Spinal discs are pads composed of protein, cartilage and water which separate the bones, or vertebrae, in the spine. Their function is to hold the spine together, to allow the body to twist and bend, and to act as shock absorbers. There are 23 discs in the human spine; six in the cervical region, or neck, five in the lumbar region, or lower back, and 12 in the thoracic region, or middle back. A thoracic disc is one of the discs in the thoracic region.
Injuries to spinal discs are generally in the cervical or lumbar regions. An injury to a thoracic disc is rare because of the protection provided by the rib cage, but if injury does occur, it can result in a herniated, or ruptured, disc. Each disc has an outer layer of tough fibers called the annulus, and soft, jelly-like interior called the nucleus polposus. The disc becomes herniated if the annulus tears and the polposus material are pushed into the spinal column. There is very little room in the thoracic area for the material to go, so a herniated thoracic disc may cause serious complications, and in rare cases may even result in paralysis below the waist.
Symptoms of a herniated disc include body and leg pain, numbness, tingling and muscle weakness in one or both legs, and spastic leg motions. If an injury has occurred and the symptoms indicate the possibility of a herniated thoracic disc, then an X-ray may be taken to see if the spine shows damage or calcification. If calcification appears, it is very likely that the disc has ruptured. An X-ray cannot show soft tissue, however, so it cannot provide a view of the discs; a rupture may be present even if no damage is evident. In addition to an X-ray, doctors will generally use magnetic resonance imaging (MRI) to determine if a thoracic disc has herniated.
In most cases, a herniated thoracic disc will resolve itself and the symptoms will recede with time and rest. If the nerves in the spine are not affected and the symptoms are not getting worse, non-surgical treatment is generally advised. This may include some bed rest or temporary use of a back support to immobilize the back. Medications may include anti-inflammatory medicines, oral steroids and muscle relaxants. Physical therapy can be helpful to relieve pain, correct posture and strengthen the back.
If the symptoms get worse, or the nerves in the spine are involved, surgery can be performed to remove the ruptured disc. The surgical approach is determined by the area of damage. A surgeon may enter through the back using a procedure called costotransversectomy decompression to remove the ruptured portion of the disc. Transthoracic decompression is a surgical technique which requires the surgeon to enter through the chest cavity to remove the disc. If the removal of the disc makes the spine unstable, then it may be necessary to fuse the discs involved together.
Degenerative disc disease (DDD) is a condition that can be brought about by injury or, most often, by aging. The discs receive very little blood, so they are unable to heal as well as other parts of the body. This condition can cause pain and stiffness, but is generally not debilitating. DDD usually occurs in the cervical or lumbar regions; thoracic degenerative disc disease is very rare.
There are some steps a person can take to prevent thoracic disc problems. Chiropractic care is considered helpful by many in keeping the body in alignment and relieving pressure against nerves. Maintaining proper posture and proper lifting techniques also helps to prevent injury and unnecessary wear-and-tear on the back. Daily stretching and stretching before exercise is vital, and additional exercises are available specifically designed to strengthen and maintain spinal health.