Other things that might be masquerading as an aching back pain let’s take a look at this the possible causes of thoracic back pain kidneys what are your kidneys have to do with this oh that’s another common one yeah kidneys actually in the mid-back now think about your intestines that the contents of the belly mm-hmm now the intestines sit on the big bag right in the front but what’s behind that bag the kidneys the aorta and the spine so all of those structures that sit behind the intestines can cause mid-back pain now with kidney disease there really aren’t necessarily certain stone signs or symptoms that will tell you for sure that’s what it is but there’s one thing specific patients with kidney disease if you just gently tap them right on the side here right where the ribcage ends in the mid-back but off midline right off to the side if you just tap on that they will have severe pain and that tap will reproduce the pain they’re suffering from that’s called CVA tenderness and I check patients for that whenever they come in with mid-back pain now vascular issues are very important as well there’s something called an abdominal aortic aneurysm so a Horta is this big big big blood vessel that cares all our blood from the heart to all of our extremities the rest of our body the aorta sees tremendous pressure because think about it heart has to pump that blood really really hard to get to the toes and the fingers and the aorta is the conduit and sometimes for very unfortunate reasons the aorta weakens and it starts to develop a little outpouching imagine how scary you have this high pressure flow like from a fire hydrant inside a tube that’s about to rupture and when it ruptures usually patients don’t make it okay now that can present as a mid-back pain as well okay and it’s important to feel for the pulse and the belly it’s important to obtain proper imaging and to measure the aorta and if you catch it early you can save someone’s life Wow now we mentioned cancer briefly metastatic disease so it’s important to look for things like recent unwanted weight loss nighttime pain fractures can also produce nighttime pain and especially now elderly popular it’s possible to fracture your thoracic spine without doing anything something as simple as a cough or sneeze and all of a sudden the back hurts and it’s unremitting and it doesn’t get better and then you get proper imaging and you see that the bone sort of has accordion down you