Lower back pain is a common complaint across the globe and it’s one of the leading causes of disability. What gets less attention but is arguably harder to treat than lower back pain is middle back pain. Middle back pain can be a complex condition, with many patients never finding out the root cause of it. The middle back is a complex part of the spine: its job protecting the vital organs is crucial, but it’s also susceptible to stubborn pain. If you suffer from middle back pain, here are some stretches and exercises that can help. As always, talk to your doctor to ensure these exercises will be helpful for your unique case.

What causes middle back pain?

Upper and middle back pain is not as common as lower back or neck pain, but it still accounts for a sizable amount of pain. The upper and middle part of the back are known as the thoracic back. This part of the back contains the T1 through T12 vertebrae, part of the rib cage, and various muscles and ligaments that hold your spine together.

While the lower back and neck are made to be more flexible, the upper and middle parts of the back, along with the rib cage, are built for support and to protect many of the vital organs of the human body. This rigid structure means that the middle and upper back are naturally less mobile. It also means that when something happens to this area of the spine—trauma or another condition—it can be more difficult to treat.

On the positive side, many common complaints in the lower back and the neck are rare in the middle back. Spinal stenosis, degenerative disc disease, or disc herniation are rarely reported as a cause of middle back pain.

The main causes of upper and middle back pain occur from overuse or an injury that usually develops from continuous strain or bad posture. Continual high stress can also cause muscle tension, which can eventually devolve into a vicious cycle of stressing over ever-increasing pain that even affects your sleep.

Conditions that put pressure on the spinal nerves can also cause upper and middle back pain, such as a fracture of a vertebrae, scoliosis, or osteoarthritis.

This is especially true for those who work at a computer every day or who work in highly repetitive and physically active industries (e.g., warehouse work and construction).

Middle back pain symptoms

Some common middle back pain symptoms include:

• Pain that is either localized or spread over a large area
• Discomfort with a slow onset that gradually increases in intensity
• Pain made worse by certain activities or positions
• Variable pain that can be dull, sharp, or burning

In some cases, upper and middle back pain can be a sign of much more severe issues such as a cancerous tumor and diseases that affect the heart, lungs, and kidneys. If you experience any of the following symptoms, make sure you consult a physician immediately:

• Numbness or weakness in your extremities, chest, or stomach
• Loss of bowel or bladder control
• Chest pain or pressure
• Nausea or vomiting
• Fever

Upper and middle back pain is also a common symptom of heart attack in women. If the onset of pain is sudden without any physical trauma, contact your doctor immediately.

How to stretch the middle back 

The one thing that most back pain has in common is that it can be relieved with simple stretches and exercises to build muscle strength and reduce tension. Mid-back stretches and middle back strengthening exercises can offer profound relief and healing for many chronic pain conditions.

But this area of the body can be difficult to stretch. The skeletal structure only allows movement so far in one direction; you cannot stretch bone. There is no need for huge, dramatic stretches, though. One way to think about it is to imagine the shoulder blades as flat plates that can be shifted around on the back. Connected to muscles and tendons, even starting with this simple visualization can be helpful.

Back stretches for middle back pain

There are many different ways to treat middle back pain. Options like ice therapy, over-the-counter medications, and massage only provide temporary symptom relief. Incorporating regular middle back strengthening exercises can go a long way towards a more permanent reduction of pain.

Middle back pain stretches should be incorporated gradually and with your doctor’s supervision. Remember when doing these stretches to pay attention to your breathing and to never hold your breath. Exhale while stretching the muscle and inhale when you start to relax it. Pay attention to how it feels when you move. If something feels “off” or causes sharp, stabbing pain, move carefully out of the stretch.

These eight middle back pain stretches are a great place to start. You can also find more in our yoga for middle back pain post.

1. Seated twist

A simple stretch you can do at the office or while sitting in front of the computer is a seated twist. Inhale deeply, then as you exhale, press your navel to your spine as you twist to the right. If your chair has armrests, place the right hand on the back of the right armrest and the left on the front. If not, place your right arm on the back of the chair and let your left arm come to the outside of your right thigh.

If it feels good for your neck, you can look gently over your right shoulder. Otherwise, just look forward or to the side. Hold for three to five full breaths, sitting tall on the inhale and pressing your navel to your spine on the exhale. Return to the center on an inhale, then twist to the other side.

2. Passive back bend

A passive back bend is an amazing stretch to do at the end of a long day and requires minimal effort. Start by rolling up a towel or use a pillow or yoga bolster. Lay it down horizontally so your shoulder blades can lay across it. Lie across the rolled-up item so your shoulder blades are supported.

Breathe deeply and relax into this stretch for at least five minutes. If you would like a deeper stretch, you can turn the pillow or towel so that it runs vertically up and down your spine, or you can add another pillow.

3. Supported hamstring stretch

Hamstrings stretches should be part of middle back strengthening exercises. Try a supported hamstring stretch. It’s easy on the back and only requires a chair.

Stand in front of a sturdy chair and place the heel of one foot up on the seat. Hinge at your hips to fold forward with your navel to your spine and a long, straight spine. If you feel any pain behind your knee, bend the knee. You want to feel this stretch in the belly of your hamstring.

Take three to five full, deep breaths, lengthening your spine on the inhale, and folding on the exhale. Switch sides. This is a good stretch to do periodically during the day.

