Thoracic back pain is pain that occurs in the thoracic spine, which is between the bottom of the neck to about the waistline.
The thoracic spine is located at the back of the chest (the thorax), mostly between the shoulder blades. Most thoracic back pain goes away on its own but there can be warning signs that mean something more dangerous could be going on.
If you have thoracic spine pain, concerning features are:
- Recent serious injury, such as a car accident or a fall from a height.
- Minor injury or even just heavy lifting in people with ‘thinning’ of the bones (osteoporosis).
- Age under 20 or over 50 years when the pain first starts.
- A history of cancer, drug misuse, HIV infection, a condition or drugs that suppresses your immune system (immunosuppression) such as steroids for a long time (about six months or more) or chemotherapy or radiation.
- Feeling generally poorly – for example, a high temperature (fever), chills and unexplained weight loss.
- A recent infection by a bacteria
- Pain that is there all the time, severe and getting worse.
- Pain that wasn’t caused by a sprain or strain (non-mechanical).
- Pain that doesn’t get better after 2-4 weeks of treatment.
- Pain that is accompanied by severe stiffness in the morning.
- Changes to the shape of the spine, or the appearance of lumps or bumps.
- Pins and needles, numbness or weakness of the legs that is severe or gets worse over time.
- Losing control of your bowels or bladder accidentally (can indicate pressure on the spinal cord).
The most common cause of thoracic back pain is inflammation of the muscles or soft tissues of the thoracic spine.
This inflammation can occur for a number of reasons:
- A sudden sprain or strain (as in car accidents or sports injuries).
- Sitting or standing in a slouched position over time.
- Using a backpack.
- Sitting for a long time at a computer.
- Lack of muscular strength by sitting or lying down too much.
- Repeating a movement persistently that involves the thoracic part of the spine (as in sport or work): also called overuse injury.
- Compression fractures
- Osteoporosis.
- Spinal infection.
- Shingles(especially in people aged over 60 years).
- Spinal osteoarthritis.
- Ankylosing spondylitis – inflammation of the joints between the vertebrae.
- Scheuermann’s disease – an inflammation of the joints of the spine which results in spinal curvature.
- Spinal tumors.
Not all pain in the thoracic spine is coming from the spine itself. Other causes of pain in this area can include problems affecting the lung, the uppermost part of the gut (the esophagus), the stomach, the gallbladder and the pancreas.