Mid-back (thoracic spine) pain is discomfort or stiffness in the upper to middle back, often due to poor posture, muscle strain, or prolonged sitting. Symptoms range from dull aches to sharp pain. Treatment typically involves rest, gentle activity, posture correction, and pain management. Maintaining good ergonomics and staying active are key to prevention and recovery.

Mid back (thoracic spine): Pain (Overview & Treatment)

Thoracic spine pain home exercise program

Thoracic Spine Anatomy and Upper Back Pain

Thoracic Epidural Injection

Radiofrequency Ablation in the Thoracic Spine

Epidural Steroid Injection Patient Education Handout

Medial Branch Blocks Educational Handout

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Lower back pain is a very common condition causing discomfort, stiffness, or sharp pain in the lower back, often due to muscle strain, poor posture, or overuse. Most cases improve with conservative approaches like rest, ice/heat, gentle movement, and over-the-counter pain relief. Adopting good posture, maintaining a healthy weight, and regular, appropriate exercise are key lifestyle changes that can help manage and prevent it.

Lower Back: Pain (START HERE! Overview & Conservative Treatment)

A herniated disc occurs when a spinal cushion bulges or ruptures, irritating nearby nerves in your lower back. This can cause a "pinched nerve" sensation, often leading to sciatica – pain, numbness, or weakness radiating down your leg. Treatment focuses on pain relief and recovery through rest, physical therapy, and sometimes injections to reduce inflammation. Lifestyle considerations like proper body mechanics also support healing.

Lower Back: Herniated Disc/ Sciatica/ Leg pain/ Pinched nerve (Epidural steroid injection)

Lumbar spinal stenosis is a common condition where the spinal canal in your lower back narrows, often due to aging and arthritis. This can press on nerves, causing leg pain, numbness, tingling, or weakness, especially when walking or standing. Management often includes physical therapy, medication, and sometimes epidural steroid injections to reduce inflammation and pain, helping you stay active and comfortable.

Lower Back: Lumbar Spinal Stenosis (Epidural steroid injection, mild procedure)

Lower back facet joint disorders involve pain from small spinal joints, often due to wear and tear. Symptoms include aching pain, worse with standing or bending backward. Staying active and physical therapy are key. If pain persists, specific nerve blocks can help pinpoint the source, and radiofrequency ablation (RFA) may offer longer-term relief by calming those nerves.

Lower Back: Facet Joint Disorders (Medial branch blocks, RFA)

Vertebrogenic pain is a type of lower back pain originating from changes within the vertebral bones, particularly the endplates near spinal discs. It often feels like deep, aching pain, especially when sitting or bending. Lifestyle adjustments like maintaining good posture and gentle exercise can help, and specific treatments, including certain nerve-targeting procedures like Intracept, may be considered for persistent pain.

Lower Back: Vertebrogenic Pain (Intracept)

Post-laminectomy syndrome (also called failed back surgery syndrome) describes persistent back or leg pain that continues or develops after spine surgery. This can occur due to nerve changes, scar tissue, or other factors, even if the surgery was technically successful. Management focuses on improving comfort and daily function through various therapies, medications, or devices like spinal cord stimulators.

Lower back: Post-laminectomy syndrome/ failed back surgery syndrome (spinal cord stimulator)

Sacroiliac (SI) joint pain affects the lower back and buttocks, sometimes radiating down the leg, often worsening with standing or walking. This discomfort stems from inflammation, injury, or instability of the SI joints, which connect your spine and pelvis. Management typically involves physical therapy, medication, or injections. For persistent pain, stabilization procedures (like those including PainTeq) may be explored to restore joint function, alongside lifestyle adjustments such as gen...

Lower Back: Sacroiliac (SI) joint pain/ buttock pain (SI joint injection/ stabilization, PainTeq)

Lower back multifidus muscle dysfunction occurs when the small, deep muscles essential for spinal stability don't work effectively, often causing chronic back pain. This can result from injury, inactivity, or prolonged pain. Treatment aims to restore muscle function, improve stability, and reduce discomfort, often through targeted exercises or specialized therapies.

