Prevalence and Symptoms of Middle Back Pain
Middle back pain, typically located between the shoulder blades and the bottom of the rib cage (corresponding to the thoracic spine), manifests as localized aching or sharp pain, muscle stiffness, tenderness, radiating pain to the neck or shoulders, and limited mobility.
While less common than lower back pain, middle back pain still affects a significant portion of the population, particularly adults over 40 years old. Factors such as degenerative changes, poor posture, and accumulated wear and tear on the spine and surrounding muscles contribute to its prevalence.
High-Risk Occupations:
Office Workers: Prolonged sitting and poor ergonomic setups lead to a high prevalence, with estimates ranging from 20% to 30%.
Manual Laborers: Heavy lifting, repetitive tasks, or activities that strain the thoracic spine also contribute to a higher risk, with prevalence estimates up to 25% in some studies.
Referred Pain Patterns:
Heart and Lungs: Conditions like angina or pleuritis may cause pain radiating to the middle back.
Kidneys: Kidney stones or infections can result in pain that radiates to the middle back.
Gallbladder: Issues with the gallbladder may cause pain in the right shoulder blade and middle back.
Red Flags: Be aware of symptoms like unexplained weight loss, persistent or worsening pain, numbness or tingling in the limbs, bowel or bladder dysfunction, or a history of cancer or recent trauma. These warrant prompt medical attention.
Causes of Middle Back Pain
Middle back pain is frequently attributed to muscle strain (including Myofascial Pain Syndrome) and poor posture, each accounting for approximately 40% of cases. Spinal issues such as scoliosis, kyphosis, and osteoarthritis, along with joint dysfunction or trauma, contribute to about 10% of cases.
When middle back pain is caused by spinal problems or joint dysfunction, the symptoms can differ significantly from those caused by muscle strain.
Muscle Strain : Pain is usually confined to the middle back and may extend slightly to the shoulders or neck but rarely to the chest or lower body. Tenderness, spasms, or knots (trigger points) are common, and pain often improves with rest, stretching, or gentle exercise.
Spinal Problems/Joint Dysfunction: Pain is often localized to one side of the spine or a specific vertebral level, potentially radiating around the ribcage or into the lower back. If nerves are involved, pain may extend to the legs.
The muscles most commonly responsible for middle back pain due to strain or trigger points include:
Rhomboid Major and Minor (20-30%): Strain or tightness can cause pain between the shoulder blades and along the upper thoracic spine, often from repetitive pulling movements, poor posture, or overhead lifting.
Trapezius (Middle and Lower Fibers) (30-40%): Trigger points here can cause pain in the middle back, often extending between the shoulder blades. Strain is often due to heavy lifting, prolonged poor posture, or repetitive shoulder movements.
Multifidus (Thoracic Portion) (15-25%): Strain or fatigue in these muscles can lead to middle back pain, often from heavy lifting, twisting motions, or prolonged sitting.
Latissimus Dorsi (10-15%): Tightness or strain can cause pain that radiates through the middle back, typically from overhead activities or sudden forceful movements.
Iliocostalis Thoracis (5-10%): Trigger points can cause referred pain to the middle back, often from twisting and bending, lifting objects asymmetrically, or prolonged bending.
How to Relieve Middle Back Pain
Acute middle back pain typically lasts a few days to a few weeks and is often caused by muscle strain, poor posture, or minor injuries. For acute middle back pain, rest, cold and heat therapy, over-the-counter pain relievers, and gentle stretching are effective.
Chronic middle back pain lasts more than three months and may require a combination of therapies to manage symptoms and address underlying causes.
Physical Therapy: A personalized exercise program can strengthen muscles supporting the spine, improve posture, and increase flexibility, helping prevent recurrence and manage chronic pain.
Regular Exercise: Low-impact aerobic exercises like walking, swimming, or cycling help maintain overall fitness and reduce pain. Yoga and Pilates improve flexibility, strength, and posture.
Muscle Strengthening: Strengthening back and core muscles is crucial for providing support to the spine and preventing future strain or injury.
Posture Correction: Improving posture, especially during prolonged sitting or standing, can significantly reduce strain on the middle back. Ergonomic furniture, adjusting computer screens to eye level, and taking regular breaks to stretch are important steps.
Lifestyle Modifications: Changes such as weight management, quitting smoking, and reducing stress can help manage chronic pain and reduce overall strain on the back.
Trigger Point Massage : Trigger point massage is a highly effective, non-invasive treatment for relieving middle back pain It reduces muscle tension, improves circulation, and alleviates referred pain. Trigger point massage can be combined with other treatments like physical therapy, stretching exercises, and posture correction for a comprehensive approach to middle back pain management
Research supports its efficacy for both acute and chronic middle back pain. Regular therapy, whether through professional sessions or self-care using specialised tools, can provide significant and lasting relief. Here’s a summary of relevant research:
Myofascial Trigger Points and Back Pain: A study in the Journal of Bodywork and Movement Therapies found that patients with middle back pain often have active myofascial trigger points in muscles like the trapezius and rhomboids. Trigger point massage significantly reduced pain and improved muscle function, supporting its effectiveness in treating back pain.
