Middle Back

A thoracic sprain or strain occurs when muscles or ligaments in the middle back are overstretched or torn. It can result from poor posture, heavy lifting, or sudden twisting motions. Without proper care, thoracic strains can become chronic and impact spinal mobility. Therapy focuses on reducing inflammation, restoring movement, and strengthening the mid-back muscles for stability.

Symptoms may include:

• Mid-back pain with movement
• Muscle tightness or spasms
• Tenderness along the spine
• Pain when twisting or bending
• Stiffness after prolonged sitting

Rib dysfunctions happen when a rib joint becomes restricted or slightly misaligned, causing sharp pain, breathing discomfort, or limited upper body movement. These can result from trauma, poor posture, or repetitive strain. Left untreated, rib dysfunction can mimic conditions like heart or lung issues. Physical therapy focuses on restoring rib and thoracic spine mobility to relieve pain and improve breathing.

Symptoms may include:

• Sharp pain near the spine or chest wall
• Pain with deep breathing, coughing, or sneezing
• Tenderness over the affected rib
• Difficulty twisting the upper body
• Muscle tightness around the ribs

Thoracic disc herniations are less common than lumbar or cervical herniations but can cause significant mid-back pain or nerve symptoms. They occur when the cushioning discs between the thoracic vertebrae bulge or rupture, pressing on spinal nerves. Herniations in this region may cause referred pain around the chest or abdomen. Therapy focuses on reducing nerve irritation, improving spinal stability, and restoring functional movement.

Symptoms may include:

• Mid-back pain that wraps around the chest
• Numbness or tingling in the torso
• Sharp pain with movement or coughing
• Muscle weakness in the upper body
• Difficulty standing upright

Postural kyphosis is an exaggerated forward rounding of the upper back caused by prolonged poor posture. It can lead to muscle fatigue, joint stiffness, and breathing difficulties over time. If untreated, kyphosis may worsen, contributing to chronic mid-back pain and shoulder dysfunction. Therapy focuses on posture correction, spinal mobility, and strengthening the postural support muscles.

Symptoms may include:

• Rounded shoulders or visible hunchback
• Aching pain in the upper or middle back
• Fatigue after sitting or standing
• Reduced spinal flexibility
• Difficulty maintaining upright posture

Costovertebral joint dysfunction occurs when the joints connecting the ribs to the spine become irritated or restricted. This can happen from trauma, repetitive strain, or prolonged poor posture. Dysfunction can cause sharp, stabbing pain with certain movements or breathing patterns. Therapy focuses on restoring joint mobility, reducing inflammation, and improving thoracic spine mechanics.

Symptoms may include:

• Localized mid-back pain near the spine
• Pain with deep breathing or coughing
• Tenderness at the rib attachments
• Stiffness with rotation or bending
• Sharp pain with overhead activities

Thoracic outlet syndrome (TOS) involves compression of nerves or blood vessels between the neck and upper chest. It can cause symptoms in the shoulder, arm, and hand, often mimicking cervical radiculopathy. Poor posture, trauma, or anatomical variations can contribute to TOS. Therapy focuses on improving posture, strengthening the surrounding muscles, and relieving pressure on the compressed structures.

Symptoms may include:

• Numbness or tingling in the arm or hand
• Weakness in the hand grip
• Pain or aching in the neck, shoulder, or chest
• Swelling or discoloration in the arm
• Fatigue with overhead activities

Scoliosis is a sideways curvature of the spine that can develop during growth or adulthood. Mild to moderate curves often cause uneven muscle tension, postural changes, and mid-back discomfort. Physical therapy helps improve spinal alignment, strengthen postural muscles, and reduce symptoms to maintain spinal health and mobility.

Symptoms may include:

• Uneven shoulders or hips
• Prominent rib hump on one side
• Mid-back or rib pain
• Muscle fatigue with prolonged standing
• Limited spinal flexibility

Muscle spasms in the mid-back can develop suddenly from lifting, twisting, or prolonged poor posture. Spasms can cause sharp, stabbing pain and make breathing or moving uncomfortable. Without treatment, spasms may persist or recur frequently. Therapy focuses on calming the muscle spasm, improving flexibility, and correcting any underlying biomechanical issues.

Symptoms may include:

• Sudden mid-back pain
• Muscle tightness or “knotting”
• Pain that worsens with movement
• Difficulty taking deep breaths
• Stiffness and reduced flexibility

Scheuermann’s disease is a condition where the vertebrae in the thoracic spine grow unevenly, leading to a rigid form of kyphosis. It typically develops during adolescence but can cause pain and posture issues into adulthood. Physical therapy focuses on improving posture, strengthening the spinal stabilizers, and enhancing flexibility to reduce discomfort.

Symptoms may include:

• Visible rounding of the mid-back
• Back stiffness and reduced mobility
• Aching pain in the thoracic spine
• Fatigue after sitting or standing
• Tightness in the hamstrings or chest muscles