Pain in the back and middle of the cervical spine can be caused by several reasons: first, supraspinous ligamentitis and interspinous ligamentitis, which are chronic inflammation of the supraspinous and interspinous ligaments of the spine due to cold and strain, resulting in pain, which should be diagnosed by early physical examination, spinal X-ray and CT to exclude other diseases. Second, tumors, when there are tumors or metastases in the cervical and thoracic spine, there can be pain in the back and the middle of the cervical spine, which can be accompanied by systemic symptoms, such as low fever and wasting, then the spine should be examined by MRI, CT and blood tests to diagnose. Third, tuberculosis, the cervical and thoracic spine can have pain in the middle of the back when there is tuberculosis, which can be accompanied by symptoms of low fever and weight loss, which should be diagnosed by blood tests and X-ray and MRI of the cervical and thoracic spine. Fourth, osteoporosis, severe osteoporosis can also lead to pain in the spine, which should be diagnosed by blood tests and CT and MRI of the spine.