Upper and middle portion of the spine, comprising twelve vertebrae that articulate with the ribs.
mikeingram1; recoloration : MJL — CC0 1.0. Image source.
Understanding the structure and its role
The twelve levels T1 through T12 help support the rib cage. Ribs and sternum constrain some movements while allowing breathing. The normal thoracic curve is kyphosis. The spinal cord occupies this region, making neurological assessment important when mid-back pain is unusual or progressively worsening.
Symptoms and assessment
Pain between the shoulder blades and stiffness may be mechanical, but chest pain should not automatically be attributed to the spine. Chest pressure, breathlessness or feeling faint warrants urgent assessment. Following injury, or with fragile bones, vertebral fracture needs consideration.
Assessment considers symptom onset, distribution, restricted activities and medical history. Imaging findings must be compared with the clinical examination: a visible abnormality does not, on its own, establish the source of pain.
Management and outlook
Thoracic mobility and endurance work are individualized after excluding a non-musculoskeletal cause. Thoracic herniation with spinal cord findings calls for specialist assessment rather than a standard traction program.
For a mechanical problem without concerning findings, care aims for a gradual return to activity, individually selected exercises and measurable functional goals. Manual care may complement this approach when the examination supports it. Progress is judged through walking, sleep and daily tasks, as well as symptoms, rather than through an image alone.
When to seek prompt assessment
New or progressive weakness, newly impaired walking, loss of sensation around the saddle region, or new bladder or bowel control problems require urgent medical assessment.
Frequently asked questions
Is thoracic kyphosis abnormal?
No. A moderate curve is normal; excessive or progressive curvature needs assessment.
Can breathing change mid-back pain?
Yes, but that alone does not distinguish a muscular cause from an internal-organ cause.
Can imaging establish the diagnosis alone?
No. Findings must fit the clinical history and examination before they guide treatment.
Should all activity stop?
Usually not: loading is adjusted and gradually increased according to tolerance and the diagnosis.
How should progress be monitored?
Track functional abilities, neurological symptoms and resumed activities so care can be adjusted.
Concept diagram showing key relationships; this is not a scan or an anatomical drawing to scale.
Role of TAGMED care
At TAGMED, this information helps clarify your history, guide assessment and determine whether conservative care is appropriate or medical referral is needed. An anatomical structure, sign or test result is not, by itself, an indication for decompression, laser, shockwave or manual treatment. Care selection depends on the cause of symptoms and your clinical circumstances.
Medical references
- OpenStax, Rice University. Anatomy and Physiology 2e — The Vertebral Column.
- NIAMS, National Institutes of Health. Back Pain: Diagnosis, Treatment, and Steps to Take.
- American Association of Neurological Surgeons. Herniated Disc.
References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.
Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.
TAGMED clinic contact details
For non-urgent consultations and information about available services.
Clinique TAGMED — Terrebonne
1150, rue Lévis, Suite 200
Terrebonne (Québec) J6W 5S6
450‑704‑4447
Clinique TAGMED — Montréal
1140, avenue Beaumont
Mont-Royal (Québec) H3P 3E5
1‑877‑672‑9060