Pain in the middle of the back that is exacerbated by coughing can be caused by a number of different conditions. One common cause of this type of pain is a muscle strain or sprain. The muscles in the middle of the back, known as the thoracic muscles, can become strained or sprained if they are overworked or injured. This can cause pain and discomfort, particularly when the affected muscles are used, such as when coughing.

Another possible cause of middle back pain when coughing is a spinal injury or condition. The spine is made up of a series of vertebrae that are connected by muscles, ligaments, and tendons. If any of these structures are damaged or weakened, it can lead to pain and discomfort in the back, especially when the spine is subjected to pressure or strain, such as when coughing.

In some cases, middle back pain when coughing may be caused by a lung condition, such as pneumonia or bronchitis. These conditions can cause inflammation and irritation in the lungs, which can lead to pain in the middle of the back. Coughing can exacerbate this pain, as it puts additional strain on the lungs and the surrounding muscles.

Other potential causes of middle back pain when coughing include:

• Rib injuries: The ribs are connected to the spine, and any injuries or damage to the ribs can cause pain in the middle of the back.
• Kidney infections: The kidneys are located in the lower part of the back, and infections or other problems with the kidneys can cause pain that radiates to the middle of the back.
• Gallbladder problems: The gallbladder is a small organ located under the liver, and problems with the gallbladder can cause pain in the upper abdomen and middle of the back.

If you are experiencing middle back pain when coughing, it is important to see a doctor for a proper diagnosis and treatment plan. The doctor will conduct a physical examination and may order additional tests, such as X-rays or blood tests, to determine the cause of the pain. Treatment will depend on the underlying cause, but may include medications, physical therapy, or surgery. In most cases, middle back pain when coughing can be effectively managed with the right treatment.