Pain in the middle or upper back can be due to a number of causes. Pain in this region is far less common then pain or stiffness in the lower back or neck, however it can be just as painful if not more intense. The middle back is known as your thoracic spine, which consists of 12 vertebrae and it also serves as the attachment site of the ribcage. This section houses our vital organs and is responsible for respiration. It is a region of the body that does not rest due to its interplay with the ribs and providing the vital function of breathing. So when we experience pain in this region, it is important to get a diagnosis to rule out pain referral from an organ. This is certainly possible, although the cause the majority of the time is musculoskeletal. As this region is adjacent to the neck and lower back, referral from these regions is also possible.