Pain in the thoracic spine may be caused by the following reasons: 1. It may be a misalignment of the small joints of the thoracic spine, which usually manifests as pain in the middle of the thoracic spine and is accompanied by restricted activities, and the symptoms can be relieved soon after the massage practitioner gives a manual reset. 2. The herniated disc, caused by compression of the dural sac, is usually caused by chronic strain on the muscles of the thoracic spine while the disc protrudes backward, and if it compresses the dural sac there will be pain in the place of the thoracic spine. If the nerve roots on both sides are compressed, there may be double back nerve pulling pain, numbness and other symptoms. 4, there may be tuberculosis or tumor of the thoracic spine.