Chronic midback pain
Chronic mid back pain spikes and how to settle them safely
Nicola Tik
A spike in mid back pain can feel like a setback, especially when things have been ticking along reasonably well. The sudden increase in discomfort can be unsettling, and the instinct to either push through or stop everything entirely is understandable. Neither tends to serve the mid back well. This article looks at what is actually happening during a spike, and some practical ways to move through it with more confidence.
A pain spike is a temporary increase in discomfort, not a sign that something has been damaged or that recovery has gone backwards. For people with persistent mid back pain, spikes are a normal and expected part of the picture rather than an indication that something has gone seriously wrong.
The mid back sits at the centre of almost every movement you make, from sitting at a desk to reaching overhead to twisting in the car. Because it is so consistently involved in daily life, it does not take much to tip it into a more reactive state. What often drives a spike is not injury but a temporary increase in the nervous system's sensitivity. The mid back has been asked to do a little more than it was ready for, or something outside the physical, such as a run of poor sleep, a stressful period, or an unusually demanding few days, has lowered the body's tolerance threshold. The pain is real, but the cause is usually temporary and manageable.
How you respond in the first hours and days of a spike has a real effect on how quickly things settle. A response driven by worry, such as stopping all movement, holding the area very stiffly, or reading the spike as a sign that something is seriously wrong, tends to keep the nervous system on high alert and can prolong the experience.
A calmer, more deliberate response, one that acknowledges the increase in discomfort without treating it as a crisis, tends to move things along more quickly. This is easier said than done when pain is high, but even small steps in this direction make a difference.
Reducing load and intensity makes sense in the early stages of a spike, but stopping movement altogether is rarely the most helpful approach. The distinction matters because complete rest tends to increase stiffness in the mid back and can leave the area feeling worse rather than better after a day or two.
Gentle movement within a comfortable range is usually more useful. The mid back responds particularly well to slow, varied movement rather than sustained stillness. A short, unhurried walk, some careful seated spinal rotations, or simply standing and taking a few fuller breaths to encourage natural movement through the ribcage can all help keep the area gently mobile without pushing into significant discomfort.
Warmth is often a good support at this stage. A heat pack or warm shower applied to the mid back can ease muscle tension and make gentle movement feel more accessible. Warmth works best as preparation for movement rather than as a replacement for it.
During a spike it is natural to hold the mid back more rigidly, to move carefully, and to avoid positions that feel unfamiliar. Some of this is sensible in the short term. The difficulty arises when holding the area tightly becomes a habit that outlasts the spike itself.
If you notice yourself holding the mid back very stiffly or breathing more shallowly than usual, a brief conscious effort to soften the area can help. Slow, fuller breaths that allow the ribcage to expand naturally encourage the thoracic spine, the section of the spine that runs through the mid back, to move gently, and can reduce the sense of compression and tension that often accompanies a spike.
Once the initial peak of a spike begins to ease, gradually returning to usual activities tends to support recovery more than waiting until the pain has completely gone. Waiting for zero discomfort before resuming normal movement is often a longer route back than carefully resuming while things are still a little sore.
A useful approach is to return to activities at a slightly reduced level first, and build back over a few days rather than returning to your usual baseline all at once. This gives the mid back time to readjust without triggering another spike. If you have a VIDA exercise plan, returning to the easier parts of it during the recovery phase, at a reduced pace if needed, is usually better than pausing completely until everything feels normal again.
Rather than treating a spike purely as something to get through, it is worth reflecting briefly on what may have contributed to it once the worst has passed. Not to assign blame, but to build a clearer picture of what the mid back currently finds manageable.
Was activity significantly higher than usual in the days before? Has sleep been disrupted? Has there been an unusual amount of tension or demand in daily life? These patterns, once visible, make it easier to anticipate and soften future spikes before they fully develop. Your VIDA pain check-in is a useful place to note these observations over time. Even a few brief entries around a spike can reveal patterns that are hard to see in the moment.