Kidneys, vascular issues, cancer, fracture, and neck pain are possible causes of middle back pain. Dr. Ronald Tolchin, Medical Director of the Baptist Health Center for Spine Care, says it is better to make sure they check imaging of the spine with an MRI for people with cancer to look for any metastasis.

He explains with osteoporosis, the bones are soft and they easily can get compressed, the nerve endings are there and the back pain can be very painful.