Anatomy of The Spine
The word “thoracic” means pertaining to the chest, and the thoracic spine (also called the upper back or mid-back) is the portion of the spinal column that corresponds to the chest area.
Twelve vertebrae in the middle of the spine with ribs attached make up the thoracic spine. When viewed from the side, this section of the spine is slightly concave.
Each vertebra in the thoracic spine is connected to a rib on both sides at every level and these in turn meet in the front and attach to the sternum (the breastbone). This creates a cage (the thoracic cage) that provides structural protection for the vital organs of the heart, lungs and liver, and also creates a cavity for the lungs to expand and contract.
The upper nine ribs start at the spine, curve around and are joined at the front of the chest. Because the ribs are firmly attached at the back (the spine) and the front (the sternum), they allow for very limited motion in the spine.
The lower three ribs do not join together at the front, but do function to protect the vital organs while allowing for slightly more motion.
The joints between the bottom thoracic vertebra (T12) and the top lumber vertebra (L1 in the lower back) allow twisting movement from side to side.
Because there is little motion and a great deal of stability throughout the upper back (thoracic spine), this section of the spine does not tend to develop common spinal disorders, such as a herniated disc, spinal stenosis, degenerative disc disease, or spinal instability. These conditions can cause upper back pain but are exceedingly rare in the upper back.
Because of this stability and lack of motion, in most cases anatomic causes of upper back pain cannot be found, and an MRI scan or CT scan will rarely image an anatomic problem that is amenable to any sort of surgical solution for the upper back pain.