Thoracic radiculopathy describes irritation to a spinal nerve that is in the upper or mid back. Sometimes called a ‘pinched nerve’, radiculopathy usually involves compression of a spinal nerve, as it exists the spine through the intervertebral foramen. The most common cause of this is a herniated or bulged thoracic intervertebral disc. Other causes are bones spurs, tumors and disorders affecting the nerves.
What causes thoracic radiculopathy?
Thoracic radiculopathy is usually caused when the space where the nerve roots exit the spine, the intervertebral foramen, is narrowed. This makes it easier for the nerve to become ‘pinched’ and irritated causing the classic sharp, shooting and sometimes burning pain and numbness associated with radiculopathy. This can occur for reasons that include the following:
- Spinal stenosis
- Foraminal stenosis
- Herniated disc
- Bulging disc
- Degenerative disc disease
- Bone spur
- Spine injury
The most common is perhaps a herniated or bulging disc. When the intervertebral disc is mildly injured, it can be stretched or pinched and won’t necessarily irritate the exiting nerve root causing radiculopathy. However, with a more severe injury, the outer surface of the disc can be weakened, allowing the inner substance to push towards the outside and approximate with the nerve root and/or spinal cord itself. This is called “mechanical radiculopathy.”
With further damage, the outer surface of the disc can tear, and the inner disc fluid might leak out. This is known as a complete herniation or extrusion. The disc material may then irritate nearby nerves as they exit the spinal cord. This is called “chemical radiculopathy” and is associated with a poorer prognosis.
Types of radiculopathy
There are 3 different types of radiculopathy, which include the following:
- Cervical. Refers to the nerves in the cervical spine (neck), but also affects nerves that extend through the shoulders, arms, hands, and fingers. It can cause pain, weakness, tingling, or numbness in these areas.
- Thoracic. Occurs in the thoracic spine (upper and mid back) region, but is relatively uncommon. Symptoms can affect the chest, abdomen, mid-back, or upper back.
- Lumbar. Effects the nerves in the lumbar spine (lower back) as well as those that travel trough the buttocks, legs, and feet (like the sciatic nerve). Lower back pain and muscle weakness are common symptoms.
Symptoms of thoracic radiculopathy
Thoracic radiculopathy will cause back pain around the area of nerve compression. If it is compression caused from a herniated disc (i.e., discogenic radiculopathy), movements that increase pressure on the disc such as forward bending and straining may increase the pain. Radiculopathy means compressed nerve (typically). Spinal nerves supply sensation and nerve impulses to the muscles they connect to (i.e., innervate). Therefore, changes in sensation, pain and muscle weakness can develop. Progressive muscle weakness requires immediate assessment to avoid long-term function loss.
Treatment of thoracic radiculopathy
The good news is that pinched nerves or thoracic radiculopathy can be treated very successfully with conservative management. Chiropractic management for a pinched nerve will involve treatments to improve movement, reduce inflammation, reduce pain and improve function. Treatments delivered by our chiropractors at Sydney Spine & Sports Centre (S3C) are gentle, safe and effective. They also involve self-management and education, which is an important factor in radiculopathy. This is the gold standard of care for non-surgical neck, mid back and low back pain.
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