The Thoracic spine/ Dorsal spine has 12 vertebrae stacked on top of each other, labelled from T1 down to T12. These vertebrae form the foundation of the Thoracic region’s sturdy spinal column that supports the neck above, the rib cage, soft tissues, flexible joints, blood vessels, and nerves. The joints of the Thoracic spine are important to arm movement, bending over, and other movements. Because the Thoracic spine is used so much in daily life, it is prone to strain and injury for many reasons, from improper posture to compression fracture. Some injuries can put pressure on the spinal nerves, creating even stronger pain and other symptoms.
Aging and certain disease processes can change the natural convex curvature of the Thoracic spine. If the curvature is severe enough, it can restrict lung expansion and compromise breathing.
The Thoracic spine can develop an exaggerated curvature called kyphosis, giving the back a hunched appearance. Kyphosis is usually caused by aging and associated loss of bone mass; however, kyphosis can also develop as a result of other diseases, such as Marfan syndrome and Scheuermann’s disease. Age-related kyphosis is often due to weakness in the spinal bones that causes them to compress or crack. It can be caused due to Fractures / Broken or crushed vertebrae, Osteoporosis, Disk degeneration, Scheuermann's disease etc.
When the Thoracic and lumbar spine curve 10 or more from side to side, the condition is called thoracolumbar scoliosis.Curves are classified by many different components such as their location in the spine. They can occur in the upper back (cervical spine scoliosis), in the middle back (Thoracic spine scoliosis) and in the lower back (lumbar spine scoliosis) in various combinations. A lumbar curve typically involves a left convex scoliosis in the lumbar spine that affects an average of 5 vertebrae. Thoracolumbar scoliosis is curvature that includes vertebrae in both the lower Thoracic and upper lumbar portion of the spine.
A Thoracic/Dorsal disc prolapse is another term for a herniated disc located in the region of the 12 Thoracic vertebrae T1(D1) to T12(D12), which form the central portion of the spine. A prolapsed disc is less likely to occur in the Thoracic spine than in other areas of the spine, like the neck (cervical spine) or lower back (lumbar spine). This is because the Thoracic spine offers a limited range of motion, especially when compared to the highly flexible cervical and lumbar spine. Thoracic intervertebral disc disease is a rare source of pain and neurologic dysfunction, and it is not as well known to most clinicians as lumbar or cervical disc disease. Thoracic disc disease has been described as causing many different symptoms like mid dorsal pain,pain radiating to till chest,rib cage pain,shoulder blade pain etc.Levels of disc prolapse mostly occurs in D1-D2,D2-D3,D10-D11 and D11-D12.
The Thoracic portion of your spine refers to the middle of your back. The cervical part of the spine is the upper section that includes the neck. The lumbar section is your lower back. Each section can experience spondylosis. Thoracic spondylosis is less common than lumbar or cervical spondylosis. Spondylosis in Thoracic section can cause Thoracic back pain, costovertebral joint pain, radiating pain to rib cage, shoulder blade pain related to upper Thoracic spine etc.
Similarly Problems in Dorsal spine can also leads to Shoulder Blade Pain. Many individuals may notice they have decreased shoulder ranges of motion (movement). Either they have pain with movements in certain directions or they have the inability to move their shoulders due to a pinch or 'block'. A very important part of the shoulder blades resting position is the Thoracic spine. The perfect starting place for most folks when troubleshooting shoulder pain or limited ROM is with the Thoracic spine. Thoracic mobility is key for shoulder motions especially overhead movements. Normal scapular and Thoracic spine motion allows optimal mechanics for shoulder motions. Increased Thoracic kyphosis (rounding of the upper back and spine), reduced Thoracic mobility, or rounding shoulders from pectoralis minor tautness can contribute to shoulder impairment and injury as well.
The Thoracic spine / Dorsal Spine are composed of 12 vertebral levels T1-T12. Thoracic radiculopathy is the pain and resulting symptoms associated with compression on the nerve or nerve roots of the Thoracic spine. When the symptoms radiate or refer distally from the spine into the back and outward along the ribs to the anterior chest wall it is considered radiculopathy. The patients with Thoracic radiculopathy often suffer from radicular symptoms such as pain around the chest,mid dorsal pain radiating through ribs till chest, shoulder blade pain.
Depending on which nerve root is affected, the loss of sensation will occur in a segmental pattern across the thorax. Sometimes the patient also will complain from lower limb pain, vague abdominal or chest pain and axial pain.
Many Thoracic herniated discs occur from gradual wear and tear on the disc, which breaks down the walls of the disc.
Sudden fall or trauma such as a motor vehicle accident
Aging and general degeneration of the intervertebral discs
Improper or heavy lifting
Genetic factors may contribute to the likelihood of intervertebral disc disease.
Being an overweight individual puts pressure on the discs in your back
Degenerative disc disease: As you age, you may lose fluid in the discs located in your vertebrae, this reduces the support and flexibility of your spine.
Arthritis or osteoporosis
Pinched nerve: Narrowing of the space where spinal nerves leave the spinal cord to go to the rest of the body. This can be caused by herniated discs, degenerated disc disease, or trauma to this specific area.
Spinal stenosis: Rare, degenerative condition that is a result of the spinal canal being narrowed
Pain in the upper back or radicular to the chest and stomach area.
Sensory changes such as numbness, tingling, or parasthesia if the nerve is compromised.
axial back or chest pain
Thoracic nerve pain symptoms like tingling, numbness, burning, a pins and needles sensation
Sitting and bending can be difficult if the bulge is severe. Often the patient will present in a shifted posture and have difficulty finding a comfortable position.
A patient with a bulge may be symptom free if the disc does not press on a sensitive soft tissue structure.
If the disc bulges into the spinal cord area it can result in sensory loss and weakness below the effected level along with balance and possible bowel and bladder issues.