Shamloo Elite Spine & Pain Institute
CONDITIONS / SPINE

Thoracic Spine Pain & Middle Back Pain

Pain between the neck and lower back can be surprisingly difficult to diagnose. Problems involving the discs, joints, nerves, muscles, or vertebrae of the thoracic spine can cause pain ranging from a dull ache to sharp, burning, or radiating discomfort.

What is the thoracic spine?

The thoracic spine consists of the 12 vertebrae between the cervical spine in the neck and the lumbar spine in the lower back. Unlike the cervical and lumbar regions, the thoracic spine is connected to the ribs and forms an important part of the chest wall.

Because of its unique anatomy, thoracic spine problems can present differently from neck or lower back conditions. Pain may remain localized to the middle or upper back, or it may travel around the ribs and chest in a band-like pattern.

What thoracic spine pain feels like

Thoracic pain can vary considerably depending on its underlying cause. Patients may experience:

— Aching, throbbing, or pressure in the middle or upper back
— Sharp or stabbing pain
— Burning or tingling sensations
— Pain that wraps around the ribs or chest
— Pain that radiates from the spine
— Muscle tightness or spasms
— Numbness or altered sensation
— Weakness
— Pain that worsens with movement, twisting, or bending
— Pain that interferes with sleep, work, or exercise

Some patients describe thoracic nerve pain as a band of burning, tingling, or shooting pain around the torso. This may be associated with irritation or compression of a thoracic spinal nerve.

When mid-back pain may be an emergency

Not all mid-back pain is caused by a spinal condition. Because the thoracic spine is located near the heart, lungs, and other vital organs, certain symptoms require immediate medical attention.

If you are experiencing sudden or unexplained mid- or upper-back pain along with any of the following, do not wait for an appointment with our office. Call 911 or seek emergency medical care immediately:

— Chest pain, pressure, tightness, or discomfort
— Shortness of breath
— Pain spreading to the arm, shoulder, neck, or jaw
— Nausea or vomiting
— Cold or unusual sweating
— Lightheadedness, dizziness, or fainting
— Unusual fatigue or weakness
— A rapid or irregular heartbeat

These can be warning signs of a heart attack or another potentially serious condition. Symptoms vary, and some people — particularly women — may experience upper-back pain, nausea, shortness of breath, or unusual fatigue without prominent chest pain. If you are unsure whether your symptoms could be related to your heart, it is safer to seek emergency evaluation than to assume the pain is coming from your spine.

Common causes of thoracic spine pain

Identifying the specific source is important, because conditions that produce similar symptoms may require very different approaches to care.

01
Thoracic disc herniation
Occurs when a disc between the thoracic vertebrae bulges or herniates and potentially irritates nearby nerves or the spinal cord. Less common than cervical or lumbar herniations, but can cause significant pain and neurological symptoms.
02
Thoracic radiculopathy
A nerve root in the thoracic spine becomes irritated or compressed, causing burning, shooting, tingling, or numbness that travels from the middle back around the ribs toward the chest or abdomen.
03
Thoracic spinal stenosis
The space available for the spinal cord or nerves becomes narrowed, which may cause pain, numbness, weakness, or other neurological symptoms depending on location and severity.
04
Arthritis & degenerative changes
Arthritis, disc degeneration, and changes to the facet joints may contribute to chronic stiffness, aching, and localized mid-back pain.
05
Vertebral compression fractures
Can occur when a vertebra partially collapses, sometimes following trauma and sometimes because the bone has been weakened by osteoporosis. May be mistaken for a muscle strain.
06
Muscle, ligament & soft-tissue injuries
Strains can occur after heavy lifting, repetitive activity, sports, poor posture, or trauma. While many improve with time, persistent pain may warrant further evaluation.
07
Other sources
Thoracic pain may also be associated with spinal injuries, structural abnormalities, nerve irritation, previous surgery, or other medical conditions.

When should you see a thoracic spine specialist?

Occasional muscle soreness or mild back pain may improve with rest and conservative care. However, consider a specialized evaluation if your symptoms:

— Persist or repeatedly return
— Are becoming progressively worse
— Radiate around the ribs or into the chest or abdomen
— Cause burning, tingling, or numbness
— Are accompanied by weakness
— Interfere with sleep or daily activities
— Develop following an accident, fall, or other injury
— Do not improve with conservative treatment

Thoracic symptoms accompanied by significant weakness, difficulty walking, changes in coordination, loss of bladder or bowel control, or other sudden neurological changes require prompt medical attention.

How thoracic spine pain is diagnosed

Dr. Shamloo begins by reviewing your symptoms, medical history, and previous treatments and performing a detailed physical examination. Depending on your findings, diagnostic imaging such as X-rays, MRI, or CT scans may be recommended to evaluate the vertebrae, discs, joints, spinal canal, and surrounding structures.

In some cases, additional diagnostic testing or targeted procedures may help determine which structure is responsible for the pain.

The goal is to move beyond simply identifying where you hurt and determine what is causing the pain.

A personalized approach to thoracic spine care

Thoracic spine pain does not have a one-size-fits-all solution. Treatment depends on the underlying diagnosis, the severity and duration of symptoms, your medical history, and your individual goals.

Once the source of your pain has been identified, Dr. Shamloo can discuss the options that may be appropriate — from conservative management to targeted interventional procedures, regenerative medicine, neuromodulation, or minimally invasive spine procedures.

The goal is to match the treatment to the condition — not the other way around.