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Thoracic Degenerative Disc Disease

Thoracic degenerative disc disease describes wear and tear of the spine intervertebral discs. It is not as common as degenerative disc disease in the neck and low back. Degenerative disc disease happens in us all to some degree and is a process that occurs with age. Accidents and injuries that occur over a lifetime can also increase the likelihood of wearing the spinal joints. When degeneration advances, both tears in the cartilage disc and bone spur development is likely.

How does degenerative disc disease come about?

Degenerative disc disease involves a cascade of injury and degenerative changes. There are 3 phases to spinal disc degeneration:

  1. Acute (initial and resolvable) phase. Characterised by tearing of the outer fibres of the disc (i.e., annulus fibrosis) causing an autoimmune-like response in the injured tissue, which promotes inflammation. Muscles will spasm to act as a brace and inflammation pools in tissues and joints, which restricts movement and causes pain.
  2. Subacute (derangement and reoccurrence) phase. Condition has not fully resolved and the disc undergoes further loading leading to more micro-trauma.
  3. Chronic (degenerative) phase. The outer disc material has become considerably weak and can bulge as the inner disc material (i.e, nucleus pulposus) pushes outwards, which can irritate adjacent nerve roots causing ‘sciatica’ (i.e., radiculopathy). The disc itself has thinned and lost considerable height due to the loss of water and proteins in the tissue. This leads to a further decrease in mobility and inability to distribute fluid in the area. Stagnate fluid promotes further degeneration to the surrounding tissue.

For a more detailed description of this degenerative disc disease cascade, please visit our blog on disc herniation.

Why do we get thoracic degenerative disc disease?

Typically, this condition develops after years of repetitive abnormal and strenuous movement and weight gain, which increases pressure to the discs until it dehydrates, bulges or herniates, leading to pain and other symptoms. Because the thoracic spine is attached to the rib cage and doe not carry the same weight or movement as the other areas of the spine, developing thoracic degenerative disc disease is much less likely than developing it in the low back or neck.

Symptoms of thoracic degenerative disc disease

Back pain is the most common symptom of thoracic degenerative disc disease. When degeneration progresses and spur formation leads to nerve or spinal cord compression, neurological symptoms such as muscle weakness and changes in sensation through the chest and trunk may develop. More serious symptoms to look out for are power loss in the lower limbs, muscle wasting, unrelenting night pain that keeps you awake, and changes in bowel or bladder function. These ‘red flag’ signs and symptoms warrants immediate medical attention.

Treatments of thoracic degenerative disc disease

Thoracic degenerative disc disease can be a painful mid back pain condition. When the majority of pain is coming from the intervertebral disc (i.e., discogenic pain) or the facet joints (i.e., facet joint pain), chiropractic treatments are very successful. In cases where degenerative disc disease has lead to disc bulging and nerve compression chiropractic treatments may still be very successful. At Sydney Spine & Sports Centre (S3C), the aim of our clinician’s conservative management is to:

  • Unload the affected intervertebral disc(s) and improve spinal mobility by encouraging self-management with specific, directionally-favoured spinal movements and reducing risk factors, such as prolonged sitting and poor posture.
  • Reduce inflammation in the joints and other tissues and reduce spasm or tension in surrounding muscles by implementing P.O.L.I.C.E protocol, or heat therapy and therapeutic ultrasound.
  • Strengthen and condition surrounding musculature once pain is managed with a focus on patient self-management.

However, when spinal cord compression is present, or there is persistent spinal nerve compression, our chiropractors will need to send you for surgical review. Surgical necessity is rare in people with thoracic degenerative disc disease. In most cases, thoracic degenerative disc disease responds well to conservative management.

More information

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