Thoracic pinched nerve
A thoracic pinched nerve is uncommon but can occur. Pinched nerves are more common in the cervical (neck) and lumbar (low back) spine. A pinched nerve is the common way to say thoracic radiculopathy. A pinched nerve implies that there is a level of compression on a nerve coming from the spinal cord in the upper or mid back. This pressure irritates the nerve and we call this radiculitis.
What causes a pinched nerve?
The most common causes of a pinched nerve are a herniated disc, disc degeneration and bone spurs. These conditions cause pressure on the nerve itself, its protective covering (myelin sheath) or both. Inflammation around the area can further irritate these nerve structures. When this occurs, the nerve’s ability to conduct sensory impulses to the brain and motor impulses from the brain are impaired, leading to numbness, neurological pain, paraesthesia (pins and needles) and weakness. In severe cases, it can eventually lead to atrophy (shrinking) of the muscles. In its early stages, many people may describe this sensation as a body part that has “fallen asleep.” However, if nerve inflammation persists, this sensation persists into neurological and chronic pain, rather than resolving after a few minutes. Other uncommon causes of a pinched nerve would be traumas and other metabolic conditions that irritate nerves.
What are the risk factors for pinched nerve?
Anything which increases pressure around a nerve can cause a pinched nerve. Common causes include body position such as leaning on elbows, habitually crossing legs, or poor posture. Over time this may lead to pressure injury to nerves in these regions. Other risk factors include:
- Disc herniation or bulging discs and arthritis in the spine, which cause pressure on nerve roots, leading to pain or discomfort associated with a pinched nerve.
- Weight gain or water retention that predisposes people to developing pinched nerves; thyroid disease (especially hypothyroidism, or low thyroid hormone levels) can contribute to both water retention and weight gain and can increase the risk of certain types of pinched nerves.
- Pregnancy, which is associated with increased weight and occasionally associated with water retention, is also a common risk factor for developing certain types of pinched nerves.
- Repetitive activities (typing and using certain tools) can also increase swelling around specific nerves and lead to symptoms of a pinched nerve.
Symptoms of a thoracic pinched nerve
The most common symptoms of a thoracic pinched nerve are pain and discomfort into the arms, hands, chest or truck. Pain at the level of the pinched nerve is common with changes in sensation along the cause of the pinched nerve (dermatome) common also. Again, pinched nerves in the thoracic spine are not common, however like all pinched nerves, such as those in the low back and neck, persistent ‘pinching’ can lead to permanent neurological defects and ultimately loss of function of the nerves. For this reason, persistent pain in the upper or mid back must be checked by a chiropractor.
Treatment of a thoracic pinched nerve
Treatment of a thoracic pinched nerve will depend of the severity of the “pinch” or compression; however, in general terms, pinched nerves respond very well to chiropractic management. Chiropractic treatments for pinched nerves in the mid back involve a combination of active and passive treatments such as McKenzie Method, mobilisations and muscle therapy. Pinched nerves that are progressing or causing ongoing symptoms may need a surgery review, although this is rare.
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