Pain in the mid-back or thoracic spine (also known as the dorsal spine) usually arisen in similar ways to pain the lower back or neck, except that disc protrusions are less common and nerves are less likely to be trapped. Thoracic pain should always be investigated by a doctor.

Spine Anatomy
Spine Anatomy


Acute attacks may be caused by a fall or stumble, repeated heavy lifting, an awkward bend, a violent twist or wrench, a cough or sneeze, or a trivial uncoordinated movement, such as turning over in bed or getting up from a chair. The actual physical causes are probably due to mechanical dysfunction: a facet or rib joint strain or protrusion. More long-standing pain that develops gradually may be related to scoliosis.


The thorax houses important organs, such as the heart and lungs, which can refer pain to the front, side, or back of the chest. Symptoms include central or one-sided thoracic pain: it may hurt more when coughing, sneezing, or breathing deeply, and it invariably hurts to rotate the trunk in one direction more than the other. Central, severe pain that is made worse by bending forwards or backwards and radiates through to the front directly is more suggestive of a disc problem. In an older person who is coughing violently,a stress fracture of a rib is a possibility. Similarly, a young athlete may develop a stress fracture through repetitive strain, or may pull or tear one of the large muscles of the back in a violent movement. Pain that is worse a night may signify an underlying illness or disease. Pain may be referred to the abdomen or as low as the groin in any of the above conditions.

Risks and Complications

It is important that you rule out any potentially serious causes of thoracic pain, as it may be linked to diseases of the heart, aorta, lungs, pancreas, or kidneys. Infection in a disc or vertebra involves the thoracic spine more than any other area of the back. Very rarely, the cause of pain is secondary cancer.

Treatment – Mechanical

  • If you have acute thoracic pain of mechanical origin, you should:
    • see a doctor
    • use ice pack
    • take pain killers
    • try not to rest for more than 3 days
  • If your condition is slow to improve, you should:
    • consult a physiotherapist for treatment
  • If after 14 – 21 days you are not able to resume normal activities, you should:
    • consult your doctor for further examination, advice or treatment.
  • If after 6-8 weeks, you are not recovering as expected, you should:
    • seek further advice fro your doctor, who may consider arranging investigations such as an MRI or blood test.

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