Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 28 September 2026.

Middle back pain is a common complaint that affects people of all ages. It can be caused by various factors, ranging from poor posture to more serious conditions like herniated discs or arthritis. Ergonomic-related back pain comprises 60% of Singapore’s confirmed occupational disease cases between 2019 and 2021. In this article, we will explore the possible causes of middle back pain and discuss different remedies and medical treatments that can help alleviate the discomfort.

Possible Causes of Middle Back Pain

Middle back pain is a condition where structures along the thoracic spine are affected by various conditions that may cause abnormalities in their functions. Middle back pain occurs due to various factors, including the following:

Poor Posture

Middle back pain can be attributed to poor posture, as this bad habit places excessive strain on the muscles, ligaments, and joints in that region. When you consistently maintain an improper posture, such as slouching or rounding your shoulders forward, it disrupts the natural alignment of the spine and places additional stress on the middle back.

Obesity

Obesity is another factor that can contribute to middle back pain. Excess weight puts additional pressure on the spine, leading to discomfort and potential injuries. Engaging in a combination of healthy eating and regular exercise to shed excess weight can effectively alleviate back strain and reduce associated pain.

Ageing

As we age, our bodies go through natural changes that can contribute to middle back pain. The spinal discs, which act as cushions between the vertebrae, gradually lose their flexibility and may become thinner. This can lead to conditions like degenerative disc disease, which can cause middle back pain. Strength training exercises, regular stretching, and maintaining a healthy lifestyle can help slow down the ageing process and minimize the risk of developing such conditions.

Muscle Strain or Sprain

Muscle strain or sprain in the middle back is a common cause of pain. This can occur due to sudden movements, improper lifting techniques, or engaging in activities that put excessive strain on the back muscles.

Resting the affected muscles, applying heat or cold packs, and gentle stretching exercises can help relieve the pain. However, if the pain persists or worsens, it’s important to consult with a healthcare professional for a proper diagnosis and treatment plan.

Fractured Vertebrae

In more severe cases, mid-back pain can be caused by fractures in the thoracic and lumbar spine. This can occur due to traumatic events like falls or accidents. If you suspect that you have broken bones in the back, it’s crucial to seek immediate medical attention.

Treatment options for fractured vertebrae may include wearing a brace, physical therapy, or, in some cases, surgical intervention. A healthcare professional will assess the severity of the fracture and recommend the most appropriate treatment plan.

Herniated Disc

A herniated disc in the middle back can also lead to significant pain. This happens when the inner core of a spinal disc protrudes through the outer layer, potentially irritating a nearby pinched nerve.

Treatment options for a herniated disc may include physical therapy, pain management strategies, and, in severe instances, surgical intervention. It’s important to consult with a healthcare professional to determine the best course of action based on the severity of the herniation.

Spinal Stenosis

Middle back pain associated with spinal stenosis usually occurs when the stenosis affects the thoracic spine, which is the region of the spine corresponding to the middle back.

This is a condition characterized by the narrowing of the spinal canal, which is the hollow space within the spinal column that houses the spinal nerves. The spinal column is made up of individual vertebrae, and between these vertebrae are openings that allow the spinal nerves to exit the spinal canal and branch out to different parts of the body.

When spinal stenosis occurs, the narrowing of the spinal canal puts pressure on the spinal nerves, leading to various symptoms, including middle back pain.

Arthritis

Arthritis is a chronic condition that can affect the joints in the middle back, leading to pain and stiffness. Osteoarthritis and rheumatoid arthritis are the most common types that can affect the spine.

Treatment options for arthritis may include pain medications, physical therapy, and lifestyle modifications. In some cases, joint injections or surgical interventions may be necessary. A healthcare professional will provide a tailored treatment plan based on the type and severity of arthritis.

Osteoporosis

Osteoporosis, a condition characterized by reduced bone density, can also contribute to middle back pain. As the bones become weaker and more prone to fractures, individuals with this bone disease may experience significant discomfort in the middle back.

