The pain in the middle of the back can be caused by several reasons: first, supraspinous ligamentitis and interspinous ligamentitis, these two diseases can lead to pain on the surface of the spinal processes in the middle of the back, often when bending, exertion or cold pain is more obvious, then early examination and examination to exclude other diseases to diagnose. Second, lumbar or thoracic spine osteophytes, when there is osteophytes in the spine, there can also be pain in the middle of the back, often degenerative pain, then we should check the spine X-ray, CT to diagnose. Third, osteoporosis, when there is severe osteoporosis in the spine, there can be pain in the middle of the back at the spine. If there is a compression fracture of the vertebral body, the pain is more obvious. Fourth, tumors, when there are tumors in the spine, there can also be pain in the middle of the back. Fifth, rheumatoid diseases, when there is rheumatoid spondylitis or ankylosing spondylitis, there can also be pain in the middle of the back spine, there can be morning stiffness and pain in the sacroiliac joints, it is necessary to check the MRI, X-ray and blood tests of the spine for diagnosis and early treatment.