Thoracic Disc Herniations

Mid Back Pain: Thoracic Disc Herniations

It seems like recently there has been a surge in mid back pain complaints in patients coming to our Henderson Chiropractic clinic. Several of our recent patients have been suffering from this type of pain associated with Thoracic Disc Herniation. After reading the results of MRIs, and consulting with clients regarding this type of pain it made sense to write an article with information about this condition.

Please note that this article is for information purposes only and if you feel that you are suffering from mid back, or any type of constant pain, an evaluation from a licensed physician will help identify the cause, and together with your practitioner you can develop a treatment plan for your unique circumstances. This article is not intended to diagnose or treat any condition.

What Are Thoracic Herniated Discs?

Any injury that causes a high degree of sudden force on the discs in the upper spine has the potential to cause a thoracic herniated disc. A few examples of the type of traumatic event that could lead to a thoracic herniated disc include a fall, car accident or sports related injury, really any incident that places sudden force on the upper back.

spinal column sectionsThoracic herniated discs have a tendency to occur in younger patients, usually prior to significant degenerative disc changes. Often times some history of mild trauma has led to an aggravation of the patient’s symptoms. In these cases, a mild trauma will usually just worsen symptoms from a degenerated disc and cause the patient to seek help from a chiropractor or other physician. Regardless of the cause of the thoracic back pain, getting a correct diagnosis is critical as it will guide treatment and ultimately the healing process. Thoracic disc disease is quite similar to disc disorders in the cervical, thoracic and lumbar spine, but symptomatic lesions (anatomical problems related to the symptoms) tend to be far less common.

The most common location for thoracic disc disorders is at the thoracolumbar, also referred to as the thoracic and lumbar parts of the spinal column, in the mid back. The true frequency of this type of pain is unknown because many thoracic disc disorders do not cause thoracic back pain or other symptoms, and they comprise only a very small percent of all herniated disc surgeries.

Thoracic Herniated Discs Occur More Often Than You Think

In one study, 90 patients with no history of pain or other chronic mid back symptoms were evaluated and MRI scans were taken of their thoracic. The results were staggering:

1. 73% of patients were found to have disc abnormalities in the upper back, such as a thoracic herniated disc.
2. 37% specifically had a thoracic herniated disc.
3. 29% had radiographic evidence of spinal cord impingement identified on the MRI.

These patients were followed for 26 months and none of them developed thoracic back pain from their thoracic disc disorders. The fact that so many people had thoracic herniated discs but no pain or symptoms is important to mention, as it shows that people may have both upper back pain and a thoracic herniated disc, but that the disc disorder may not be the cause of the thoracic back pain – it may just be an incidental finding. In fact, there are many causes of upper back pain that are much more common than a herniated disc.

It is also important to note that this study was conducted on 90 asymptomatic patients, and that a different sampling may find drastically different results, however, in our experience thoracic herniated discs often don’t manifest in superficial pain. Any pain associated with the mid back should be taken seriously and a consultation with a trained chiropractor is warranted.

Thoracic Disc Herniation Treatment

Often times thoracic disc herniation can be treated without thoracic surgery if given proper care. There are a variety of non-surgical, and non medicinal treatment options that can be tried, and many patients will need to try several, or a combination of different treatments, to find what works best for them.

1. A few days of rest and activity modification or in some instances eliminating the activities and positions that worsen or cause the thoracic back pain. After a short period or rest, the patient should return to activity as tolerated. Gentle exercises are a great way to return to activity.
2. Manual manipulation, as performed by a chiropractor, combined with cold therapy. Often this means to apply ice packs to the painful area for 15 to 20 minutes at a time. This therapy can be continued at home, but be sure to ask your chiropractor or physician for proper techniques.
3. Strengthening exercises, specifically stabilization exercises do not directly affect the herniated disc, but may stabilize the thoracic spine muscles. Stronger, more well balanced muscles may help to minimize the risk of injury to the nerves and discs.

The patient’s activity levels should be progressed gradually over a 6 to 12 week period as symptoms improve. In the vast majority of cases, the natural history of thoracic disc herniation is one of improvement with one or a combination of the above treatments, but additional options may be provided if little or no benefits have been found from these treatments.

What to do Next

If you have any questions please feel free to contact us at Synergy Chiropractic and we would be glad to help point you in the right direction. If needed, we will see you for an initial consultation and may refer you to get imaging on the affected area. After a deep analysis of your condition and underlying problems, plus your medical history a treatment program will be created for your recovery.