The causes of back pain in the thoracic spine are as follows: 1, inflammation: if there is supraspinous ligamentitis or interspinous ligamentitis in the thoracic back, it will lead to the emergence of thoracic back pain; 2, heart disease: if there is myocardial ischemia, coronary artery disease, angina pectoris or myocardial infarction in elderly people, it will cause the left side of the back of the thoracic vertebrae to appear radiating pain; 3, cholecystitis: if cholecystitis is in the period of acute attack, it may appear after dietary Other factors: chest tumors, infections, mediastinal diseases and herpes zoster can cause chest and back pain. In addition, middle-aged and old people’s back pain is usually due to spinal inflammation, supraspinous ligament and interspinous ligament excessive tension, tension and ligament damage and ossification, resulting in the appearance of back pain when hunching over. At this time, appropriate hot compresses and physical therapy can be used to promote blood circulation and reduce pain. Patients can also perform swallow fly, three-point support, five-point support or other functional exercises, which can effectively increase the strength of the muscles at the back of the spine, and can better protect the stability of the spine to avoid frequent episodes of symptoms. Therefore, the mechanism of back pain in the thoracic spine is more complex, and a multi-faceted and multi-systematic examination should be carried out according to the patient’s symptoms and accompanying symptoms in order to rule out the corresponding diseases.