Mid Back Pain

Introduction

Mid back pain — often felt between the shoulder blades or along the spine — is a very common but frequently overlooked source of discomfort. It can affect everyday activities such as sitting at a desk, driving, exercising, or even breathing deeply.

Research suggests that around 30–40% of adults experience thoracic (mid back) pain at some point, particularly those who spend long hours sitting or working in sustained positions. While mid back pain can feel restrictive and frustrating, it is rarely serious and is usually related to stiffness, movement habits, or accumulated strain over time. The reassuring news is that physiotherapy is highly effective in restoring movement, easing discomfort, and helping you return to normal daily life with confidence.

Anatomy & Biomechanics

The mid back, known as the thoracic spine, sits between the neck and lower back and plays a vital role in posture, breathing, and upper-body movement. This region is designed to provide stability while still allowing controlled motion, particularly rotation and extension.

Key structures include:

• Thoracic vertebrae (T1–T12) forming the middle portion of the spine.
• Ribs and rib joints, which connect to the spine and assist with breathing.
• Facet joints and discs, guiding smooth spinal movement.
• Muscles between the shoulder blades, supporting posture and arm function.

Because the thoracic spine is naturally stiffer than the neck or lower back, it can become problematic when movement is reduced further — often through prolonged sitting, slouched posture, or limited variation in daily movement. When this area stiffens, the neck and shoulders frequently compensate, which can contribute to ongoing discomfort.

What Causes Mid Back Pain (Acute vs Chronic)

Mid back pain may develop suddenly or build up gradually, and most cases are not linked to a single injury.

Acute mid back pain may occur after:

• Lifting or carrying something heavy or awkward.
• Sudden twisting or reaching movements.
• Sports-related strain.
• Sleeping in an unusual or sustained position.

Chronic or recurring mid back pain:

More often related to repeated low-level stress, such as prolonged desk or computer work, sustained slouched or rounded posture, repetitive upper-body tasks, or reduced thoracic movement following neck or shoulder pain.

Important points to understand:

• Mid back pain is very common.
• There is often no single clear cause.
• Pain usually reflects stiffness or sensitivity, not damage.
• The tissues here are strong, adaptable, and respond well to rehab.

Common Symptoms

Mid back pain is often described as stiff, tight, or achy rather than sharp. Common symptoms include:

• Dull ache or tightness between the shoulder blades.
• Stiffness after sitting or first thing in the morning.
• Discomfort with twisting, reaching, or extending the upper body.
• A feeling of the back being “locked” or hard to straighten.
• Symptoms aggravated by prolonged sitting or poor posture.

Many people notice improvement with gentle movement or position changes, which is a good sign that the area simply needs better load management and mobility.

Common Diagnoses

Mid back pain is often given different labels. Common diagnoses include:

• Thoracic joint dysfunction: Stiffness or irritation of spinal joints.
• Thoracic muscle strain: Overload of the muscles between the shoulder blades.
• Costovertebral joint irritation: Rib-to-spine joint sensitivity, sometimes linked to breathing.
• Postural-related thoracic pain: Discomfort from sustained positions.
• Thoracic disc irritation: Far less common and usually not serious.

How Physiotherapy Can Help

At Peak Performance Physiotherapy, treatment for mid back pain always begins with a comprehensive assessment. We look at how your thoracic spine moves, how your posture and daily activities load the area, and how the neck, shoulders, and breathing patterns may be contributing.

Your care will include:

• A clear explanation of your pain and what’s driving it.
• Hands-on therapy to improve joint and rib movement.
• Targeted rehabilitation exercises to restore mobility and strength.
• Postural and movement education to reduce recurring strain.
• Confidence-building strategies to help you move without fear.

Most patients notice improvement within a few sessions. The aim is not only pain relief, but long-term function and prevention of recurrence. If you’re looking for physiotherapy for mid back pain in Pretoria, The Moot, or Mayville, we are here to help you move comfortably again.