Chiropractic treatment can provide relief for many people with mid and upper back pain. The spine is divided into three sections: the lower back, the mid to upper back and the neck. Your middle and upper back are the longest portion of your spine—called the thoracic spine—which anchors the rib cage. As part of your backbone, the thoracic spine is subject to the same ailments that can affect the rest of the spine. However, because it is attached to the ribs, it has less movement than other parts of your spine, so problems with it are not as common as with the lower back or neck.

The thoracic spine includes the 12 vertebrae that run between the base of the neck and the low back region. Pain in the mid or upper back may be felt anywhere between the base of the neck where your cervical spine ends to the bottom of your ribcage where your lumbar spine begins. It can also be felt around the shoulder blades and between the ribs.

Causes of Mid and Upper Back Pain

There are numerous vertebrae, joints, muscles, ligaments and nerves that must work together for proper functioning of the mid and upper back. When something goes wrong with any part of this interconnected system, pain and inflammation can result. The pain can be dull, aching, burning or sharp, and it may be accompanied by muscle tightness or stiffness. If a nerve in the thoracic spine is pinched, the effects may be felt in the arms, legs or other places that the nerve travels.

Middle and upper back pain can come from:

• sprains and strains
• muscle knots
• a pinched nerve
• torn ligaments or muscles
• joint damage
• a disc problem

What causes these problems?

• Poor posture — Activities like working at a computer can keep our posture in a forward-bended position, particularly if we tend to slouch. When our neck is bent forward and down, we can develop thoracic spine pain as well as cervical kyphosis, an unnatural curvature of the spine which can lead to a hunched back.
• Injury — Whether because of a sports injury, an accident or a repetitive stress injury, overstretching the back muscles can cause pain and could result in vertebrae slipping out of place.
• Heavy lifting — Daily activities such as carrying heavy backpacks or lifting heavy loads at work can lead to misalignment of the thoracic spine and may cause disc problems.
• Long hours of driving — People who drive for a living are prone to thoracic spine problems. For example, bus drivers have three times more mid and upper back problems than the general population.
• Sleep positions — Keeping your body in the wrong position for several hours each night can result in misalignment of the mid and upper back.

Although pain in the mid and upper back is usually due to injury or poor posture, it can sometimes have a more serious cause, which must be ruled out before treatment begins.

What to Expect at Your First Chiropractic Visit

Many mid and upper back problems involve other parts of the spine as well, so chiropractors will look at your entire spine when you come for an evaluation. Pain in your upper back sometimes stems from disease in another part of your body, so an accurate diagnosis is important. Chiropractors typically take your health history, give a complete examination and, if necessary, take x-rays or request a different imaging study. A treatment plan will be devised for you based on a thorough evaluation.

Treatment of Thoracic Spine Pain

Treatment for mid or upper back pain may involve a variety of techniques, based on what is causing your discomfort. Treatments may include:

• Gentle manipulation (adjustments) of your spine
• Stretching and strengthening exercises
• Adjustment of the ribs
• Heat or ice
• Massage
• Treatment with a weighted device that works on head position
• Electrical stimulation, ultrasound or cold laser therapy

Why Seek Chiropractic Care for Mid and Upper Back Pain?

Chiropractic care has been shown to be effective in treating mid and upper back pain as well as improving range of motion and posture. Here are two studies of note:

• A study of 30 patients with mid- and upper-back pain found a statistically significant improvement in both range of motion and pain threshold among those who received chiropractic adjustments when compared to patients who received placebo treatment (“pretend” adjustments).
• Another study of women with with abnormal curvature of the spine found that the greatest improvement in posture resulted from chiropractic manipulation (adjustments) of the thoracic spine in combination with stretching and strengthening exercises.

Chiropractic care offers a surgery- and medication-free option for treating your mid to upper back pain. The research shows that in addition to relieving pain, chiropractic treatment can help reduce stiffness and get you moving freely again—so before you consider more invasive treatments like medication or surgery, schedule an appointment with a chiropractor.