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Thoracic Disc Bulge

Disc bulges can occur anywhere in the spine, but are more common in the low back and neck than the upper back or mid back. A disc bugle literally means that the outer fibres of the cartilaginous ring of intervertebral discs, called the annulus fibrosis, has ‘bulged’ out to a certain degree. A bulging disc is commonly referred to as a slipped disc or a protruding disc. However, when the disc bulge is significant enough that the inner disc material, called the nucleus pulposus, protrudes through the annulus, it is known as a herniated disc. This usually occurs when we develop wear and tear in the intervertebral discs and they loose some of their strength. A thoracic disc bulge may also occur from trauma or injury.

Why do thoracic disc bulges occur?

A thoracic disc bulge occurs due to either:

  1. Accumulated microscopic trauma (chronic degenerative). Years of repetitive abnormal and strenuous movement, weight gain and poor postural loading increases pressure to the discs until it dehydrates, bulges or herniates. Degenerative changes in the disc material ensues facilitating a disc bulge. Pain and other symptoms typically occur in late phases when neurological and surrounding tissue become irritated by means of compression or stretch.
  2. Sudden unexpected load (acute injury). Occur in traumatic situations like a motor vehicle accident or lifting a heavy object with poor technique. This may happen due to the nature of the sudden forces exerted through your body at the time of impact and your bodies attempt to repel those forces. This type is often associated with a sudden onset of severe and disabling pain.

Risk factors of thoracic disc bulge

There are several risk factors for thoracic disc bulge, some include:

  • Age: The most common risk factor is being between the ages of 35 and 50. After age 50 or 60, osteoarthritic degeneration (such as spondylosis) or spinal stenosis (narrowing of the spinal canal) are more likely causes of low back pain or leg pain. Interestingly, the condition rarely causes symptoms after age 80.
  • Gender: Men have roughly twice the risk for lumbar herniated discs compared with women.
    Physically demanding work: Jobs that require heavy lifting and other physical labour have been linked to a greater risk of developing a lumbar herniated disc. Pulling, pushing, and twisting actions can add to risk if they are performed repeatedly and with poor posture. The most common mechanism of injury is forward bending and twisting of the low back while lifting heavy loads.
  • Family history: the medical literature has shown a hereditary tendency for disc degeneration, and disc degeneration is associated with an increased risk for a herniation. Family history of lumbar herniated discs is a good predictor of a future herniation.
  • Previous history: Patients who have had a low back injury, a herniated disc or back surgery are also at a higher risk of developing further disc injury.
  • Vibration: Exposure to constant vibration (such as driving a truck or operating a crane with poor suspension) is linked to disc irritation.
  • Physical inactivity: Not exercising regularly, doing strenuous exercise for a long time, or starting exercise too strenuously after a long period of inactivity may increase your risk.
  • Smoking: Nicotine and other toxins from smoking can keep spinal discs from absorbing all the nutrients they need from the blood, making disc injury more likely. Smoking also increases your sensitivity to pain.
  • Being overweight/obese: Carrying extra body weight (especially in the abdominal area) may put additional strain on the lower back, although this has not been proven. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These factors can lead to low back pain and potentially disc injury.

Symptoms of a thoracic disc bulge

In general terms, a thoracic disc bulge does not cause pain. Most people have asymptomatic disc bulges in their back and do not know. Disc bulges are more common in the low back and neck however can occur in the mid and upper back. Disc bulges in the upper back and mid back can cause pain when they are associated with tears in the disc (discogenic pain) or when they compression the spinal cord or spinal nerves. Spinal nerve compression is more likely to cause pain than spinal cord compression.

Treatment for a thoracic disc bulge

Chiropractic is an excellent choice for mid back and upper back pain. Most disc bulges are asymptomatic and you will not need treatment from one of our chiropractors at Sydney Spine & Sports Centre (S3C). However for pain associated with disc bulges chiropractic is an excellent first treatment option. Our chiropractors use the latest treatments supported by the latest research to ensure you get the very best treatment for thoracic disc bulges. At 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.

More information

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