Treatment options for osteoporosis may include lifestyle modifications, calcium and vitamin D supplementation, medication, and fall prevention strategies. It’s important to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan.

Ways to Relieve Pain in the Middle Back

Relieving middle back pain may be as mild as relieving muscle tension and changing some bad habits that cause this problem or as intensive as surgeries as the last resort to treat middle back pain.

Lifestyle Modification

Making certain lifestyle modifications can have a positive impact on reducing middle back pain because, as mentioned previously, lifestyle factors like poor posture and obesity can contribute to middle back pain.

Incorporating regular exercise in your daily routine, such as low-impact activities like swimming or walking, can effectively enhance the strength of the muscles that support the spine. It’s also essential to maintain a healthy weight, as excess weight can put additional strain on the back. Avoiding smoking and excessive alcohol consumption can also contribute to a healthier spine.

Home Remedies

Several home remedies can provide relief from middle back pain. Applying heat or cold packs to the affected area can help reduce inflammation and alleviate discomfort. Gentle stretching exercises and yoga poses that target the middle back can promote flexibility and relieve tension. Additionally, practising relaxation techniques such as deep breathing and meditation can help manage stress, which can contribute to back pain.

Physical Therapy

Physical therapy is a common treatment option for middle back pain. A physical therapist will assess your condition and design a personalized exercise program to target the specific muscles and improve mobility.

Physical therapy appointments may include a combination of stretching exercises, strengthening exercises, and manual therapy techniques. Following a consistent physical therapy plan can lead to significant pain relief and improved functional abilities.

Physiotherapy

Physiotherapy, also known as physical rehabilitation, focuses on improving and maintaining physical function. It utilizes various techniques such as exercise, manual therapy, and electrotherapy to address pain and promote healing.

A physiotherapist, such as our clinicians at Phoenix Rehab, will assess your condition and develop a customized treatment plan to address the underlying causes of your middle back pain. Regular appointments of back pain physiotherapy in Singapore can help reduce pain, improve mobility, and enhance your overall quality of life.

Medical Treatment

While lifestyle modifications and home remedies can often provide relief from middle back pain, there are cases where medical treatment becomes necessary.

Painkillers

Painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, can help alleviate middle back pain by reducing inflammation and blocking pain signals. However, it’s important to use these medications as directed and under the guidance of a healthcare professional. Long-term use of painkillers can have adverse effects on the body, so it’s best to explore other treatment options in conjunction with painkillers.

Minimally Invasive Procedures

In some cases, minimally invasive procedures may be recommended to address middle back pain. These procedures aim to treat the underlying cause of the pain while minimizing the impact on surrounding tissues. Examples include corticosteroid injections, nerve blocks, or radiofrequency ablation. These procedures are typically performed by clinicians and can provide significant pain relief and improved function.

Surgical Interventions

Surgical interventions are usually considered as a last resort when all other treatment options have been exhausted. They are typically reserved for severe cases where the underlying cause of middle back pain requires surgical correction.

Surgical procedures may involve herniated disc removal, stabilizing fractured vertebrae, or correcting spinal deformities, as in the case of scoliosis. A healthcare professional will assess your condition and determine whether surgery is the most appropriate course of action.

When to Seek Medical Attention

Although treating middle back pain can be done effectively through lifestyle modifications and home remedies, there may still be instances when it is necessary to seek medical attention.

If your pain is severe, persistent, occurring for too long that it may be considered chronic back pain, or is accompanied by other symptoms such as numbness, tingling, or loss of bowel or bladder control, it’s important to consult with a healthcare professional immediately.

The chronic and severe pain with these symptoms may be indicative of a more serious underlying condition that requires a more accurate diagnosis and prompt medical evaluation and treatment to prevent further complications from occurring.

What our patients say

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   Micah 
 54 days ago
 
 
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Amazing experience with Phoenix Rehab, was assisted by Mavis. She’s very kind and professional and did thorough check on my wrist. I feel very comfortable during the process.

