Thoracic spine

The thoracic spine is the middle section of the spine: twelve vertebrae, numbered T1 to T12, between the neck and the lower back. Every one of them joins a pair of ribs, and the ribs and the shape of the vertebrae limit how far this part of the back bends forwards and backwards (Waxenbaum et al., 2026).

How is the thoracic spine built?

The defining feature is the joints with the ribs. Each typical thoracic vertebra has six small joint surfaces for ribs: the head of each rib meets the bodies of two neighbouring vertebrae, and the rib also joins the side projection of its own vertebra. T1 carries the whole of the first rib, while T11 and T12 each carry a single pair of ribs and have no rib joints on their side projections (Waxenbaum et al., 2026).

A few other features matter in practice (Waxenbaum et al., 2026):

• Thin discs. On average, the discs here are the thinnest of any region of the spine.
• Rotation in the middle. Within the thoracic spine, T5 to T8 can rotate the most.
• A change of gear at the bottom. T12 is a transitional vertebra, partly thoracic and partly lumbar in shape.
• A gentle outward curve. Together, the thoracic vertebrae form the backward curve called the thoracic kyphosis.

Above it sits the cervical spine. Several muscles that desk workers feel attach here: the trapezius, the rhomboids and the long erector spinae on either side of the spine.

What does the thoracic spine mean for desk workers?

Upper and mid back pain is common, though it has been studied less than neck or low back pain. A systematic review of 33 studies found that, depending on the study and how pain was defined, roughly 15% to 28% of people had thoracic spine pain over a year. It was linked with other musculoskeletal pain, posture, and psychological, lifestyle and environmental factors, and was reported more often in children and adolescents, especially girls (Briggs et al., 2009).

The shape of the upper back is also tied to the shoulders. In people without shoulder pain, those with a shorter pectoralis minor differed in how rounded their upper back was (Borstad, 2006). That is part of the rounded upper back picture, and the wall posture test is a simple self-check.

Common misunderstandings about the thoracic spine

“Pain between my shoulder blades must come from my upper back”

Not always. In 50 people with a compressed nerve root in the neck, pain between the shoulder blades was most often linked with the C7 or C8 root, and in 70% the pain came before any arm symptoms (Tanaka et al., 2006). The guide to pain between the shoulder blades goes through the other causes.

“A rounder upper back always means trouble”

The thoracic curve naturally increases with age, faster in women than in men (Fon et al., 1980). And a review of 54 studies found no strong evidence that the curves of the spine, seen from the side, are linked with spinal pain (Christensen & Hartvigsen, 2008).

“Upper back pain is just like lower back pain”

The NHS treats it a little differently. Pain coming from the top of the back, between the shoulders, rather than the lower back is on its list of reasons to see a GP (NHS).

When should you see a doctor?

See a GP if back pain comes from the top of your back, if it doesn’t improve with rest or is worse at night, if you have lost weight without trying, if your back has changed shape, or if it hasn’t improved after a few weeks. Ask for an urgent GP appointment or contact NHS 111 if you feel hot, shivery and unwell. Call 999 or go to A&E if back pain comes with chest pain, or with numbness or weakness in both legs (NHS).

Bavelu’s upper back sessions, designed and filmed by physiotherapists, focus on mobility for this part of the spine.