THORACIC RADICULOPATHY

Thoracic Radiculopathy

The spine is a 33-bone layered structure — a network of muscles, tendons, and ligaments that holds the vertebrae in place. As such, the spine has nerves that go to various parts of the body, including the arms and legs. In addition, every part of the spine has its own name and function and identifies as:

• cervical spine or neck
• thoracic spine or mid-back
• lumbar spine or lower back
• The sacrum, a bone that connects the spine to the hips
• coccyx or tail bone

A disc separates each vertebra from its neighbor to prevent them from rubbing against each other. When these discs become injured or inflamed as a result of an injury, they might compress a nerve root. For example, a person may suffer pain or other symptoms in locations that relate to the function of a compressed nerve. Therefore, radiculopathy can develop as a result of an injury, but it can also develop without a clear cause.

Types of Radiculopathy

 

Cervical radiculopathy

This occurs when a nerve root in the neck or upper back gets “pinched” and causes:

• Pain in the neck, shoulder, upper back, or arm
• Muscle weakness

Thoracic radiculopathy

This occurs when a nerve root gets compressed in the mid-back area. However, this occurs rarely and can sometimes imitate and wrongly identify as shingles, cardiac, stomach, or gallbladder problems. Doctors normally treat these symptoms without surgery; however, in certain cases, they may recommend minimally invasive surgery.

As an example, the following identify symptoms of this condition:

• Rib, side, or abdominal scorching or shooting pain
• Band-like pain
• Weakness, numbness, and tingling
• When nerve compression develops in the mid-back area, a person may suffer pain throughout the chest and torso.
• Numbness and tingling in the ribs, side, or abdomen numbness and tingling in the ribs, side, or belly
• When the cause relates to disc herniation or trauma, advanced stages may show motor impairment

When pinched nerves occur, doctors find them in a variety of places throughout the mid-back area.

• Stenosis, bone spurs, disc herniation, or other disorders will cause the narrowing of the space 
• Thoracic vertebrae (T1-T12)
• The thoracic vertebrae’s intervertebral disc
• 12 nerve roots in the spine.

Lumbar radiculopathy

When a nerve root becomes compressed in the lower region of the back, a person may suffer pain in the low back, legs, and hips. So, sciatica refers to another name for lumbar radiculopathy. With this condition,  the symptoms cause pain and numbness in the low back, hips, buttock, leg, or foot, which become worse by prolonged sitting or walking. As such, nerves related to the colon and bladder can get squeezed in rare cases, resulting in a lack of control. Other symptoms include:

• A searing pain that starts in the back.
• A strong ache when sitting or coughing.
• Numbness or weakness in the leg and foot.
• Tingling in the back or leg
• Changes in feeling or reflexes.

Epidemiology /Etiology

The diagnosis of thoracic radiculopathy often gets missed since the cause rarely gets identified. Therefore, this condition has been rarely documented and doctors consider it as being very rare. Although the most prevalent cause of radiculopathy occurs when a nerve root gets compressed, finding the affected nerve requires significant testing.  However, the following also cause this condition:

• Diabetic thoracic polyradiculopathy affects 15% of insulin-dependent diabetics and 13% of non-insulin-dependent diabetics.
• Spondylosis and disc herniation provide examples of degenerative spine alterations that can cause a pinched nerve.
• A tumor, trauma, scoliosis, viral infection/inflammation, connective tissue disease, and TB provide some of the other probable reasons for patients to get a pinched nerve.

Diagnosis of Radiculopathy

The first step in identifying radiculopathy begins with a thorough physical examination and a study of a patient’s medical history. For instance, your doctor will evaluate your neck, shoulders, arms, and hands.  Depending on the location of your symptoms, doctors will check:

• Numbness or a lack of sensation
• Reflexes in your muscles
• Muscular endurance
• Posture, or how your spine curves

To conduct a through diagnosis, your doctor may also recommend the following diagnostic tests:

• X-rays to detect the position of the bones in your neck and any disc narrowing or damage.
• Doctors can diagnose bone spurs and bulging or ruptured discs pushing on the nerve roots or spinal cord using a spine MRI or CT scan.
• An electromyogram identifies which nerve root causes the condition.

