Whether you sat too slouched too often, never worked your back muscles, or have poor posture - this article is about how you can undo middle back pain and build up a more resilient back than you started with. One disclaimer - if you strained or bruised your mid back from a high-impact event this will not apply, and this post is not for you. However, if you have a phantom, achy mid back and suspect your back strength and posture could use work - this is for you.
Middle Back Pain Causes
Several phenomena could cause pain to be felt in the middle back, but in this article, we are going to focus on myofascial pain (muscle pain) which I believe to be the most common source of mid back pain. Granted in rare cases you could have a rib out of place, a disc injury, etc. but I am generalizing and assuming for the sake of simplicity that your case has the most common root of muscle pain (see Rhomboid pain for a specific mid back muscle example).
Myofascial pain is also known as muscle pain, trigger points, knotting, muscle tension, and many more terms. The main point of myofascial pain and its synonyms is the underlying pain source is rigid, tight, angry muscle fibers constantly pulling on joints - causing imbalance and pain.
How To Fix Middle Back Pain
The steps to fixing myofascial mid back pain are 1) massage, 2) stretch/mobilize, and 3) strengthen. These steps are to be done in sequential order because they each build off each other. For instance, once we complete step 1 of mid back massage our backs will be much more susceptible to stretch and move in step 2 of mobilization.
Mid Back Pain Fix Step 1: Massage
The goal of step 1 is to rid the mid back of all of its angry knots, trigger points, and rigid muscle tissue that hold constant tension. Read that sentence again for clarity. This step can take time - 60 seconds of massage isn't likely enough to iron out years of bad posture and habits - but it is important to push through discomfort, spend a few minutes and focus on working out tender spots in the mid back for optimal pain relief.
Mid Back Pain Massage with Ball on Wall
How To: You will need a ball (tennis or lacrosse balls work), foam roller, or another back pain relief product for the job. Focus on the mid and lower trapezius, Rhomboid, and spinal erectors (or just areas that feel tense) thoroughly, and spend extra time on tender spots. Make sure to slow the breath and relax so your physiology can tell your body and muscles that it is safe to unwind. A sign of a successful massage is that the massage feels less tender at a higher pressure on the same spots.
Sets/reps: I recommend 2 rounds of 2-4 minutes on each side of the mid back. This will do 2 things: 1) give you clarity and feedback on which areas, sides, and specific muscles are most tender to focus on in the future, and 2) apply enough pressure and time to adequately work out some or most mid back muscle tension.
Mid Back Pain Fix Step 2: Mobilize/Stretch
The goals of step 2 are to correct our posture so it is mid back friendly, as well as mobilize and stretch areas that have been potentially locked up from years of bad habits. Both goals are middle back pain relieving on their own, and the two goals combined are a surefire way to make sure we are giving our mid backs the best chance of pain relief we can.
How To: There are a handful of mid back pain relief exercises you can do for this step. I'm sure if you search Google or YouTube you will find plenty of movements - but here are a few quick ones you can implement.
Kneeling Mid Back Twist
Cat Cow Stretch
Buddy Mid Back Opener (Proceed with Caution)
Sets/reps: Pick your favorite mid back mobilization exercise and do it diligently for 2-3 sets of 6-10 reps. Like with the step of massage, there are areas and movements that will bring you better relief than others, so feel free to double down on what feels best.
Mid Back Pain Fix Step 3: Strengthen
By this point, your middle back pain should be mostly gone. Step 3 is the least important but the most fun in my opinion - getting stronger and more resilient so you have more movement capacity and less risk of mid back pain in the future. These exercises range from beginner to advanced, make sure to proceed with caution.
How To: Work these into your workout or rehab routine 2-3 times per week, allowing a day of rest in between. You can do as many as 20 sets per training day of different exercises if you are an athlete or advanced trainer, otherwise, 3-5 sets are plenty to see some improvement if you are a beginner.
Middle Back Strengthening Exercises:
- Bird Dog
- Face Pulls
- Band Pull Aparts
- Read Delt Raises
- Bird Dog Row
- Machine Row
- Lat Pull Downs
- 3 Point Dumbbell Row
- Farmer's Carry
- Bent Over Row
- Power Cleans
Middle Back Pain Conclusion
There you have it, my take on fixing middle back pain through corrective exercises. It is worth mentioning that I am an active gym-goer, and I train my back twice per week with a variety of the exercises above - and my middle back rarely hurts anymore. Sometimes I can feel it creeping up after a long day or two of sitting with poor posture, but these 3 steps get me feeling like gold again in no time. Hope you enjoyed the article, read these next:
 Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
 Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.