What is a Herniated Disc?
The upper and middle of the back is referred to as the thoracic spine. All of the bones that make up the spine are referred to as vertebral bodies. The spine should look like a backwards ‘S.’ When looked at from the side, your spine from right beneath your skull to the tailbone should form a backwards ‘S.’ It should look like this at all times, whether you are seated or standing. A lot of people slouch when they sit. This makes the spine look like a ‘C.’ When the spine looks like a ‘C’ we say it is flexed.
In between each of the vertebrae in the spine lies an intervertebral disc. These discs are soft and malleable and, among other functions, allow for increased motion of the spine and act as shock absorbers. After an acute trauma, or more commonly a lifetime of poor posture, one of those intervertebral discs may tear a bit or be misshapen, causing pain in the back due to the disc itself being out of place or in more severe cases, the disc ruptures significantly and starts to puts pressure on the nerves located in or around the spinal canal. The terms ruptured disc, herniated disc, and prolapsed disc are all synonymous.
What Causes a Herniated Disc?
People are usually surprised to learn that the most common cause of disc prolapse is having a sedentary job, where the spine has been in a position of poor posture for hours every day. Sitting with poor posture stresses these discs and causes them to be deformed. The inside of the disc is a jelly like substance which is easily molded to the position that the bones are in. If the bones of the spine, the vertebrae, are in a poor position, so will be the discs. If upper back pain is allowed to continue and is left untreated and the underlying cause of this pain is not determined, the disc will continue to be displaced, weakening the outer, more fibrous part of the intervertebral disc and eventually may rupture.
Poor posture is not the only cause of a herniated or ruptured disc, however. This can happen as a result of a car accident or other injury to the back. Also, if someone has a very active job that requires a lot of lifting, they can have a prolapsed disc if not educated on proper body mechanics when lifting, carrying heavy objects, etc.
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Symptoms of a Herniated Disc
Symptoms of a herniation range from mild to severe depending on the size and location of the prolapse. You may be unaware that you have this condition in the back if the herniation is not in a position that it is placing pressure on any nerves. But if you do have pain from this, it can be quite debilitating. Symptoms of a ruptured disc in the thoracic spine may include:
- Pain in your upper back
- Pain, weakness, numbness and tingling that radiate around your body and locate in the chest and belly
- Pain only one side of your upper back
- Loss of range of motion
If You Are Experiencing Symptoms, Schedule an Appointment Dr. Burke Orthopedics Immediately.
Treatments for a Herniated Disc
The treatment decided upon by your orthopedic surgeon will be made on a case by case basis depending on your specific symptoms. A thorough evaluation is crucial here in order to get an accurate diagnosis. This may involve being ordered an MRI of your upper back.
Surgical intervention is always a last resort with back pain and a course of physical therapy will likely be attempted first in order to treat this conservatively. Physical therapy will consist of being taught specific movements, called directional preference, in order to reduce the herniation, then restore any loss of range of motion and strength. In some cases, reduction of a herniation is not possible as it has progressed too far for physical therapy to be of help and surgical intervention will be necessary. Surgeries may include full or partial disc removal. With a full disc removal, sometimes the surgeon will decide to fuse the vertebrae above and below the problematic disc.