What is thoracic spine pain?
Thoracic spine pain usually involves a dull or pressing pain in the middle segment of the spine directly behind the chest. The adjacent muscles are very often hardened and painful. Given that the ribs connect to the thoracic spine, the pain is often associated with movement and breathing. Patients typically feel pain in the area between the shoulder blades. This pain may radiate outward in a ring across the rib cage.
One anatomical peculiarity of the thoracic spine is that the intervertebral discs, which increase in size from top to bottom are relatively flat in the thoracic spine compared the height of the vertebral bodies. At the same time, the spinal canal in this segment of the spine is relatively narrow. This does not present a significant problem, however, because the thoracic spine’s range of motion is rather limited. Moreover, disc herniation occurs relatively infrequently in the thoracic spine.
The anatomical position of the thoracic spine with its slightly convex curve, which is sometimes referred to as a hunchback when it is considerably pronounced, means that the front of the vertebral bodies are exposed to more significant loading than the rear of the vertebral bodies. In connection with various conditions such as osteoporosis and degenerative arthritis, this can lead to bone fractures that may trigger other bone reactions such as the development of bone spurs. These can cause a painful narrowing of the spinal canal and the apertures that provide a passageway for the nerves running between the ribs (intercostal nerves).
What are the causes of thoracic spine pain?
Obstructions in the area of the thoracic spine represent one of the most common causes of thoracic spine pain. Another common cause of considerable thoracic spine pain relates to degenerative changes to the spine that result from wear and tear and that trigger the growth of bone spurs. Beyond this, the following conditions may play an important role in the development of thoracic spine pain: congenital and acquired diseases (e.g. wedge-shaped vertebrae, scoliosis, Scheuermann’s disease, and osteoporosis), inflammation (e.g. rheumatism, ankylosing spondylitis, and viral and bacterial infections), spinal injuries, and tumors and metastases.
What forms of treatment are available for thoracic spine pain?
So long as there are no clear signs of conditions that threaten the health of the spinal cord, treatment for thoracic spine pain is conservative in nature (i.e. non-surgical). This usually involves the administration of painkillers to alleviate the pain as well as attempts to loosen the muscles and unburden the spinal discs using physical therapy, hot and cold applications, and massage. Injections of a local anesthetic may be administered to treat more stubborn cases. Acupuncture, posture training and stretching exercises may also be introduced to help ensure the success of treatment.
If conservative forms of treatment fail to bring about a lasting alleviation of the pain, patients may wish to consider special palliative treatment at a palliative care center.
Surgery is necessary when there are clear signs of spinal cord compression. The standard procedures include laminectomy, which involves removing a portion of the vertebral bone (lamina) from the rear, and costotransversectomy, which involves removing a portion of the rib and the articulating transverse process from the side. The relatively high rate complication associated with these procedures increases the importance of arriving at an accurate diagnosis.
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