4. Cat-cow pose

The cat-cow yoga pose can really help with back pain. Start on all fours with shoulders over wrists and hips over knees. Come into cow pose. Inhale, arch your lower back to let your belly reach towards the ground as you draw your shoulder blades onto your back. Let your heart shine through your upper arms and lift your gaze to the sky.

As you exhale, tuck your pelvis under and arch your back like a cat, letting the shoulder blades fall away from each other as you press your hands into the ground and drop your head.

Follow your breath for a series of five of these mid-back stretches.

5. Heart-melting pose

Heart-melting pose is also called “puppy pose” in yoga. Start on all fours with your hips directly above your knees. Keep your knees and hips in one straight line as you walk your hands forward to lower your forehead towards the ground.

If this pose feels too intense on your shoulders, keep your arms separated. You can also place a bolster or a couple of pillows underneath your chest (and a block underneath your forehead) if you cannot quite reach the ground.

Breathe here for at least ten breaths, then slowly walk your hands towards you to come out of the stretch.

6. Thread the needle

Start on all fours with your hips directly above your knees and your shoulders above your wrists. Inhale, then twist your torso to reach your right hand behind your left wrist, lower your body so that your shoulder and the right side of your face rests on the ground and the back of your right arm is on the ground stretching towards the left. You can keep your left hand where it is or stretch it forward. Take three to five breaths in this pose, then press into your left hand to unwind.

Repeat on the other side.

7. Shoulder flossing

Shoulder flossing moves the shoulder blades gently through their range of motion. It is the same shoulder action as cat and cow pose, only this time you keep your lower body still and engaged, with your navel pressing to your spine.

On all fours, inhale and press the floor away, feeling your shoulder blades slide away from each other. Exhale and drop your chest so that your shoulder blades come together on your back.

Repeat three or four times.

8. Half-dog at the wall

Half-dog at the wall is a great upper and mid-back stretch that also stretches tight hamstrings. Stand at the wall with your hands flat on the wall. Walk your feet back and begin to hinge at the hips, walking your hands down the wall to gradually form an “L” shape with your body.

Pull your navel to your spine and move your shoulder blades together and down your back as you reach the crown of your head towards the wall. This creates space between your shoulders and your ears. Let your chest relax towards the ground but keep your belly engaged.

If your hamstrings are tight, bend your knees slightly, but make sure that your hips and ankles are in one line. Take three to five breaths here, then slowly walk your hands up the wall as you walk your feet forward.

Middle back exercises to try

It’s important to support your middle back pain stretches with some whole-body exercise and targeted middle back strengthening exercises. Improving your overall level of fitness is a great way to address the mental health aspects of chronic pain as well. A stronger back is also less prone to further injury in the future.

For low-impact exercise, consider beginning a walking program or hopping in a pool three to five times a week. Both of these offer full-body exercise that works well if you are still in the acute stages of injury. Engaging in tai chi or yoga is another great meditative way to slowly increase your fitness level, in both body and mind!

Once you are feeling stronger and can add some cardio, the following are great options:

• Stair climbing
• Using a rowing machine
• Biking

As your fitness level increases, you can also start to add some specific strengthening exercises. Try these three middle back strengthening exercises to start.

1. Resistance band pulls

Stand with feet parallel and hip-distance apart. Holding a resistance band, lift your arms out in front of you at shoulder height. Keep your navel engaged and stand tall.

Inhale, and on an exhale pull hands away from each other. Squeeze your shoulder blades together as your hands separate, then slowly release back to center. Repeat three to five times for three sets, increasing either the number of repetitions or moving your hands closer together as you get stronger.

2. Dumbbell row

This can be completed on all fours or with the use of a bench or a chair.

On all fours, start with a dumbbell in each hand. Engage your navel to keep your lower back supported. Inhale, and on an exhale, slowly lift your elbow to bring the dumbbell in your right hand to your armpit. Keep your arm hugged close to your body.

If you are using a bench, your left knee and hand stays on the bench and your right leg stays on the ground as you row on the right side. Aim for five to seven rows, starting with one set and working up to three.

3. High plank dumbbell row

If you want to combine a core-strengthening exercise with a cardio workout and muscle strengthening all rolled into one low-impact exercise, this is the move for you.

Come into high plank with your hands wrapped around dumbbells instead of on the ground. Makes sure your shoulders and hips are in line. Press your navel towards the sky to keep your lower back safe.

Moving on either an inhale or an exhale (whichever feels most natural to you), shift your weight into your left hand as you bend your elbow and bring the right dumbbell to your armpit (as in the dumbbell row). Alternate sides, making sure to maintain proper plank form with the crown of your head reaching forward, and your heels reaching back.

Complete three to five on each side, rest, and try another set. Again, increase either the number of repetitions or the amount of weight, one at a time.

How to relieve middle back pain 

Middle back pain stretches and strengthening are a great way to work on healing middle back pain, but what if they don’t completely help with your pain? Sometimes you need more than one approach. Physical therapy, chiropractic care, acupuncture, and some types of injections are other treatment options to consider.

At Arizona Pain, we know that middle back pain can seem like an unsolvable riddle. With therapeutic options tailored to you, we can help you put the pieces together. Get in touch today.