Thoracic pain: what might lie behind middle back pain

Name: Thoracic Spine Pain – Intrador: Middle Back Pain
Creator: Clínica Intrador

Dr. Helio Widson Alves Pinheiro• CRM/PE 21167 | RQE 2217, 2808

Pain in the thoracic region — the "middle of the back", between the shoulder blades — is less talked about than cervical and lumbar pain, but it is quite frequent.

It can arise from simple musculoskeletal causes, like posture and muscle overload, but can also, in some situations, be associated with cardiac, pulmonary, or visceral problems.

Therefore, the first care is always to take the pain seriously, especially if it is different from usual.

Common musculoskeletal causes

Among the main causes of thoracic pain of musculoskeletal origin, the following stand out:

Prolonged posture in forward flexion

spending a long time hunched over, typing or driving;
shoulders closed and head projected forward.

Weakness of muscles between the shoulder blades

muscles that should better support the trunk become overloaded.

Thoracic spine stiffness

reduced mobility due to lack of movement, sedentary lifestyle, or training focused too much on lower limbs.

Overuse in sports or physical work

repetitive movements of pushing, pulling, rotating the trunk.

Scoliosis alterations or misalignments

can generate overload at certain points of the thoracic spine.

Attention: when thoracic pain might not be from the spine

It is essential to seek quick evaluation, mainly in emergency care, if thoracic pain comes accompanied by:

shortness of breath;
chest pain (squeezing, radiating to arm, jaw, or neck);
cold sweat;
dizziness or intense malaise;
persistent cough with fever;
sudden intense pain without apparent cause.

These signs can indicate cardiovascular or pulmonary problems, and not just something "in the spine".

Treatment of musculoskeletal thoracic pain

Once serious causes are ruled out and musculoskeletal origin is identified, treatment may include:

Posture and ergonomics correction

Strengthening of thoracic, scapular, and core muscles

Thoracic mobility exercises

essential for those who sit a lot

Physical therapy

with manual and educational techniques

Medical acupuncture

for pain modulation and muscle tension relief

Careful use of medications

when necessary

Interventional procedures

In chronic cases refractory to conservative measures, the following may be evaluated:

specific infiltrations in spine joints;
image-guided interventional procedures, when well indicated.

In summary

Thoracic pain usually evolves well when correctly evaluated and treated. The most important thing is not to underestimate the symptom and ensure serious causes are ruled out.

After that, the focus shifts to mobility, strengthening, and strategies to keep the thoracic spine freer and more resistant in daily life.

Dor no Sacro

Pain at the base of the spine and sacroiliac joint

Schedule your Evaluation

If you have persistent thoracic pain and have ruled out serious causes, our team can help identify and treat the musculoskeletal origin of your problem.

Approaches typically considered

For this condition, our team may consider one or more of the approaches below, from least to most invasive. The actual choice depends on individual clinical evaluation.

Acupuncture
Magnetic Stimulation (SIS)
Nerve Blocks
Image-Guided Block or Injection
Radiofrequency

This list is informational. The effective indication depends on individual clinical evaluation, with criteria and limits discussed with you.

Talk with our team See all approaches

Clinically Reviewed by:

Dr. Helio Widson Alves Pinheiro

Pain Medicine | Acupuncture

CRM/PE 21167 | RQE 2217, 2808

Published on: January 17, 2026

Reviewed on: January 29, 2026

This content is informative and does not replace individual medical evaluation.

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Fundador da Clínica Intrador, médico especialista em Medicina da Dor e Acupuntura, com atuação em tratamentos intervencionistas e neuromodulação.

Note: This content is for educational and informational purposes only. The information is based on scientific evidence and the clinical practice of the Intrador team, but it does not replace individualized medical evaluation. Conduct, indications, and treatments must be defined after medical consultation.

Clinical reviewer: Dr. Helio Widson Alves Pinheiro · Pain Medicine | Acupuncture · CRM/PE 21167 | RQE 2217, 2808

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