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Thoracic Osteophytes

Thoracic osteophytes are also called bone spurs. Osteophytes are boney projections that develop around cartilage or tendons. They typically occur near joints in the mid back and upper back (i.e., thoracic spine). Osteophytes are usually first noticed because they irritate or inflame joint structures and nerves. Spinal joints that undergo wear-and-tear, or processes such as arthritis, will typically develop bone spurs. Thoracic osteophytes will only be felt if they approximate into a pain-sensitive structure, such as joints structures or nerves.

How do thoracic osteophytes come about?

Osteophytes form because of the increase in a damaged joint’s surface area. This is most common from the onset of osteoarthritis:

  1. Excessive mechanical stress and the presence of structural fissures in the articular cartilage result in cartilage damage in the joints.
  2. 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 osteophyte formation.
  3. Osteophytes 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 osteophytes.
  4. Osteophytes contain fibroblasts, prechondrocytes, maturing chondrocytes, hypertrophic chondrocytes and osteoblasts. Type II collagen is the most prominent component in the cartilaginous zone of osteophytes.
  5. 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 osteophytes 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 osteophytes. Risk factors for thoracic osteophytes include:

  • Age (>45 years old)
  • Previous traumatic injury to the thoracic spine
  • Genetics
  • Poor posture
  • Obesity
  • Weak “core muscles”
  • Alcohol and/or tobacco abuse
  • High-impact sports and activities

Symptoms of thoracic osteophytes

Thoracic osteophytes will only cause symptoms if they compress or irritate a joint structure or nerve. If they do not irritate these structures it is unlikely patients will experiencing pain. Rather, they may feel stiffness and restricted movement. The symptoms of thoracic osteophytes will depend on where they are located. If in the upper back, bone spur development may cause radicular (nerve) symptoms all the way from the back to the hands. If in the middle back (T2-11), bone spur development may cause discomfort to be felt in the chest and abdomen. If in the last thoracic vertebrae, bone spurs can compress the last thoracic nerve (T12) causing pain and discomfort in the pelvis.

Treatment of thoracic osteophytes

In many instances, chiropractic management will be effective for conditions associated with thoracic osteophytes. In other more persistent and serious cases, surgical opinion may be necessary. At Sydney Spine & Sports Centre (S3C) we use spinal treatments that are based on the best available research. Our management strategies are gentle and safe. Our chiropractors educate, communicate and reassure all patients they manage. S3C is a chiropractic centre of excellence for the treatment of thoracic pain.

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