I went in for thermoplastic splint, and everything went smoothly. She was able to address my needs on my left wrist sprain.

They were prompt with appointment process and inquiry. Also the clinic is very close to Tanjong Pagar MRT. I highly recommend!
  
 
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   Chiky Phan 
 58 days ago
 
 
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Fist time doing ultrasound for my tennis elbow!! Let’s hope it gets better the next few weeks!! Thank Mavis Tham!!
  
 
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   XIN WANG 
 75 days ago
 
 
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Great treatment from my therapist. My painful wrist felt a lot of relief after the session. I’m glad I can slowly get back to doing my usual activities without constant pain.
  
 
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   Abby Lee 
 91 days ago
 
 
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Very helpful and friendly !
  
 
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   雪梅Cui 
 129 days ago
 
 
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The masseur is very professional and provides excellent service ，yati is very good!
  
 
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   Tra Nguyen 
 220 days ago
 
 
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I wasn’t able to close my fingers due to an injury. Nurul at Phoenix Rehab has helped me tremendously with my recovery process. I have been able to resume my daily activities and exercises after only a few sessions. Nurul has been very professional and positive throughout the entire process. Thank you so much for your help!
  
 
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   Juzer K 
 258 days ago
 
 
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Huge shoutout to Yuna Zhang from Phoenix Rehab for helping in my recovery from golfer’s elbow 🙌

I walked in with persistent elbow pain that was affecting workouts and everyday tasks, and Yuna immediately made me feel confident I was in the right hands. She took the time to properly assess my condition, explain the root cause, and tailor a treatment plan to my specific needs instead of using a one-size-fits-all approach.

What I really appreciated was how personalised every session felt. The exercises she gave me were practical, easy to follow, and actually worked. Within a short time, the pain reduced significantly and my strength and mobility improved much faster than I expected.

On top of that, the pricing is very reasonable and affordable, which made committing to recovery much easier.

Professional, knowledgeable, and genuinely caring — highly recommend Yuna at Phoenix Rehab if you’re dealing with hand-related sports injuries 💪
  
 
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 342 days ago
 
 
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I enjoy coming to Phoenix rehab as they offer a wide variety of services. I had a finger accident and was working with a very experienced hand therapist. Place is clean and comfortable.  Staff were friendly and appointment was on time
  
 
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   Stella Yam 
 483 days ago
 
 
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Very good
  
 
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   Juliana 
 485 days ago
 
 
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Have both physio n Tcm visits here, highly recommend!
  
 
 
  
 
 
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Final Words

Middle back pain can significantly impact your daily life and overall well-being. By understanding the possible causes and exploring various remedies and medical treatments, you can take steps towards finding relief. Remember to prioritize good posture, maintain a healthy weight, and engage in regular exercise to strengthen the muscles supporting your spine.

If you’re experiencing persistent or severe middle back pain, don’t hesitate to seek medical attention. A healthcare professional can provide a thorough evaluation and recommend the most appropriate treatment plan to help you overcome the discomfort and improve your quality of life.

Also on this site: the page on upper right back pain covers the causes on that side and the ones a doctor should check, and the page on spinal pain covers how physiotherapy assesses pain along the spine.

Where are you with this right now?

1. It is settling on its own

Most episodes of back pain settle substantially within six weeks, and staying active beats resting. Scans early on tend to find changes that are common in people with no pain at all. If it is easing week on week and you are moving more rather than less, that is the normal course. You do not need us for this, and we would rather say so.

2. It has stopped improving

You think about how you will get out of the car before you park. You brace before you sneeze. You have stopped lifting anything off the floor without planning it.

The pain leaving is not the same as the capacity coming back. If nothing was loaded again, the back returns to daily life with less than it had. That is the gap worth measuring, and it is not measured by how you feel on the day.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.

3. You have had surgery, or you have a date

Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the recovery programs, or lower back physiotherapy if you are not sure which applies to you.

All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.

Next step

Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.

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