Diagnostic Difficulties

The following identifies some of the problems with diagnosing thoracic radiculopathy

• Because there is usually no concomitant motor deficiency, the symptoms of this condition can easily get overlooked.
• The appearance of a band-like stomach pain might signal a variety of ailments.
• With so many possible causes, it’s no surprise that this condition gets missed for months or even years after symptoms appear.

Treating Radiculopathy

In some cases, radiculopathy symptoms improve with time and may not require treatment. Based on the symptoms and location of the injured nerve root, our Specialists may propose a surgical treatment if pain or other symptoms continue. Additionally, our doctors treat this condition using the following methods:

• Rest or a change in activities
• Physical therapy helps with the recovery of injured persons
• Nonsteroidal anti-inflammatory medications (NSAIDs) (NSAIDs)
• Injections of steroids into the spine

Doctors may recommend surgery to address underlying issues such as:

• Spinal decompression surgery
• Spinal Fusion
• Disc replacement surgery

Thoracic Manual Techniques and Exercises

Doctors recommend therapy to treat thoracic movement problems as this treatment works to help joint limitations or muscle weakness.  Also, the thoracic region’s range of motion (ROM) is required for a variety of everyday activities and sports, including golf, throwing sports, tennis, and rowing. Moreover, problems with the thoracic spine can cause respiratory problems and cause postural problems later in life. In addition, increasing thoracic spine ROM also has a positive effect on the body.

• Motion restrictions can create a negative influence on performance.
• The thoracic spine moves in tandem with the ribs. When you bend to the side, your spinal segments bend to the side, and your ribs on the same side join together while your ribs on the opposite side separate. Thus, people who cannot move properly in all directions become more prone to injury and suffering.

Physical therapies such as joint mobilization and manipulation can help with joint stiffness and movement.  As such, most thoracic spine mobility therapies need an experienced therapist to conduct and oversee the procedures. Also, the capacity of the patient to include therapeutic exercise regimens may aid in a speedy recovery.

Physical Therapy for the Thoracic Spine provides a wide range of options

Physical therapists are educated in a variety of approaches in order to select the ones that will improve a patient’s health. For further information, the information below will help support further research.

• Traction
• Massage
• Trigger Point Therapy
• Active Release Techniques: A doctor uses touch to detect the location of adhesions, and then connects the patient’s active movement with his or her touch.
• Assisted Active Range of Motion (AAROM)
• Passive Range of Motion
• Stretches (muscle, neural tissue, joints, fascia)
• Instrument Assisted Soft Tissue Mobilization
• Joint Manipulation: A passive, high-velocity, low-amplitude push to a joint complex to remove a gas bubble with the goal of restoring optimum mobility, function, and/or pain relief.
• Joint Mobilization: A manual therapy approach that consists of a series of competent passive motions applied to the joint complex at changing speeds and amplitudes, with the goal of restoring optimal mobility, function, and/or pain relief.

Clinical Bottom Line

Mild Cases

Rest, ice, and medicine alleviate pain in minor instances. To avoid recurrence of the injury, physical therapy may establish a program of postural, stretching, and strengthening exercises. Doctors recommend a gradual return to activity to avoid a repeat of symptoms.

Moderate to Severe Cases

In conclusion, patients should not live with pain from any condition.  We specialize in treating thoracic radiculopathy and know how to best treat the condition; so we sincerely invite you to call us if your condition persists.

We can help

From the first time you walk into one of our offices in either Dallas, Plano, and Frisco, Texas, you will feel at ease. You will talk to one of our expert doctors.  Our doctors will listen and understand your problem and perform a detailed exam. The doctor will review your X-rays and other tests with you, in detail, and provide a diagnosis. After you become well informed, you and your doctor will plan the right treatment. Finally, if your spine doctor feels surgery is not the right decision in your case, he’ll tell you that, too, and offer a non-surgical remedy as to the first course of treatment.

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Footnote:

Physio-Pedia: Thoracic Radiculopai