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Mid back pain
Do you have mid back pain?
Your thoracic spine is the middle section of your spine. It starts at the base of your neck and ends at the bottom of your ribs.
The thoracic spine is designed to be strong and stable to allow us to stand upright and to protect the vital internal organs in the chest. As this area is very stable, it is less prone to the injuries experienced by the neck and low back, but it is susceptible to pain, particularly when this area becomes stiff.
Pain is often felt when sitting, when twisting the body or can feel like restriction when taking a deep breath. This is usually when the spine is stiff.
What you can do to help
Read tips on how you can support mid back pain
- Avoid staying in one position for long periods of time and keep active throughout the day.
- Look at your work position and try seated (desk-based) exercises during the workday.
- Adopt good posture throughout the day’s activities.
- Regularly carry out seated or movement exercises to reduce stiffness.
- To maintain a healthy spine and prevent reoccurrences, progress to strengthening exercises.
When to seek further support
It is rare that spinal pain is actually an indication of a more serious underlying medical issue (<1%). However, an in-depth assessment by a health care professional (A&E/GP/physiotherapist) is recommended if:
- Your mid-back pain started suddenly following significant trauma (such as a vehicle accident or fall from a height).
- You felt/feel unwell with the spinal pain (such as fever, chills, unexplained weight loss or have had a recent bacterial infection).
- You have a medical history of osteoporosis, cancer, HIV, drug abuse, have an immunosuppressive condition or are on long-term steroid medication.
If your mid back pain is progressively getting worse, is not relieved by lying down and is keeping you constantly awake throughout the night, despite trying the advice and exercises for 1-2 weeks or if the exercises are making your pain significantly worse. Then please seek further advice from your GP.
Mid-back pain and exercise
You may find that the exercises suggested on this page slightly increase your symptoms initially. You should find that with practice, the exercises themselves become easier to do and that you begin to move more comfortably.
How much exercise should I do?
Exercise 2 - 3 times a week
Allowing rest days in between to let soft tissues recover and develop.
Choose 3 or 4 exercises
Choose exercises that are challenging but manageable.
Repeat the exercise
Perform 3 to 5 sets of 5 repetitions for each exercise.
Rest
Rest for up to 1 to 2 minutes between each set and monitor how you are feeling during and after exercising.
Once an exercise is easy, progress it
If the exercises are feeling easy after a week at this level, try a small increase in difficulty. You can do this by increasing the resistance (tension in band or weight used), depth of the movement, slowing down the return phase of the movement or adding a hold for a few seconds at the end of the movement.
How much pain is too much pain?
Before exercising
Before exercising, rate your pain at the moment on a scale of 0-10, where 0 is no pain and 10 is the worst pain you can imagine.
A maximum pain level
A maximum pain level of 4/10 whilst exercising is fine as long as it eases within 45 minutes of the session and does not interfere with sleep or activities the next day.
If your pain increases
If your pain increases beyond this, simplify the exercise by reducing the range of movement or number of repetitions, or try an easier exercise.
Seated (desk based) exercises
Throughout the working day, aim to complete some exercises every 1-2 hours. Perform each exercise until you feel that some of the stiffness has reduced.
Sitting on a chair, gently straighten your spine. Then push your hands forward and allow your upper back and neck to round. 
Sit sideways on a chair with a cushion between your side and the back of the chair. Place your hands behind your neck (or cross them over your chest).
Start sitting on a chair, hold a stick/broom/golf club with a wide grip.
Start sitting on a chair with your legs hip width apart and feet flat on the floor. Movement exercises
Choose 3 or 4 exercises from the set below that are challenging but manageable. Gradually build your range of movement. Perform each exercise until you feel that some of the stiffness has reduced.
Stand comfortably and lean your trunk forwards with your arms outstretched. 
Start on your hands and knees, ensure knees under hips and hands under shoulders. Start with your back in a neutral position.
Start on your hands and knees, ensure knees under hips and hands under shoulders. Place one hand behind your head.
Start next to a wall in a half-kneeling position (use a pillow underneath your knee if required), with your raised leg against the wall. Your foot should be flat on the floor, and your hip bent to 90 degrees.
For this exercise you can use a foam roller or roll a few towels together.
Start side-lying with knees bent. Place both your hands together and extend your arms in front of you.Strengthening exercises
Complete these exercises every other day to allow enough rest for the soft tissues to recover and develop.
Choose 3 or 4 exercises from the set below that are challenging but manageable.
Perform 3 to 5 sets of 5 repetitions of each exercise.
Rest for up to 1 to 2 minutes between each set.
Once an exercise is easy, progress it by increasing the number of repetitions (aim for 10) or by holding the position for longer, or moving to a more challenging exercise.
Start on your knees with your arms outstretched on a gym ball.
Stand tall, facing a wall. Feet slightly wider than hip-width apart, toes point slightly outward. Arms lifted, elbows straight, and hands against the wall. Squat down, keeping your trunk upright and weight in your heels.
Start lying on your stomach. Take your arms out to the side with your elbows at right angles. Lengthen and align your body through your toes to the top of your head. Maintain with width of your chest and back.
Start lying on your stomach, with your arms diagonally above your head. Lengthen and align your body through your toes to top of your head.
Start kneeling on your hands and knees, ensure your hands are under your shoulders and knees under your hips. Your spine should be in a neutral position. Lift one arm and the opposite leg.
Stand tall and hold a weight plate with hold hands. Squat down, rotate from your trunk and bring the weight plate to one side, next to your thigh.Need more help?
Consider self referring using the link below:
If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.
If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.
