MID BACK PAIN

The term ‘middle back’ often refers to the thoracic spine – the region of the back between the rib cage and the base of the neck. This region has 12 spinal discs, several vertebrae, and many muscles and ligaments. Damage or irritation to these structures can lead to mid-back pain.

Discomfort in the area of the spine between the base of the neck to the bottom of the ribcage.

PREVALENCE:

Pain in the mid back is relatively common early in life, with a prevalence of 13% in children and 35% in adolescents as mentioned in the study done by Wedderkopp et al., in 2001 and Kjaer et al., in 2011.

 

RISK FACTORS OF MID-BACK PAIN:

1. Lifestyle factors:

  • Sedentary lifestyle – lack of physical activities leads to muscle weakness which is unable to support the back pain.
  • Inadequate sleep – leads to increased sensitivity to pain (thalamus and somatosensory cortex become overactive), reduced endorphins (natural pain killer), and increased inflammatory markers (cytokines).
  • Dehydration – A person’s hydration status may be an important factor in their perception of acute pain
  • Ergonomics – Related reasons – more working hours sitting job, heavy lifting jobs, etc.]

 

2. Behavior factors:

  • Stress and anxiety- inadequate sleep leads to stress which releases cortisol (responsible for muscle tension and pain)
  • Depression – depression-associated chronic pain (lowering the pain threshold)
  • Somatic symptom disorder.
causes of midback pain

Non-specific:

1. Restricted mobility: limited mobility to perform activities limited ROM of the shoulder and neck and thoracic spine leads to a functional limitation on bending and twisting.

2. Muscle imbalance: Imbalance between the agonist and antagonist / right and left side musculature.

3. Overload principle: a person’s performance beyond their tolerance, which leads to a sprain in the muscle \ muscle catch. 

 

Specific reasons for mid-back pain:

It includes both traumatic (direct impact or injury to the mid back area) and atraumatic reasons (postural deformities /inflammatory or infectious causes also reason for the mid back pain).

 

Symptoms of mid-back pain :

1. Pain or discomfort: dull, aching pain sometimes worse with movement.

2. Stiffness: feeling tightness over the mid back.

3. Muscle spasm: sudden and involuntary muscle contractions in mid-back pain.

4. Breathing difficulty: pain exacerbated by deep breaths and cough.

5. Limited mobility: Difficulty in bending and twisting movements.

 

HOW TO PREVENT MID-BACK PAIN:

Here are some tips to prevent mid-back pain:

1. Lifestyle modification – physical activity (moving your body) improves the overall body health and

Try to maintain a healthy diet

2. Sleep – Adequate sleep enhances the overall body rest

3. Hydrated yourself – In summary, maintaining adequate hydration is essential for managing pain levels, as dehydration can exacerbate various types of pain, including acute pain, joint discomfort, and headaches

4. Stress-free life – do yoga and meditation

prevention of mid back pain

TREATMENT FOR MID-BACK PAIN

  • Medical management 
  • Physiotherapy management 

 

Pain medication:

1. Steroids

2. Non-steroidal anti-inflammatory drugs

3. Muscle relaxants

4. Opioids (painkillers)

 

Over-the-counter pain relievers like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) like Advil or Aleve can help with mild to moderate pain. But it should be under the guidance of a physician. It’s not the permanent solution you find the reason to eliminate it permanently.

 

Heat or cold therapy: applying heat or ice to the affected area can help reduce inflammation and relieve pain. You can try using a heating pad on low or medium for 15 to 20 minutes every 2 -3 hours. But It will give only temporary relief.

 

Complementary and alternative treatments: these can include manipulation of spine nearby tissues or transcutaneous electrical stimulation (TENS), IFT, dry needling, cupping, and muscle release which are commonly used for midback pain nowadays, but this will also give only temporary relief and there is no high-quality research evidence that supports these treatments.

 

Physiotherapy exercise for mid-back pain:

 

Mobility:

1. Thoracic extension mobility

2. Thoracic rotation mobility

 

Stretching:

1. Trapezius stretches

2. Rhomboid Stretch

3. Levator scapulae stretch

4. Latissimus dorsi stretch

 

Scapular strengthening exercises

1. Prove V

2. Prone T

3. Prone A

4. Prone W

5. Prone angels

6. Wall angels

7. Serratus push with dumbbells

8. Rowing

 

Click to learn more about mid-back pain exercises.

 

OUR BEST TREATMENT APPROACHES FOR MIDBACK PAIN:

The best treatment approaches start with a proper assessment of the patient (not just in the assessment of the condition). Our assessment will include,

1. History collection (collecting information about the possible reasons for the symptoms,)

2. Understanding of pain: in, we collect all the parameters of pain

(pain intensity, aggravating factor, relieving factor, irritability, sensitivity, duration of pain).

3. Assessment for the fear of movement.

4. Psychosocial -social factor assessment

5. Identify the root cause /risk factors for having mid-back pain.

6. Physical examination

 

CONCLUSION

Mid-back pain is not always a serious problem. With proper treatment and care, most of the individual recover fully. However, it is important to identify the root cause and treat it accordingly. So, it is essential to consult a qualified physiotherapist before beginning any new exercise routine.

At Exercise Prescriptor Clinic, we provide a professional assessment that will help to determine the root cause of your pain and ensure that the given exercises are appropriate and tailored to your specific needs, reducing the risk of further injury or complications.

Schedule a consultation today to take the first step toward a healthy and pain-free life.