Mid-Back Pain Causes

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Middle Back Pain

Published: 31 December 2015

If you have a pain from between the shoulder blades down to the waist, then it is what I would consider to be Middle Back Pain. Often this is described as a pain between the shoulder blades, and I have written specifically about in another article, but the underlying causes and treatments are similar. If you think that your pain is around your waist, or below the rib cage, then I have some articles that look at this area here

Pain in the middle of the back

what is the cause?

So if you have a pain in the middle of your back, for example between the shoulder blades, or between the ribs, then I find that it could be due to a number of underlying causes. These include incorrect posture, disc injuries, whiplash injuries and sometimes even a lung conditions.

The way it is treated is very much down to the cause it, so we need to take a bit of time to look at each one in turn:

• Poor sitting posture: Is the most common cause of pain between shoulder blades that I see on a daily basis. When you sit, you should sit upright, and allow the spine to curve naturally in a slight ‘S-shape’. However If you ‘slump’ or ‘slouch’ when you sit, then excess pressure can be placed on this area of the spine. Over time, the ligaments and muscles that support the spine become stretched and distressed. In treating such cases, I strongly encourage patients to become aware of their posture and take some posture exercises to help remove the underlying cause of their mid back pain.

• Thoracic kyphosis: This is where there is an excessive curve in your mid-back. It can be genetic or can be developed through poor postural habits over time. If left untreated, it can cause moderate to severe and chronic shoulder pain in the shoulder blade area. Again, treatment is largely down to postural positioning and exercises, particularly where the kyphosis is structural and cannot be corrected. You can read more about Kyphosis here.

• Lung conditions: If you have a chest infection or lung condition you can also get pain between your mid-back, upper-back or between shoulder blades. In these cases, we should take a more detailed look at the lungs. Treatment includes treating the lung complaint with medication and breathing exercises, as well as unloading the muscles the lung condition. I have an article on back pain associated with lungs here.

• Disc injuries: May arise in your or mid-back, and may refer pain to between your shoulder blades. Treatment is directed towards realigning your disc, followed by specific disc exercises to strengthen and mobilise your back so that you will not have a re-occurrence.

• Whiplash injuries: May refer pain into your mid-back and between your shoulder blades. Treatment is needed to unload the affected spinal leves, followed by mobilisation exercises and specific exercise for whiplash to resolve your whiplash injury. As always, diagnosis is the key! Ensure that you receive a correct diagnosis from your Physiotherapist - this will ensure that the correct treatment is applied for your specific situation.