Thoracic Discogenic Pain
Thoracic discogenic pain syndrome is a relatively rare cause of back pain and can be a challenging condition to diagnose and treat. It is typically categorised as pain that slow to build up and comes on insidiously. Symptoms will typically start locally and if left, may lead to radiculopathy (i.e., nerve root pathology) or myelopathy (i.e., spinal cord pathology).
What is thoracic discogenic pain syndrome?
In discogenic pain syndrome, the intervertebral spinal disc is the source of the back pain. Typically, this is caused by tears within the disc. Tears can be caused by many factors, such as repetitive heavy lifting with poor technique, excessive body weight (i.e., obesity) and older age (>35 years old).
Tears can be small or large, singular or multiple. Even the shape of the tears will impact the severity of pain and dysfunction. For instance, a concentric tears (i.e., about the lining of the annulus fibrosis of the disc) may be associated with less pain than compared to multiple rim tears (i.e., outer surface of the disc) as these tears may irritate surrounding sensitive structures.
Importantly, there are only pain receptors in the outer third of the disc. Therefore, tears within a disc must reach or occur in this outer third location for back pain to be felt.
Symptoms of thoracic discogenic pain
Back pain is the most common symptom that someone will have with thoracic discogenic pain syndrome. Around 60% of affected people present with back pain. Purely discogenic back pain is typically located at the level where the damaged intervertebral disc is located. Pain may refer to behind the stomach (retrogastic), behind the sternum (retrosternal), or the lower abdomen (inguinal areas) and can be misdiagnosed as coming from these structures or as a heart attack or hernia.
Sensory disturbances affect approximately 25% of patients with thoracic discogenic pain syndrome. Numbness is the most commonly reported sensory disturbance, but dysesthesias (i.e., unpleasant sensation when touched) and paresthesias (i.e., pins and needles) in a dermatomal distribution may also be reported.
Weakness may present in 17% of patients with thoracic discogenic pain syndrome. The motor nerves of the thoracic spinal segments supply the abdominal and intercostal muscles.
Treatment of thoracic discogenic pain
At Sydney Spine & Sports Centre (S3C), our clinicians are experts in non-surgical diagnosis and treatment of the spine. This means our chiropractors are well positioned to be your first point of contact when it comes to mid back and upper back pain. For discogenic pain in the mid and upper back, we use a combination of techniques that reduce inflammation (e.g., soft tissue massage, dry needling therapy, cryotherapy and ultrasound), enhance movement (e.g., graded exercise and strengthening programs, mobilisations, taping and self-management exercises), and abolish pain, sensory and motor disturbances. All our back pain treatments are safe, gentle and supported by the current scientific research.
Please visit our website for more articles and blogs relating to discogenic pain and mid back conditions:
- Lumbar disc herniation risk factors
- Lumbar disc herniation pathophysiology
- When are scans indicated in disc herniation?
- Chronic Pain: why does it still hurt?
- When to worry about back pain?
- Diagnostic imaging in chiropractic
- How chiropractors treat back pain
- Joint pain
- Thoracic myelopathy
- Thoracic osteophytes
- Thoracic spine stenosis
- Thoracic disc herniation
- Thoracic arthritis
- Thoracic foraminal stenosis
- Thoracic pinched nerve
- Thoracic facet syndrome
- Thoracic facet joint pain
- Thoracic disc bulge
- Thoracic disc protrusion
- Thoracic spondylosis
- Thoracic spondyloarthropathies
- Thoracic radiculopathy
- Thoracic degenerative disc disease
- Acute mid back pain
- Chronic mid back pain
- Stiff mid back
- Upper back arthritis