Thoracic disc herniation can be caused by degenerative disc disease, which occurs as people age and their discs become less flexible. Wear and tear over the years causes the spine to degenerate and break down. It may also be related to smoking, obesity, and/or caused by an injury.

The most common symptom of thoracic disc herniation is axial back or chest pain. Sometimes the pain spreads around the chest in a “band like fashion.” You may also have:

Numbness or sensory changes

Weakness in your arms or legs

Problems with your bowel or bladder

Problems with sex

Problems with your walking

How is a thoracic disc herniation diagnosed?

Most thoracic disc herniations can be treated with conservative treatment including activity modifications, physical therapy, injections and/or pain medications. 

Most thoracic disc herniations are able to heal on their own without surgery. This is because the disc can be resorbed and shrinks, but this process may take weeks or even months. 

If the disc herniation results in bladder or bowel issues, numbness around the genital area, weakness in your arms or legs, problems with your balance and/or gait then surgery may be warranted.

Thoracic stenosis can be caused by disc herniations, arthritis, fractures, bone spurs or tumors. Some people are born with congenital forms of thoracic stenosis, which causes the area that houses the spinal cord to be narrowed from birth. Most other people develop it over time from normal ‘wear and tear’ of the spine and aging.

The most common symptoms are:

Numbness in the shoulders, arms, hands, feet or legs

Stiffness in your neck

Unsteady balance or abnormal walking

Pain in the thoracic region of the back or around the ribs

Treatment is done in a graduated manner, starting first with conservative measures and ultimately leading to surgery if the symptoms are not managed appropriately. Most patients can be treated with either level 1 or 2 treatment plans. One should understand that conservative treatments may not address the underlying cause of the thoracic stenosis. These treatments are to simply treat the pain and allow you to function better. Treatment of the underlying cause is usually only able to be addressed with surgery.

Thoracic myelopathy is caused by compression of the spinal cord in the thoracic region. The most common causes are bulging or herniated intervertebral discs, bone spurs, or spinal trauma. It may also be caused when there is spinal stenosis, or narrowing of the bony passageways of the spine where nerves travel. In rare cases, it may be caused by cancer or autoimmune diseases such as rheumatoid arthritis.

neck pain 

neck stiffness 

numbness in the shoulders, arms, or hands 

an electric shock pain shooting down your legs 

feeling as though your foot is dropping or slapping on the ground

difficulty with normal standing or walking in a straight line 

urinary or stool incontinence

There are three levels of treatment Dr. Wilson uses to treat patients with thoracic myelopathy. Some patients may only need conservative management, while others, due to their emergent nature, may require the urgent surgery. 

Most patients are able to be managed with conservative treatment only, namely pain medications and/or injections. If this fails to alleviate the pain or if you have progressive muscle weakness, problems with your gait, bowel, or bladder then surgery may be recommended.