Upper & Middle Back Pain (Thoracic)

Because we believe in treating our patients with the most conservative care, our thoracic spine specialists first consider nonsurgical upper and middle back pain treatment options.

Medications may be helpful to relieve thoracic spine pain in some patients. In addition to over-the-counter medicines like ibuprofen, prescription medications are often used in people with upper and middle back discomfort. Some patients benefit from muscle relaxants.

Physical therapy is a common treatment for upper and middle back discomfort and is also an important part of your recovery if you have had thoracic spine surgery. Physical therapists help patients learn about proper alignment of the thoracic spine and approaches to move safely and comfortably, while teaching ways to improve strength, posture, and flexibility. They may provide manual therapy to mobilize the soft tissues and gently manipulate the joints. Other techniques may include exercises you learn with your therapist and do at home to stretch and strengthen your upper and middle back muscles.

Specially trained physical therapists may use "directional preference" techniques to help identify and treat painful spine conditions. Directional preference exercises are determined during the physical examination of patients with back pain and referred pain from the spine, using directed repeated movements by the patient. These exercises have been shown to decrease radiating symptoms and increase function in many people with spine disorders. 

Acupuncture from a licensed acupuncturist has helped many people with upper and middle back pain. It involves the placement of very thin sterile needles into specific energy points in the body to unblock energy pathways and encourage the flow of "qi," the body's life force. 

Steroid spine injections provide short-term relief from upper and middle back pain and can allow you to engage more fully in physical therapy. The relief of pain may be immediate or gradual and can last up to several months. A physiatrist (physical medicine and rehabilitation doctor) or anesthesiologist can deliver the injection, guided by an X-ray technique called fluoroscopy to inject cortisone into the epidural space around the spine. 

Nerve blocks are a form of regional anesthesia. With this treatment, the nerve supply to the area of discomfort in the upper and middle back can be temporarily blocked with a local anesthetic (numbing medication). 

Radiofrequency ablation (RFA) is a same-day procedure performed under light sedation or an anesthetic. The doctor first performs a nerve block to determine the exact source of the pain. A needle is then inserted to target the nerve causing the pain, and heat is applied. This heat creates a lesion that blocks pain signals between the affected nerve and the brain.

At-home treatments can often work to help relieve upper and middle back pain. These may include over-the-counter medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen. Applying a heat or an ice pack and resting your back muscles may also be helpful. Regular exercise and stretching may not only relieve your upper and middle back pain, but can also prevent it from occurring in the first place. Always practice good posture. Slouching can exaggerate any existing upper and middle back pain and lengthen recovery time.