Thoracic (Mid Back) Pain Degenerative Disc Disease

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Is Degenerative Disc Disease Causing Your Thoracic Back Pain?

The sad fact is that as we age, degenerative disc disease can occur in our middle (thoracic) spine causing pain. Ostephytes, which are little bone spurs can develop, discs can begin to bulge or herniate, vertebrae can begin to slip and we may even experience pain radiating along our ribs.

Understanding How Degenerative Disc Disease Can Cause Thoracic Pain

The midback or thoracic region of the spine is less prone to injury than the neck (cervical) and lower back (lumbar) regions, but it is still susceptible to degenerative disc disease and other conditions.  The middle back supports our ribs which curve around connecting to the sternum, the strong bony structure in the middle of our chest.

The thoracic spine’s curve is kyphotic which is Greek for ‘hump’. This “C”-shaped curve with the opening of the “C” in the front is a clever design that allows room for our lungs, heart and other essential organs in our rib cage. This part of the spine has very narrow, thin intervertebral discs. Rib connections and smaller discs in the thoracic spine limit the amount of spinal movement in the mid back compared to the lumbar or cervical parts of the spine. The vertebrae in this region are smaller than in the lumbar spine because they need to support less weight. There is also less space inside the spinal canal in this region.

As we age, we are prone to degenerative disc disease which can also compromise the discs in the thoracic region. For example, each vertebrae includes a pair of facet joints on each side which articulate with the ribs. As anyone who has played football, soccer or basketball knows, your ribs can take a pounding and that stress impacts on the articulate joints of your middle back and on your vertebrae.

Once we turn 50, our spinal discs can start to break down, or shrink. In some cases, they can degenerate so much that they completely disappear. When degenerative disc disease occurs, the vertebrae above and below the damaged disc begin to rub against each other because there is no longer a healthy cushion to separate them. This can cause extreme pain and stiffness.

Through gradual wear and tear, the spinal discs begin to lose some of their water content. In doing so, they become less flexible, and more prone to damage with even the most basic of movements. As the discs dehydrate they become thinner, and lose the ability to serve as a shock absorbers that can absorb the stress of an impact. The plump discs that helped facilitate easy, fluid movement become thin and dried out. The decrease in flexibility and elasticity of the discs no longer allows them to support fluid movement. The resulting stiff discs can result in localized pain in the middle back region, plus we can experience pain that radiates from the vertebra across our ribs to the sternum.

Another reason for disc degeneration can be attributed to tiny tears or weakness in the cartilaginous outer layer of the disc called the annulus. When these occur, the soft gel inside of the disc (nucleus  pulposus) can bulge out or herniate.  The resulting compromised disc can push on nearby nerves and irritate them, resulting in pain, numbness, or tingling.

Furthermore, as the discs lose volume and the gap between the vertebrae becomes smaller, the spine becomes less stable. The body will try to compensate for this by creating small bony structures called bone spurs. This new collection of bone can put pressure on the spinal nerves or spinal cord, resulting in more pain.

While gradual degeneration of the discs is often an expected part of aging, it should be closely monitored by a spine expert. A spine doctor will be able to tailor a low back pain relief and degenerative disc disease treatment option that’s best for you, and help to prevent any future spine problems.

There are several non-surgical solutions for a bulging disc such as chiropractic adjustments, physical therapy, yoga, acupuncture and medications. For some patients, minimally invasive surgery may prove to be the optimal strategy to reduce pain. Basic Spine provides the full spectrum of minimally invasive outpatient options with many surgeries taking less than an hour to perform, and with patients returning home on the same day.
Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382964/

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