Your thoracic spine is the middle section of your spine. It starts at the base of your neck and ends at the bottom of your ribs. It consists of 12 vertebrae. Your thoracic spine is especially rigid and stable, making it the least common area of injury along your spine.
Your spine (backbone) is the long, flexible column of bones that protects your spinal cord. It begins at the base of your skull and ends in your tailbone, which is part of your pelvis. Your spine consists of three sections:
Your thoracic spine is the middle section of your spine. It starts at the base of your neck and ends at the bottom of your ribs. It’s the longest section of your spine. Your thoracic spine consists of 12 vertebrae, labeled T1 through T12.
Vertebrae are the 33 individual, interlocking bones that form your spinal column. These bones help protect your spinal cord from injury while allowing you to twist and turn. Between the vertebral bones are disks that provide cushioning for your vertebrae and flexibility for you.
Your thoracic spine is also surrounded by muscles, nerves, tendons and ligaments that help with movement and flexibility. Your spinal cord runs through the center of your entire spine. It sends and receives messages from your brain, which controls all aspects of your body’s functions.
Your thoracic spine has several important functions, including:
The three sections of your spine form three natural curves. Your cervical spine (neck) and lumbar spine (low back) form “c-shaped” curves called lordosis. The thoracic vertebrae, as a group, produce a kyphotic curve, or a “reverse c-shaped” curve.
These curves are important for balance, and they help you stand upright.
Your thoracic spine consists of 12 vertebrae numbered T1 to T12. Each number corresponds with the nerves in that section of your spinal cord, as well. These nerves branch off of your spinal cord and supply sensation (feeling) and movement to certain areas of your body. The functions of your thoracic spine nerves include:
The nerves that branch off from your spinal cord in your thoracic spine transmit signals between your brain and major organs, including your:
Together, your thoracic spine and rib cage provide a shield to protect your lungs and heart.
Your thoracic spine is located in the center of your upper and middle back. It begins at the base of your neck (cervical spine) and ends around the bottom of your rib cage, just above your lower back (lumbar spine).
Many different parts make up your thoracic spine, including:
Because your thoracic spine is much more rigid and stable, your thoracic spinal area is much less frequently injured than your lumbar (lower back) and cervical (neck) spine.
Your back has many interconnected bones, nerves, muscles, ligaments and tendons that protect your spinal cord. Experiencing pain in your thoracic region (your upper and middle back) could be due to many conditions that can affect these tissues, including:
More common causes of thoracic spine pain that directly involve your spinal column include:
“Degenerative changes of the spine” is the same condition as spinal osteoarthritis, spondylosis and degenerative disk disease. With age, the soft disks that act as cushions between your spine’s vertebrae wear down, dry out and/or shrink. This narrows the space between your vertebrae, causing certain issues.
These degenerative changes are more likely to happen in your neck (cervical spine) and lower back (lumbar spine) than your upper and middle back (thoracic spine).
Conditions that specifically affect your vertebrae, spinal cord and/or nerve roots in your thoracic spine, include:
Other conditions that can affect any region of your spine, including your thoracic region, include:
Vertebral compression fractures (VCFs) are the most common injury to the thoracic spine. They occur when a vertebra in your spine collapses, which can lead to severe pain, deformity and loss of height.
Compression fractures are especially common in the lower thoracic area, and they often result from osteoporosis and mild trauma. But they can also happen after more severe trauma in the absence of osteoporosis (such as a car crash) or as a result of tumors on your spine.
Thoracic spine nerve and spinal cord injury symptoms depend on the type of nerve damage (incomplete or complete) and where the injury is along your thoracic spine.
The main symptoms are pain, weakness and/or tingling that radiates into your arms, legs or around your rib cage.
The following symptoms may also be associated with thoracic spine nerve damage:
Get immediate medical attention if you notice any of these issues after an injury.
First, your healthcare provider will gather your medical and medication history, ask you about your symptoms, perform a physical exam, and order tests and imaging studies.
Tests and imaging may include:
Both nonsurgical treatment options, such as physical therapy and epidural steroid injections (ESIs), and surgery are available to treat many of the conditions that affect your thoracic spine.
Treatment options depend on the cause of your thoracic spine issue, its severity and your overall health. Together, you and your healthcare provider will determine the best treatment plan for you.
There are several things you can do to keep your spine healthy, including:
Because of the special structure of your thoracic spine, it’s less likely to get damaged and cause you pain than your cervical spine (neck) and lumbar spine (lower back).
Pain in your upper and middle back is more likely to be from muscle or ligament strain, which is usually temporary.
However, if you develop severe upper and/or middle back pain that’s sudden or gets worse, it’s important to see your healthcare provider, especially if you have a history of cancer. Spinal tumors are more likely to develop in this area of your spine.
It’s also important to go to the hospital as soon as possible if you experience trauma to your back, such as from a fall or vehicle accident.
A note from Cleveland Clinic
The thoracic region of your spine has several important functions. While spinal injuries are less common in your thoracic spine compared to your cervical and lumbar spine, it’s important to see your healthcare provider if you’re experiencing persistent pain in your upper or middle back. They can perform a physical exam and order tests to see what could be causing your pain.
Last reviewed by a Cleveland Clinic medical professional on 03/22/2022.
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