Thoracic disc herniation (TDH) is a rare condition affecting 40 to 50 per 100,000 people and most common in adults between 30 to 50 years of age. If you are suffering from TDH, however, you don’t have to consider surgery unless recommended by your doctor. In most cases, patients get better by doing thoracic disc herniation exercises.
What is thoracic disc herniation?
Thoracic disc herniation is a condition of the spine wherein the soft center of the nucleus pulposus, an intervertebral disc, pushes through a tear in the annulus fibrosus, the tough outer layer of the disc, and into the spinal canal.
Thoracic disc herniation is also called disc herniation, herniated disc, slipped disc, ruptured disc, bulging disc, calcified disc herniation, and disc protrusion.
What are the Symptoms of Thoracic Disc Herniation?
Thoracic disc herniation symptoms will appear depending on the location of the disc herniation. The disc herniation can extrude in a central, sideways, or centro-lateral direction.
The pain that comes with a thoracic herniated disc may be localized to the upper back or radiate down a single nerve root.
Symptoms specific to each location include:
- Central Disc Herniation
This type of protrusion puts a lot of pressure on the spinal cord which causes upper back pain and/or spinal cord dysfunction (myelopathy). A herniated disc can cause stress on the restricted space around the spinal cord in the thoracic spine and this will affect the related nerve function. Typical symptoms include numbness, weakness in the lower extremities, difficulty in walking and maintaining balance, bladder dysfunction, and in severe cases, paralysis from the waist down.
- Lateral Disc Herniation
This type of herniation extrudes to the side and the herniated disc impinges on the nerve root at that level of the spine. This causes chest wall pain or abdominal pain.
- Centro-lateral Disc Herniation
The symptoms that come with this type of herniation include upper back pain, radiating pain, or myelopathy.
What are the Causes of Thoracic Disc Herniation?
A herniated disc occurs when any disc between the 12 vertebrae of your thoracic spine extrudes through the outer core and irritates a nearby spinal nerve root.
It is important to determine the cause of thoracic disc herniation before treatment of upper back pain and any related symptoms can take place.
According to doctors, thoracic herniated discs are caused by either one of these sources:
- Degenerative Disc Disease
The gradual wear and tear on the thoracic disc lead to settling of the vertebral bodies and calcification about the disc space which then leads to a thoracic herniated disc.
Symptoms usually develop very gradually and most commonly occur between an individual’s forties and sixties. Typically, with degenerative disc disease, the patient’s symptoms are often present for a longer time before consultation with a doctor.
- Trauma to the upper back
When an injury causes a high degree of sudden force on the discs in the upper spine, such as a fall or sports injury, this could lead to a thoracic herniated disc. This type of injury usually occurs in younger patients before significant degenerative disc changes.
How is Thoracic Disc Herniation Diagnosed?
The first step that a doctor will take before diagnosing a thoracic herniated disc is to interview the patient to get the complete history of the problem followed by a physical examination.
Other diagnostic procedures that the doctor may order are:
Plain x-rays do not show a thoracic herniated disc but they can be used to help localize injuries in cases of trauma and it can help in identifying spinal instability.
- Magnetic Resonance Imaging (MRI)
An MRI is often the most accurate test for diagnosing thoracic disc herniation. The MRI uses a powerful magnet attached to a computer to produce images of the spine, nerve roots, intervertebral discs, and ligaments.
- Computerized Tomography (CT) Scan
The CT scan is a series of X-rays assembled by a computer into three-dimensional images of the body’s structure.
This procedure involves injecting a liquid dye into the spinal column followed by a series of X-rays and a CT scan. This procedure may provide useful images that will show indentations of the spinal fluid sac caused by herniated discs or bulging discs, or bone spurs that might be impinging on the spinal cord or nerves.
- Electromyography (EMG)
This procedure is a type of test that checks for damage to the nerves that control your muscles. This test helps determine the cause of pain.
What is the Treatment for Thoracic Herniated Disc?
The majority of patients suffering from thoracic disc herniation can be treated without thoracic surgery.
Non-surgical Treatments for Thoracic Disc Herniation
Patients are advised to rest for one to two days.
- Activity modification
After resting for one to two days, the patient should return to activity as tolerated, taking care to eliminate activities and positions that cause or worsen thoracic back pain. A good way to return to activity is to do gentle exercise such as walking.
- Narcotic and non-narcotic analgesic medications
Non-narcotic medication such as acetaminophen is commonly recommended for mild or moderate thoracic back pain. Narcotic pain medication is prescribed by the doctor only for the treatment of severe upper back pain for a short time.
- NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
NSAIDs such as ibuprofen help reduce inflammation around the herniated disc in the upper back.
- Epidural Steroid Injection
If pain persists, a doctor may prescribe anti-inflammatory injections, such as an epidural steroid injection.
- Manual manipulation
This type of treatment is usually performed by a chiropractor or an osteopathic doctor
- Thoracic Disc Herniation Exercises
As stated earlier, walking is a good exercise for thoracic disc herniation.
Other Safe Exercises for a Bulging Disc
NOTE: Let the acute phase of pain to subside before you begin an exercise program
- Stationary Bike
Exercises on a stationary bike are effective in restoring flexibility and improving circulation. They can also accelerate the healing of a bulging disc. Make sure that you start slow and work your way up to a more vigorous pace as your pain level decreases. Before doing this, however, consult your doctor so he/she can refer you to a physical therapist who will monitor your exercise program and make changes as needed.
- Core Exercises
Core exercises such as squats and abdominal crunches help increase spinal stability and reduce pain from bulging discs.
- Thoracic Physical Therapy Exercises
Here are some videos of thoracic disc herniation exercises by physical therapists:
Overall, thoracic disc herniation exercises will help relieve the pain that you feel and help you get back to your normal everyday routine!
To ensure that you are doing the exercises correctly, you need to consult a physical therapist. Here at Vigor Physical Therapy and Rehabilitation, we have physical and occupational therapists who can guide you and give you expert advice on how to perform thoracic physical therapy exercises.
Call us today for a free consultation.