Diagnosis

In the case of pain in the middle back, a medical history, i.e. a doctor-patient consultation, is usually first carried out to determine whether the patient has perhaps simply overextended himself or whether the pain is of a different origin. By palpation, i.e. palpation, the doctor can determine whether there is muscle cramping or a malposition of the spine. Other diagnostic procedures include an X-ray or, if an organic cause is suspected, a blood sample.

Symptoms

It is important to be aware of all other symptoms in addition to the pain in the middle back. If you only have pain in the middle back, this most likely indicates muscle cramps or spinal deformation or wear and tear. However, if accompanying symptoms such as fever occur, one can assume an inflammation.

If you have also felt a lump in the breast, it is possible that the pain in the middle back is caused by a daughter tumor whose main focus is a breast tumor. Since pain in the middle back is very general and can mean many things, it is therefore important to pay attention to the accompanying symptoms and inform the doctor. Back pain is a complicated subject, on which many questions are still unanswered today.This often makes it difficult to treat the pain.

Nevertheless, a large part of the complaints are simply due to everyday one-sided malpositions of the back. This applies to the right-sided middle back as well as to other parts of the back. In particular, overweight and lack of training of the back muscles can often be identified as the cause of back pain.

In addition, degenerative, i.e. age-related changes in the spine also play an important role in old age. Likewise, diseases such as herniated disks, spinal stenosis or listhesis should be considered when determining the cause of pain. In principle, all these diseases can occur at any height of the spine, so that they can also be responsible for complaints in the case of the right middle back.

On the other hand, however, internal diseases such as pneumonia (pleuritis) or psychosomatic difficulties can also be responsible for corresponding complaints. The causes of back pain are manifold. This is true even if their localization can be well named – for example on the left side of the middle back.

Here, too, unilateral incorrect loading of the spine due to poor posture in everyday life, obesity and poor training of the back muscles are the most frequent triggers for pain in the majority of cases. Apart from this, degenerative diseases such as herniated discs or spinal stenosis are also conceivable as causes of left-sided back pain. In addition, it should not be forgotten that internal diseases can also cause back pain.

In the case of the left middle back, for example, pleurisy (inflammation of the pleura) is conceivable, which can lead to pain depending on breathing. Especially on the left side of the upper abdomen, pain can radiate into the back due to pancreatitis or duodenal ulcer. Overall, however, internal diseases are rarely responsible for back pain.

In contrast, a not negligible part of back pain is due to psychosomatic backgrounds. For example, no organic cause can be found for up to 40% of all back pain, so that at least a certain percentage of this share is of psychosomatic origin. As in the case of unilateral pain in the middle of the back, localized on the right or left, the rule is that pain in both sides of the back is mainly due to everyday causes.

These include in particular overweight, poor posture in everyday life and weak back muscles. The back pain associated with these conditions is often described as “unspecific” because it is almost impossible to determine the exact cause. However, to a much lesser extent, orthopedic diseases are also known as triggers for back pain.

These include above all herniated discs, but also vertebral fractures, spinal stenoses and spondylolisthesis. Blockages of the vertebral joints or entrapments of nerves can also lead to bilateral pain in the area of the middle back. However, internal diseases can also lead to back pain.

In the case of pain on both sides of the thoracic spine, these include above all inflammation of the lungs (pleuritides) and, in rare cases, pancreatitis (inflammation of the pancreas). The physical effects of psychological stress are also often underestimated. It is assumed that a considerable proportion of back pain is also due to psychosomatic reasons.

The cause of lateral pain in the middle back is mostly to be found in the musculo-skeletal area. This ultimately means that they are based on diseases of the spinal column or the back muscles. Normally, all parts of the back are in a state of equilibrium that allows them to function properly.

Due to mechanisms such as incorrect posture in everyday life, untrained back muscles or overweight, this interaction can get out of balance, resulting in so-called “unspecific” back pain. Apart from this, orthopedic illnesses such as a slipped disc, spondylolisthesis or spinal stenosis can also cause pain to the side of the middle back (much less frequently). In addition, some internal diseases and psychosomatic backgrounds can also cause back pain.In many cases, the cause of night-time back pain is simply an unsuitable mattress, whereby both too hard and too soft mattresses can cause pain.

The lack of support of the individual spine shape can lead to muscle tensions. However, degenerative changes in the spine can also become noticeable overnight. Among other things, this is characteristic of arthrosis of the small vertebral joints.

Likewise, the so-called ankylosing spondylitis (ankylosing spondylitis), a rheumatic disease, is particularly noticeable in its early phase through back pain, which is particularly severe at night. For these reasons, an orthopedic clarification of night-time back pain is quite useful. Especially if the complaints have been existing for a long time, you should not hesitate to make an appointment with your orthopedist.

Inflammation of the pleura (pleuritis) is characterized by severe breath-related pain in the area of the chest and back. In addition, the affected patient suffers from a strong feeling of illness and fever. A complex of symptoms consisting of breathing difficulties and pain in the middle of the back can therefore certainly be attributed to pleuritis.

On the other hand, simple blockages of the vertebral or rib joints can also lead to breath-related pain in the middle back. These can typically be provoked and intensified by pressing on the corresponding joint. However, such joint blockages are in themselves a harmless clinical picture and can often be resolved by an experienced orthopedist.