Middle Back Pain Red Flags

Middle back pain may not be as common as neck or lower back pain, but still impacts many people at some point in adulthood. But, when is middle back pain a simple matter of muscle tension or overuse and when does it point to a serious medical issue?

In this article, we’ll help you decipher between the two with middle back pain red flags. Keep in mind that while we can provide general information, middle back pain differs from patient to patient. So, when in doubt, reach out to your doctor. 

Table of Contents

What Disease Causes Middle Back Pain?

Many diseases can cause middle back pain, including osteoporosis, fibromyalgia, scoliosis, kidney diseases, pancreatitis, and spinal diseases.

  • Osteoporosis occurs when bone tissue weakens, or your body produces less bone tissue than usual. An estimated 10 million people in the U.S. have osteoporosis, making it a prevalent bone disease. It can cause middle back pain by weakening the vertebrae and causing spinal compression fractures. 
  • Fibromyalgia is a chronic disease that triggers far-reaching musculoskeletal pain, fatigue, disrupted sleep, and even memory and mood problems. It can cause middle back pain and tenderness.  
  • Scoliosis is an abnormal, sideways spinal curvature. It can result from genetics, spinal disc degeneration, osteoarthritis, or osteoporosis. Scoliosis often causes back pain, including mid-back pain, as the spinal curve increases pressure on the spinal structures and back muscles. 
  • Kidney diseases, such as kidney stones, cysts, and infections, are a possible cause of middle back pain. Kidney pain may also be felt just under the ribs or in your sides. The pain is typically accompanied by other symptoms, such as nausea and vomiting. 
  • Pancreatitis is characterized by inflammation in the pancreas, and it’s most often caused by gallstones or consuming alcohol in excess. Along with stomach pain, nausea, vomiting, fever, rapid heartbeat, and fluid buildup in the belly, pancreatitis can cause middle back pain. 
  • Spinal diseases like spinal stenosis, osteoarthritis, and herniated discs can cause middle back pain. 

What Are the Red Flags of Back Pain?

The red flags of back pain include pain that doesn’t improve with treatment, occurs at night or at rest, wakes you up at night, or is accompanied by symptoms like fever, unexplained weight loss, or incontinence. 

Back Pain That Doesn’t Improve with Treatment

If back pain doesn’t improve with several weeks or months of treatment, it could point to a chronic or more severe condition. Your physician may recommend a different course of treatment or more invasive methods. Sometimes, surgery is necessary to resolve back pain that doesn’t improve with conservative treatment. 

Back Pain That Occurs at Night or at Rest

Back pain that occurs at night or at rest is a red flag. While it may simply be due to poor posture or a muscle strain, nighttime back pain and pain that doesn’t improve with rest are possible symptoms of spinal tumors. Other potential spinal tumor symptoms include:

  • Abnormal gait
  • Generalized mid-back pain
  • Bladder or bowel incontinence
  • Numbness, weakness, or tingling
  • Paralysis  

Back Pain That Wakes You Up at Night

Middle Back Pain Red Flags

Back pain that wakes you up at night is a red flag of serious nerve impingement, spinal infections, spinal fractures, and spinal tumors. It can also point to ankylosing spondylitis, a form of arthritis.

If your back pain consistently makes it difficult to stay asleep, reach out to your doctor for an evaluation. 

Back Pain with Other Symptoms

Back pain that occurs with certain other symptoms can indicate a serious health condition or severe nerve compression. If you experience back pain with any of these symptoms, reach out to your doctor immediately. You may need emergency medical attention. 

Symptoms that are considered red flags with back pain include:

  • Fever
  • Nausea
  • Vomiting 
  • Unexplained weight loss
  • Lost bowel or bladder control
  • Numbness and tingling in the inner thighs, genitals, or buttocks
  • Difficulty standing or walking
  • Abrupt leg weakness

Why Am I Getting Back Pain in the Middle?

You may be getting back pain in the middle because of poor posture, overuse, stress, a sudden impact, an organ condition, or a spinal condition. 

  • Poor posture keeps your spine out of proper alignment, increasing the impact on spinal structures. It also causes muscle tension. These factors are a recipe for pain in the middle, upper, and lower back. 
  • Overuse can cause back sprains, strains, pinched nerves, and even vertebral stress fractures. These conditions can often be resolved with rest and at-home care, but more severe cases require physical therapy and medications. 
  • A sudden impact on the spine, like a car accident injury, can cause middle back pain. 
  • Organ conditions, like kidney problems and pancreatitis, can cause middle back pain. While back pain is more likely to result from a musculoskeletal issue than an organ problem, it’s important to contact your doctor if you experience other symptoms with mid-back pain, like nausea, vomiting, and unexplained weight loss. 
  • Spinal conditions, spinal stenosis, spondylolisthesis, osteoarthritis, and herniated discs, can cause back pain in the middle. These conditions have the potential to cause chronic pain and disability. So, visit your doctor for an exam if you experience middle back pain that doesn’t resolve with at-home care. 

Can Stress Cause Middle Back Pain?

Yes, stress can cause middle back pain. This is because stress contributes to back muscle tension and inflammation. 

When you’re feeling stressed, you tend to tense your muscles – especially the muscles of your back. Muscle tension places more stress on the spine, often leading to back pain and stiffness. Try to pay attention to your muscles, relaxing them and breathing deeply when you’re experiencing stress. 

Prolonged stress can increase inflammation throughout the body and worsen back pain. This is because chronic stress can make your body less sensitive to cortisol, the primary stress hormone. Inflammation can exacerbate pain from poor posture, sprains, strains, and various spinal conditions.

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How Do You Fix Middle Back Pain?

You can fix middle back pain with rest, lifestyle adjustments, physical therapy, medications, or surgery, depending on its cause. 

The best way to fix middle back pain will come down to the cause and extent of your pain. Your physician may also recommend your occupation, age, and lifestyle in determining the best treatment path for your needs. 

To fix middle back pain as quickly as possible, don’t hesitate to see your doctor. Early intervention is the most effective way to achieve relief without the need for invasive procedures or prolonged recovery periods.