Middle Back Pain: Is Surgery Necessary?

When you injure your back - especially the critical thoracic vertebrae in your mid-back - your mind might automatically go to the worst-case scenario. You find yourself wondering, “Will I need surgery?”

Back surgery can mean taking weeks off of work. And your ability to complete simple day-to-day activities like folding your laundry might be limited while you recover.

But is it really necessary for people who have middle back pain to undergo surgery?

To clear up the confusion, here's what Sara Wilson, FNP, a specialist at the West Valley Spine Center, has to say about treating middle back pain.

Q: What Are The Most Common Causes of Pain in the Mid-Back?

Sara Wilson: Although middle back problems and injuries are fairly uncommon, it can cause significant pain and discomfort when they do occur. The most common causes of pain in this area are weakened muscles and overuse injuries.

Another frequent cause of pain is joint dysfunction. In the thoracic spine, your ribs connect with the vertebrae on each side, so damage to these joints can cause serious discomfort.

But in general, the thoracic spine the part between your neck and your abdomen has little risk of injury or degeneration. This is because the vertebrae have a limited range of motion and a great deal of stability.

Q: What Are The Most Common Types Of Middle Back Injuries?

Sara: The majority of injuries are muscle-related overuse injuries, muscle strains, sports injuries or motor vehicle accidents.

Fractured vertebra called compression fractures are a common cause of pain as well.

Disc herniations can occur in the thoracic spine, but they are very uncommon. Spinal stenosis, degenerative disc disease and spondylolisthesis are also very rare in the thoracic spine, but can occur.

Q: What Limitations Can Thoracic Pain Put On A Person's Day-To-Day Life?

Sara: Getting ready in the morning, doing household chores like laundry, dishes, vacuuming and mowing the lawn as well as maintaining overall functionality can be challenging.

Q: Is Surgery Generally Necessary?

Sara: Surgery is rare, but mostly because middle back issues such as disc herniations, degenerative disc disease, spinal stenosis and spondylolisthesis are rare to begin with.

Q: What Are Some Surgery Alternatives?

Sara: Muscle pain can be treated with:

• Physical therapy
• Exercises and stretching
• Massage therapy
• Acupuncture
• Chiropractic manipulations
• Heat
• Ice
• Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen

Patients should generally start with those non-surgical treatments when they experience middle back pain. Patients should seek additional treatment if pain and symptoms do not respond to these methods, or if the pain begins to impair their daily life and functionality.

It is also important to seek medical care if the patient has radiating pain, numbness or tingling.

Q: When Is Surgery The Best Option?

Sara: Surgery may be the best or only option for thoracic pain in some cases: fracture, spinal stenosis, disc herniation or severe scoliosis that does not respond to more conservative treatments.

Q: Are There Specific Steps Patients Can Take To Avoid Surgery?

Sara: Taking those initial conservative treatment steps exercise, stretching, practicing good body mechanics, heat, ice, NSAIDs, etc. are a good start.

Patients should aim to prevent spinal problems in the first place by maintaining a healthy weight, having good core strength, stretching and exercising.

It is also important to avoid injuries to the spine by using proper body mechanics to lift, bend, push, pull and twist.