The thoracic spine encompasses the upper- and middle-back region. It joins the cervical spine and extends down about five inches past the bottom of the shoulder blades, where it connects with the lumbar spine.

There are 12 vertebra making up the thoracic spine. While the cervical spine is built for flexibility (e.g. turning the head) and lumbar spine is built for power and flexibility (e.g. lifting heavy objects, touching the toes), the thoracic spine is built for stability and does not have the same flexibility. This stability plays an important role in holding the body upright and providing protection for the vital organs in the chest.

The thoracic spine is an intricate construct of bones, muscles, spinal segments, connective tissues, nerves, and joints. Although it is solidly constructed and relatively stable, it can also be a source of pain.

Common types of thoracic back pain treated at Progressive Physical Therapy

Pain in the thoracic region that is caused by muscle irritation or tension is called myofacial pain and is the most common complaint.  Poor posture or any type of irritation of the shoulder or large back muscles are the general cause.

Pain caused by joint dysfunction, where the ribs attach to the spine at each level of the thoracic spine, can cause pain.

Degenerative disc disease or a herniated disc can also be a source of pain, but is generally less common in the thoracic region.

The aging process and general wear and tear can lead the cartilage in the facet joints to become thin or even disappear or even produce an overgrowth of bone spurs and enlargement of the joints. This can lead to swelling due to arthritis in the thoracic spine and cause tenderness, pressure on the nerve, and limited range of motion. Facet joint disorders can also result from osteoarthritis.

Compression fractures are perhaps the most common form of thoracic problems. While they can be caused by an accident, generally they are the result of osteoporosis and the aging process usually occurring in the lower region of the thoracic spine.

Poor posture or a deformity, such as ankylosing spondylitis can be the cause of kyphosis, which is the rounding of the back. While kyphosis is primarily a deformity, it can also be a source of pain and stiffness.

Scoliosis is a condition in which the spine abnormally curves sideways and can sometimes produce upper back pain.

Occasionally, more serious underlying diseases or a problem are caused by pain in the upper back. Tumors putting pressure on the spine along with certain disease of the lungs, heart, kidneys and abdominal organs can also pain and should not be ignored.

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