Trigger Point Therapy and Pain Reduction: Research in the Journal of Pain Research showed that chronic back pain patients who received trigger point therapy experienced notable pain reduction and improved mobility, highlighting its value, particularly for persistent middle back pain.
Meta-Analysis of Manual Therapies: A meta-analysis in the American Journal of Physical Medicine & Rehabilitation concluded that trigger point therapy effectively reduces pain and improves range of motion in patients with myofascial pain syndrome, including middle back pain, supporting its use as a primary or adjunctive treatment.
Thoracic Pain and Trigger Points: A study in the Journal of Manual & Manipulative Therapy found that patients with thoracic pain (middle back pain) who received trigger point therapy experienced significant pain relief and improved functional abilities, providing direct evidence of the therapy's effectiveness for middle back pain relief.
While professional trigger point therapy performed by a licensed massage therapist can offer precise and effective treatment, self-massage tools are also highly beneficial. These tools are particularly useful for addressing deeply seated or complex trigger points that may require regular sessions for effective relief. Chronic middle back pain often necessitates ongoing treatment, as trigger points can recur or persist without consistent care.
In the following section, we will recommend the most suitable LittleMum trigger point massager for self-massage based on the specific muscles contributing to your middle back pain.
LittleMum Back Deep Tissue Massager
If you’re experiencing middle back pain due to Rhomboid muscle strain or trigger points, the LittleMum Back Deep Tissue Massager is an excellent tool for targeting and releasing Rhomboid trigger points. Its special design mimics the elbows of massage therapists, delivering a professional-quality deep tissue or trigger point massage while avoiding direct contact with the spine.
The massager can be used on the floor or against the back of a chair. Additionally, it also functions as a back stretcher, helping to align the lumbar spine when used on the opposite side. It is crafted from an aluminum alloy frame with silicone padding, offering both sturdiness and comfort. Despite its durability, it remains lightweight and portable, making it ideal for travel.
The massager comes with a 15-year warranty and is FSA or HSA eligible when purchased through Amazon using the link below. However, due to its powerful design, we recommend choosing another LittleMum massager fully made of silicone if you are sensitive to massage pressure .
LittleMum Trapezius Trigger Point Massager
If you’re experiencing middle back pain along with upper back pain due to tight trapezius muscles, the LittleMum Trapezius Trigger Point Massager offers an effective solution for relief. Its ability to alleviate tension in the trapezius has earned outstanding feedback, and we’re confident it can help relieve both your middle and upper back pain.
The massager is made of food-grade silicone, providing a sensation similar to a real massage, It comes with a 15-year warranty and is FSA or HSA eligible when purchased through Amazon by clicking the link below.
LittleMum Shoulder Deep Tissue Massager
If you are suffering from middle back pain caused by the Iliocostalis Thoracis, Latissimus Dorsi, or Multifidus muscles, the LittleMum Shoulder Deep Tissue Massager is an excellent choice. It effectively targets all areas of middle back pain, ensuring all muscle tension is relieved just by repositioning the massager up and down the middle back for comprehensive relief.
The massager is versatile, allowing use on the floor or against the back of a chair. Built with an aluminum alloy frame and cushioned with silicone, it provides a perfect balance of sturdiness and comfort. Despite its solid construction, it remains lightweight and easy to carry, making it an excellent choice for travel.
It comes with a 15-year warranty and is FSA or HSA eligible when purchased through Amazon using the link below. However, due to its powerful design, we recommend choosing another LittleMum massager fully made of silicone if you are sensitive to massage pressure .
LittleMum Back Trigger Point Massager
If your middle back pain originates from the Iliocostalis Thoracis, Latissimus Dorsi, or Multifidus muscles but you prefer a gentler approach to muscle relief, the LittleMum Back Trigger Point Massager is an ideal choice. The fourteen therapy nodes are ergonomically positioned on both sides of the spine, targeting common trigger points in the middle back while maintaining a neutral spinal curve. Simply lie down and let your body weight do the work.
The massager is made of food-grade silicone, providing a sensation similar to a real massage, It comes with a 15-year warranty and is FSA or HSA eligible when purchased through Amazon by clicking the link below.
LittleMum Cane Massager
The Cane Massager is an excellent way to relieve middle back pain with precision while seated. Featuring a thumb-like knob and an ergonomic angle, the LittleMum Cane Massager offers superior accuracy and control over muscle relief compared to lightweight plastic cane massagers, making it ideal for easing muscle strain in the middle back.
Crafted from high-quality materials, including 304-grade stainless steel and a food-grade silicone foam grip, it ensures durability, comfort, and a secure hold. It is also FSA or HSA eligible when purchased through Amazon using the link below
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