While back pain might be quite a common occurrence, the pain in the middle and upper back is not very common. Most of the times people refer to the lower back pain as the back pain. However, the lower back is not the only part of our back can pain. Our entire back can suffer, together or in parts, from pain owing to various reasons. In this article, we will understand in detail about the pain in our upper and middle backs and the causes for such pain. Is your pain at the lower back? This article notes all the causes of lower back pain. Let us first understand what constitutes our upper and middle back.

The thoracic spine

Have you heard your doctors speak of T1, T2 or T12? These are not some markings, but these are the 12 vertebrae that attach to your spinal column and support your back. There are discs between each of these vertebrae, a sponge-like substance with a tough exterior and soft tissue interior, to absorb any shock as these vertebrae move. There are of course muscles, ligaments, etc. along with these. All this constitute what is medically referred to as the thoracic spine or the thoracic region. And this thoracic region is what our upper and middle back consists of. Any pain that you feel in this region is categorized under the upper and middle back pain.

Who is more prone and what causes the pain?

While no specific age group is the only victims of upper and middle back pain, it is more found in people in the 30-40 year category. Following factors can lead to pain in your upper and middle back.
  • Your age
  • Lack of exercise, which leads to poor muscle tone, especially in the abdomen, shoulder and back regions.
  • You are carrying more weight on the back.
  • Cough, especially in those who smoke.
  • Poor diet and poor clothing like an unsupported bra or worn out shoes.
  • Poor posture, where you slouch while sitting or slump your shoulders when working, poor seating and sleeping conditions.
  • Stress and depression.
  • Arthritis, cancer and other medical conditions.

Let us now take a look into the different causes for upper and middle back pain in detail.

  • Growing old:
Ageing is the major cause of back pain, upper, middle or lower. This is because as we grow old, the fluid level between the joints that avoid the friction of the bones starts thinning out. The bones also get weakened, and the muscle mass goes down considerably too. This causes pain in many regions of our body, including the upper and middle back. This condition is referred to as “Osteoarthritis” by doctors. Also as you grow old, the cartilage can wear off which means your bones will start rubbing together. This further adds pressure to the nerve roots causing numbness and pain in your back.
  • Improper muscle use and poor posture:
When you exercise, especially when you undertake weight training, you are conditioning your muscles in that area. And when you do not use the muscles properly as they should be used, then you are reducing muscle strength and are more prone to diseases. When we say improper muscle use, it is mostly a result of poor posture. We often see people slouching in their chairs as they work. This is a wrong posture and slouching can easily put pressure on the neck, ligaments, spine and the discs causing pain and other issues. Even improper standing where you balance on one leg for too long or improper sleeping posture where your back is not well-supported can result in upper and middle back pain. When you are lifting an object, you have to make sure that you use the right mechanics in your body and do not twist the spine unnecessarily.
  • Overuse or strained muscles
When you are lifting heavy articles or when you carry heavy backpacks, you are adding more strain to your muscles. Even repetitive actions that use our shoulders and back continually can result in muscle sprains and strains. It starts with tightness in the muscles, irritation and then slowly develops into chronic pain in the upper and middle back.
  • Ruptured or herniated discs
As mentioned earlier the discs serve as a cushion between the vertebrae and when this cushion bulges out of its shell and adds pressure to the spinal bone, it results in back pain. While most of the times, it happens in the lower back, there are chances of the discs in the upper and middle back also getting ruptured. When your disc is ruptured or herniated, you will have pain in that respective region which will shoot up with the smallest of the pressure. And if the disc happens to compress the nearby nerve, it is referred to as the pinched nerve, and it will cause severe pain in your back region. If the pain is severe that can be kidney pain too. Do you know the difference between kidney pain and back pain?
  • Infection
This is a very rare scenario where infection in your spine results in the upper or middle back pain. When pus and germs get in between the spinal bones and cord, it can lead to swelling adding on pressure causing pain to the back.
  • Injury
If you have had an accident at your workplace or a slip and fall accident or any injury suffered due to a traumatic incident can result in back pain. Sometimes the pain is immediate, and it is easy for the doctors to diagnose it as well. However, in certain cases, the pain occurs later. It could be due to a fracture in the vertebral column further leading to chronic pain. If not attended immediately it can lead to severe consequences like paralysis or permanent nerve damage. Apart from the above, deformity in the spinal structure (could be by birth or an injury), scoliosis, cancer, etc. can also cause pain in your upper and middle back.


Our lifestyle is the major cause of the back pain, whether it is lower, middle or upper. Repetitive and overuse of muscles, unfit body, and unbalanced diet contribute greatly towards back pain. Making simple lifestyle changes can help us with relief. And if you have chronic pain in the upper and middle back (chronic refers to consistent pain for 3 months or more), then you should visit a doctor for treatment. Follow the links to read about treatment options for back pain including home remedies for chronic back pain.

Back pain


  1. Donas

    Yes, that’s true and very educating, at a point I used think back pains is usually associated with only the lower back but with this your nice article I have been able to understand more about backs and I now know the region in the which it affects which is the thoracic spine, I also now understands more about the range of age which is more prone to the back pains it ranges from 30-40 years.

    Also, I now know what may be the caused of the middle and upper pains, which may be injury, infection, overuse of muscles, improper muscles use, and old age.

    Thank you very for this nice exposure. 

    • Shani

      Dear Donas,

      Thank you for stopping by and for your comment.

      Back pain can occur in the lower, middle or upper back. You are correct in saying that lower back pain is the most common in society. I covered the reasons for lower back pain in a separate article.

      I am glad you found the information useful.

      Best wishes.

  2. raju


    Due to our busy lives, we always forget ourselves to see our body that’s why we have to suffer from pains such as back pain. You are right, we have to visit a physiotherapist or doctor which can help us in treatment in the upper back and neck.

    Thank you for writing a nice and helpful article. 

    • MediChannel

      Hi Raju,

      Thank you for stopping by and for your comment.

      We are glad to hear that you found the information in the article useful.

      Best wishes.

  3. Kehinde Segun

    Hi there

    This is nothing but pure informative and educating post. 

    This is the first time I am hearing about the causes of Upper Back Pain. But being one of the few people that is suffering from it, reading this post has made me realise and understand the real cause of my pain. It just sleeping condition I will have to take cognizance of my sleeping position now. 

    Thank you for this info. 


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