The mid-back (thoracic spine) extends from the base of the neck to the bottom of the ribcage. Thoracic (mid-back) sprains affect the ligaments in the mid-back while thoracic strains affect the muscles and tendons. The ligaments, tendons, and muscles all act together to support the mid-back and allow it to move freely forward and backward and from side to side. Sometimes, these structures can be torn or stretched during heavy lifting or twisting of the back or stressed by a sudden force such as that which occurs during a motor vehicle accident. The symptoms that occur with these conditions can be mid-back pain, stiffness, and decreased movement of the neck and back. They are diagnosed by taking a thorough history and performing a detailed physical examination. Sometimes, an imaging study such as an x-ray or an MRI may be ordered to further assess the thoracic spine and surrounding structures. Once diagnosed, however, thoracic sprains and strains are usually treated conservatively. They can be managed with medications, which can help relieve the pain or relax the muscles, and physical therapy, which stretches and strengthens the muscles of the mid-back.