Thoracic Back Pain - Symptoms and Causes

Authored by Dr Laurence Knott, 16 Jun 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 16 Jun 2017

Surveys to find out how many people have thoracic spine pain produce very variable results. For example, when asked whether they have ever had thoracic spine pain, one survey reported a result of 4 out of a 100 people, whilst another said 72 people out of 100. It appears to be at its most common in children and teenagers, especially girls. Factors cited as causing thoracic back pain included backpack use, the height of school chairs, and difficulties with homework. Mental health problems seemed to be an associated factor. It also appeared to be common in the transition period between the early teens and late adolescence. Adults with thoracic back pain often have aches and pains elsewhere as well as difficulties going about their daily tasks.

Thoracic spine pain is common, short-lived and of little consequence. However, it is also more likely than neck pain or low back pain to have a serious cause. These alarm symptoms are known as 'red flags'.

Red flags

If you have thoracic spine pain, these are the alarm features to look out for:

  • 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 that suppresses your immune system (immunosuppression) and use of steroids for a long time (about six months or more).
  • Feeling generally poorly - for example, a high temperature (fever), chills and unexplained weight loss.
  • A recent infection by a germ (bacterial infection).
  • 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, including the appearance of lumps or bumps.
  • Pins and needles, numbness or weakness of the legs that is severe or gets worse over time.
  • Passing wee or poo 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 (couch potatoes beware!).
  • Repeating a movement persistently that involves the thoracic part of the spine (as in sport or work): also called overuse injury.

Less common causes include:

  • Narrowing of part of the spine (thoracic stenosis) - usually due to wear and tear.
  • Slipped discs - these are common but rarely cause pain.
  • Fractures of the vertebrae (the bony components that make up the spine).
  • 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 tumours.

It shouldn't be assumed that 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 oesophagus), the stomach, the gallbladder and the pancreas.

Further reading and references

Hi, I've had back ache to a greater or lesser extent for about 2 years. An MRI scan showed degenerative disc disease (which I know is very common in people of my age).However the pain doesn't feel as...

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