Thoracic pain can happen at any time of life and occurs in people who are healthy as well as those who may have a serious spinal condition. Studies show that females, particularly children, and adolescents, have the highest incidence of thoracic problems. Injuries to this area can be caused by trauma, or muscle strain or poor posture. Individuals who experience constant, severe, worsening pain that is unrelieved after 2 to 4 weeks of treatment may have a serious thoracic problem.
Some of the most common types of thoracic problems are:
- Thoracic inter-vertebral joint sprain
- Scoliosis
- Scheuermann’s disease
- Thoracic fracture
- Thoracic disc herniation
Treatment choices for each problem depend on the injury’s severity.
Thoracic inter-vertebral joint sprain/strains often improve with conservative care. Heat and ice treatments, NSAIDs and other pain medication, massage, therapeutic exercise with a physical therapist, activity modification, and chiropractic manipulation may resolve mild-to-moderate pain. Severe pain may require physician consultation.
Scoliosis can improve without intervention but requires bracing if the spinal curve exceeds 25 to 30° in an individual that has much skeletal growth remaining. If bracing fails, spinal fusion or implantation of a growth system may be necessary.
Scheuermann’s disease in adultsmay require bracing, a spinal cast, or sleep on a rigid bed when the condition is severe. Orthotics may also be beneficial. In children, decreasing weight-bearing and strenuous activity is recommended. Spinal fusion may be necessary in severe cases when the curve is 75° or more, and pain remains after conservative care.
Thoracic fracture care begins with pain medication and mobilization with bracing that limits flexion. In cases when sufficient healing does not occur, and surgery is needed, spinal decompression with fusion is the primary choice.
Thoracic disc herniation treatment often starts with pain medication and analgesics, heat and ice, activity modification, physical therapy, and manual manipulation. In rare situations when the injury does not respond to nonsurgical management, spinal decompression may be required.
If you are experiencing mid-back pain that has not improved with nonsurgical care and would like to learn our treatment choices, please call one of our offices in San Antonio, Seguin or New Braunfels.