness or numbness, or other unusual symptoms.
Mid Back Pain Treatment in Scottsdale
If your middle back constantly feels tight, painful, or difficult to move, restoring movement to the thoracic spine and surrounding muscles can make a major difference.
At The Healing Joint in Scottsdale, we combine chiropractic care with therapies such as Active Release Technique, massage therapy, acupuncture, cupping, Class IV laser therapy, joint mobilization, and therapeutic exercise to address the different structures contributing to mid back pain and stiffness.
Rather than simply treating the area that hurts, we evaluate how the thoracic spine, ribs, neck, shoulders, abdominal muscles, and surrounding tissues are working together.
If you are dealing with persistent mid back pain or stiffness, schedule an appointment with The Healing Joint in Scottsdale to find out what may be causing the problem and what treatment options are appropriate for you.