Lower back: Multifidus Muscle Dysfunction (Reactiv8)

Peripheral neuropathy involves damage to nerves outside the brain and spinal cord, often causing numbness, tingling, weakness, or burning pain, typically in the hands and feet. Causes vary, from diabetes to injury. Treatment aims to manage symptoms and underlying causes, often including lifestyle adjustments. For chronic, severe neuropathic pain, a Spinal Cord Stimulator (SCS) is an advanced option that delivers mild electrical pulses to help reduce pain signals.

Peripheral neuropathy (Spinal cord stimulator)

Neck pain is a common discomfort often caused by muscle strain, poor posture, or minor injury, leading to stiffness or aching. Most cases improve with conservative care such as rest, ice or heat application, gentle movement, and over-the-counter pain relief. Maintaining good posture and ergonomic habits can significantly aid recovery and prevention.

Neck: Pain (START HERE! Overview & conservative treatment )

A neck herniated disc means a spinal cushion has bulged or ruptured, potentially pinching a nearby nerve. This can cause pain, numbness, tingling, or weakness radiating into the neck, shoulder, or arm. Often due to wear and tear or injury, treatment aims to relieve pressure and may include rest, physical therapy, medication, or targeted injections like an epidural steroid injection to reduce inflammation. Managing posture and activity can also help.

Neck: Herniated Disc / Arm pain/ Pinched nerve (Epidural steroid injection)

Cervical spinal stenosis is a narrowing of the spinal canal in your neck, often due to age-related wear and tear. This can gently press on your spinal cord or nerves, leading to symptoms like neck pain, arm numbness, weakness, or balance issues. Initial treatment often involves physical therapy, medication, or lifestyle adjustments like good posture.

Neck: Cervical Spinal Stenosis

Neck facet joint disorders cause pain and stiffness due to wear-and-tear or injury in the small joints connecting your vertebrae. This discomfort often worsens with movement. Healthcare providers may use targeted injections (like medial branch blocks) to diagnose and ease pain, and sometimes nerve treatments (like radiofrequency ablation, RFA) for longer relief. Maintaining good posture and gentle activity can support recovery.

Neck: Facet Joint Disorders (Medial branch blocks, RFA)

Failed Neck Surgery Syndrome (FNSS) is persistent or new neck and arm pain occurring *after* surgery to relieve these symptoms. Often due to nerve irritation or scar tissue, it's a complex condition. While challenging, treatments including physical therapy, medication, and sometimes a spinal cord stimulator, aim to manage pain and improve daily function.

Neck: Post-laminectomy syndrome/ failed neck surgery syndrome (spinal cord stimulator)

Neck strain or whiplash refers to injuries of the neck's soft tissues, typically from sudden forceful movements (like accidents) or poor posture. Common symptoms include pain, stiffness, and headache. Rest, gentle movement, and pain relief often help, with good posture supporting recovery.

Neck: Strain or Whiplash

Spinal fractures, often compression fractures, are breaks in the bones of your spine, frequently caused by weakened bones from osteoporosis or injury. They can lead to sudden back pain, loss of height, and a stooped posture. Management typically involves pain relief and supporting the spine, with lifestyle adjustments like exercise and nutrition being vital for bone strength.

Spinal Fractures (Compression fractures, osteoporosis)

Scoliosis is a condition where the spine develops a sideways curve, often appearing during growth spurts in adolescence. It can lead to uneven shoulders or hips, and occasionally back pain. While the cause is often unknown, it's typically managed with observation, bracing, or, in some cases, surgery. An active lifestyle is generally encouraged.

Scoliosis

Kyphosis is an excessive outward rounding of the upper back, often appearing as a hunch or slouch. It can result from poor posture, growth changes, or aging. While sometimes asymptomatic, it may cause back pain or stiffness. Management often includes physical therapy, exercise, and in some cases, bracing or surgery. Maintaining good posture is a helpful lifestyle consideration.

Kyphosis

Osteoarthritis, often called "wear-and-tear" arthritis, occurs when the protective cartilage in your joints gradually breaks down, leading to pain, stiffness, and reduced movement. While common with aging, managing symptoms through exercise, weight control, and various therapies can significantly improve comfort and joint function.

