Thoracic Bone Spurs
Thoracic (mid back) bone spurs are also called thoracic osteophytes. Thoracic bone spurs can be small or large boney projections that develop around joints. Bone spurs develop where cartilage and ligaments joint attach to bones. When bone spurs are large, they can compress nerves and grow into joint structures. This will cause mid back pain and discomfort.
How do thoracic bone spurs come about?
Thoracic bone spurs form because of the increase in a damaged joint’s surface area. This is most common from the onset of osteoarthritis:
- Excessive mechanical stress and the presence of structural fissures in the articular cartilage result in cartilage damage in the joints.
- Cartilage in this area becomes rough and worn out, affecting the movement of the joint. This may initiate the release of enzymes that expedite the disintegration of cartilage. This acts as the trigger for bone spur formation.
- Bone spurs express transforming growth factor β, a factor that is involved in the initial formation and also in the later developmental stages of bone spurs. Expression of growth factors and mediators play a key role in formation of bone spurs.
- Bone spurs contain fibroblasts, prechondrocytes, maturing chondrocytes, hypertrophic chondrocytes and osteoblasts. Type II collagen is the most prominent component in the cartilaginous zone of bone spurs.
- Ligaments thicken and begin to calcify, resulting in flecks of bone or bone spur formation. As the central spinal canal and the foramina thicken their ligaments, compression of the nervous system can cause clinical symptoms.
Why do thoracic bone spurs occur?
Normal life stressors, perhaps complicated by previous traumatic injury to the spine or a familial history, causes degeneration in the discs and the joints of the spine, leading to the bone spurs. Risk factors for thoracic bone spurs include:
- Age (>45 years old)
- Previous traumatic injury to the thoracic spine
- Poor posture
- Weak “core muscles”
- Alcohol and/or tobacco abuse
- High-impact sports and activities
Symptoms of thoracic bone spurs
Generally speaking, thoracic bone spurs will only be an issue if they irritate structures such as the spinal cord, nerves, muscles or joint structures. By themselves, people don’t know they have them. Most people will develop a few of these around the body and not even know about it. Specifically, in the mid back the symptoms of nerve compression will depend on where the bone spurs are and which nerve they compress. For example compression of the T1 nerve (first upper back nerve) will cause pain and sensation changes into the arm and potentially the hand. Thoracic nerves T2-11 may cause pain and sensation changes into the chest and trunk and the last thoracic nerve T12 may refer to the buttocks.
Treatment of thoracic bone spurs
Thoracic bone spurs really only cause problems if they approximate with joints, joint structures or neural tissues such as nerves and the spinal cord. In these cases, the treatment will really depend on how bad the spur is and what it approximates into. In some circumstances, treatments and exercises that our Sydney Spine & Sports Centre chiropractors deliver, and instruct you on, will be enough to give lasting symptomatic relief. If the spur is obstructive or causing unchanged irritation, surgery may be a consideration. This will be discussed with our chiropractors. Surgery is rare and only sort if there are large amounts of dysfunction within the spinal joints or nerves are starting to be compromised. In these cases, our chiropractors give prompt referral.
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