In the absence of worrying symptoms, the best medicine for back pain is movement and strengthening. MOVEMENT IS MEDICINE! Only in certain cases are more drastic measures such as surgical intervention, injections or strong medications indicated, and where pain has been more severe and persistent an integrated approach with multiple therapies is superior. Your treating health professionals will be able to guide you as to the appropriate course of action. Although movement can be painful in the early stages, returning to normal movement and activities in a gradual fashion is beneficial for reducing your symptoms and speeding up your recovery. Returning to normal movement helps to re-establish normal mobility in the back, strengthens muscles and can reduce the risk of chronic or recurrent middle back pain occurring. This is where a staged rehabilitation program that reduces pain, restores mobility and gradually strengthens the middle back is beneficial.

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A staged rehabilitation program will help you to recover from your mid back pain and condition your muscles so that re-injury is less likely. 


Through consultation with a physiotherapist, a staged rehabilitation program can be individualised to account for your specific injury and factors that may relate to your anatomy, biomechanics, age and general health. Most cases of middle back pain should resolve within days to weeks with a rehabilitation program involving some hands on therapy and staged rehabilitative exercise. More complex or severe presentations may take 6-12 weeks to make a full recovery. Hands on therapy can help to reduce pain and inflammation and improve mobility, and may involve a combination of the following interventions:

  • Soft tissue mobilisation and massage
  • Mobilisation of spinal joints/segments
  • Stretching techniques
  • Use of electrophysical agents to manage pain and promote healing, such as Heat/Cold, TENS and Ultrasound

In combination with hands on techniques, rehabilitative exercise then aims to gradually strengthen the middle back and correct factors that may have contributed to your injury. Exercise based therapy may involve a combination of the following interventions:

  • Modification of daily activities, work or training techniques to initially reduce stress on the middle back as it heals
  • Identification and correction of poor postures
  • Strengthening exercises for addressing areas of generalised muscle weakness
  • Targeted strengthening and muscular control exercises for addressing movement patterns including trunk stability ('core strength') and scapular stability (shoulder blade control)
  • Stretching exercises and techniques for releasing areas of muscle tension
  • Correction of sporting or exercise technique
  • Strategies for maintaining fitness whilst injury heals

With ongoing exercise and targeted strengthening, it is possible to build your middle back to be strong and resilient, so re-injury is less likely. This is particularly relevant for individuals involved in sports or physically demanding occupations/recreational pursuits.