Arthritis (Osteoarthritis)

Here is a patient-friendly description for Bursitis:

Bursitis occurs when bursae, small fluid-filled sacs that cushion your bones, tendons, and muscles near joints, become inflamed. This often causes pain, tenderness, and swelling around the affected joint, commonly due to repetitive motion or prolonged pressure. Rest, ice, and avoiding aggravating activities can typically help ease discomfort and promote healing.

Bursitis

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition, often more severe than expected after an injury or surgery. It causes intense burning pain, swelling, and extreme sensitivity, typically in an arm or leg. Treatment focuses on managing pain and restoring function through various therapies, which may include nerve blocks or devices like spinal cord stimulators, to help improve daily life.

Complex Regional Pain Syndrome (CRPS) (Sympathetic block, Spinal cord stimulator)

Chronic knee pain, often due to conditions like arthritis or past injury, can cause stiffness and limit daily activities. When conservative treatments don't provide sufficient relief, genicular radiofrequency ablation (RFA) is an option to reduce pain by targeting the nerves that send pain signals from the knee. Managing a healthy weight and engaging in gentle activity can also significantly help manage symptoms.

Knee: Pain (genicular RFA)

Fibromyalgia is a chronic condition causing widespread body pain, fatigue, sleep problems, and cognitive difficulties ("fibro fog"). While its exact cause isn't fully understood, it's believed the brain processes pain differently. Management focuses on reducing symptoms through medications, gentle exercise, stress management, and healthy sleep habits to improve daily well-being.

Fibromyalgia

Brachial plexopathy/Thoracic Outlet Syndrome (TOS) occurs when nerves or blood vessels in the space between your neck and shoulder are compressed. This can cause pain, numbness, tingling, or weakness in the arm and hand. Management often involves physical therapy, exercise, and lifestyle adjustments like improving posture to help relieve pressure and manage discomfort.

Brachial plexopathy/ Thoracic outlet syndrome (TOS)

Chronic pain profoundly impacts your thoughts, emotions, and behaviors, often leading to stress, anxiety, depression, and difficulty coping. These psychological factors can also intensify the experience of pain itself. Effective management involves addressing both physical symptoms and mental well-being through integrated therapies, support, and healthy lifestyle choices to improve overall quality of life.

Psychological Aspects of Chronic Pain

"Recursos en español" translates to "Resources in Spanish" and is not a medical condition. This term refers to information, services, or materials available in Spanish to help patients and families understand their health, manage care, and access support. If you're looking for information on a specific medical condition, please provide its name.

Recursos en español

John Rowlands

Interventional Pain Management

Board Certified in Pain Medicine & Anesthesiology

Conditions that cause pain, stiffness, and swelling in your joints.

Arthritis Types

Health issues that result in or involve pain.

Pain Management

Pain or injury to muscles, tendons, and other body-supporting tissues.

Soft Tissue and Tendon Issues

Problems with your back, including your spine, muscles, and nerves.

Back Conditions

Conditions causing pain, stiffness, or trouble moving your neck.

Neck Conditions

Conditions that don't fit into other main groups. A mixed collection of health issues.

Other

Broken bones, and conditions related to bone strength and health.

Fractures and Bone Health

Damage to the body from accidents, falls, or sudden physical forces.

Injury and Trauma

Health problems causing physical aches, soreness, throbbing, or sharp pain.

Painful Conditions

Conditions that cause pain, aches, soreness, or general unease.

Pain and discomfort

Conditions impacting nerves, affecting how your body feels, moves, and works.

Nerve Conditions

Everyday health, wellness tips, and understanding how to manage your care.

General Health & Patient Education

Health issues treated by operations and care for healing.

Surgical and Post-Surgical Care

Problems, injuries, or pain affecting your knee joint.

Knee Conditions

Shoulder problems involving pain, injury, stiffness, or limited movement.

Shoulder Conditions

Problems, pain, or injuries of the arm and elbow.

John Rowlands, MD

Mid back (thoracic spine): Pain (Overview & Treatment)

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