Upper Back Anatomy Explained

The thoracic spine, which is usually called the upper back or middle back, is very different in form and function to the cervical spine (the neck) and the lumbar spine (the lower back). We obtain mobility from the neck and lower back however the thoracic spine was designed to be extremely stable and strong enabling us to stand upright, additionally, it protects vital organs such as the heart and lungs.



As this portion of the spinal column has a good deal of stability and very restricted mobility, there is normally very little chance of degeneration or injury in the upper back over time. Quite possibly the most common causes of this type of pain are joint dysfunction and muscular irritation. There may have been an injury to a disc in the upper back like a thoracic herniated disc or degenerated disc that causes such related upper back pain, but these injuries are very rare.



The word "thoracic" means related to the chest, and the thoracic spine is the part of the spine that corresponds to the chest area consisting of:



• Twelve vertebrae in the centre of the spinal column with ribs attached make up the thoracic spine. If viewed from the side, this section of the spine is slightly concave.

• Each vertebra in the thoracic spine is attached to a rib on both sides at every level and they in turn meet in the front and attach to the sternum which is also known as the breastbone. This results in a cage (the thoracic cage) that provides structural protection for the vital organs of the lungs, heart and liver, and also creates a cavity for the lungs to expand and contract.

• The upper nine ribs begin at the spinal column, curve around and are joined at the front of the chest area. Because the ribs are firmly attached at the back (the spine) and also the front (the sternum), they allow for very limited mobility in the spine.

• The lower three ribs do not join together at the front, but do function to shield the vital organs while allowing for slightly more mobility.

• The joints between the bottom thoracic vertebra (known as T12) as well as the top lumber vertebra (L1 in the lower back) allow for twisting movement from side to side.



As there is very little motion and a great deal of stability throughout the thoracic spine, this area of the back does not have a tendency to develop common spinal disorders such as degenerative disc disease, herniated disc, spinal stenosis, or spinal instability. These conditions can cause long-term back pain but are quite rare in the upper back.



Because of this stability and lack of mobility, in most cases anatomic causes of upper back pain cannot be found. An MRI scan or CT scan will rarely image an anatomic problem that is amenable to any sort of surgical remedy for the upper back pain. Main reasons therefore seem largely to be either joint dysfunction or muscular irritation and any associated treatment should be based on this diagnosis.



David A Griffiths has carefully researched upper back pain relief and writes for many internet resources to help sufferers.