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Thoracic Radiculopathy Treatment in New Jersey

While less common than other types of radicular pain, thoracic radiculopathy may develop when degenerative conditions such as osteoarthritis or disc herniation begin to compress the spine or nerve roots. This can cause a person great discomfort. Within northern New Jersey, Centers for Neurosurgery, Spine & Orthopedics (CNSO) has a comprehensive team of neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists, who work together to eliminate pain and discomfort from neck or back pain. The team at CNSO is experienced in treating every cause of nerve pain including radiculopathy, with both non-surgical and surgical interventions. Learn more about treatment options for thoracic radiculopathy.

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What Is Thoracic Radiculopathy?

When a herniated disc, bone spur, tumor, or some other spine condition compresses a spinal nerve, the irritation can lead to a group of symptoms known as radiculopathy. Thoracic radiculopathy develops when a nerve in the mid-back, or thorax region, is irritated, causing pain, weakness, or numbness. Radiculopathy is more common in the lumbar spine (lower back) and cervical spine (neck) than in the thoracic spine.

Understanding Thoracic Spine Anatomy

The spine is a flexible column of 33 vertebrae, stacked on top of one another, that protects the spinal cord. The three main sections are the cervical, thoracic, and lumbar spine. Of these three, the thoracic spine is the longest, consisting of 12 vertebrae (labeled T1 through T12). The thoracic spine is the only section of the spine that attaches to the ribcage.

The spinal cord runs through the spinal canal. Nerve roots branch off the spinal cord and travel out peripherally, to innervate various anatomic structures. These nerve roots exit the spinal canal by passing through small openings of the spinal column called foramen. When bone, cartilage, or tissue pushes up against one of these nerve roots, the result is radicular pain or radiculopathy, commonly known as a pinched nerve.

Identifying Symptoms of Thoracic Radiculopathy

Most often, radiculopathy is caused by age-related changes to the spine, such as osteoarthritis, bone spurs, or herniated discs. Common signs of thoracic radiculopathy include:

  • Chronic chest or torso pain
  • Shooting or burning pain through the rib cage, abdomen, or side
  • A band of pain in the torso
  • Numbness or tingling feeling in the ribs, side, or abdomen

Unlike lumbar or cervical radiculopathy, thoracic radiculopathy does not typically radiate pain to arms, legs, hands, or feet.

Diagnostic Approaches

The first step in diagnosing radiculopathy is a thorough listening to the patient describe their symptoms and through physical examination. A neurosurgeon, orthopedic spine surgeon, or pain management doctor will check for loss of sensation, movement, or numbness or have the patient move into specific positions to see if it makes the pain better or worse.

If the symptoms indicate a potential thoracic spine abnormality, the doctor will conduct imaging tests such as an X-ray, MRI, or CT scan. If there is radiculopathy in the extremities, electromyography (EMG) and nerve conduction studies may be used to determine which nerve root is compressed and how it is affecting the muscles.

The Role of Conservative Treatments

The goal of thoracic radiculopathy treatment is to provide symptom relief, as well as address the underlying cause of radicular pain. At CNSO, the medical staff philosophy is to use a non-invasive approach to treatment and pain management to reduce pain caused by swelling throughout the patient’s journey. Surgery is only considered if there is a tumor or structural abnormality that will not resolve with physical therapy and/or steroid injections by a pain management doctor.

Radiculopathy often can be addressed through conservative care, including rest, activity modification, and pain management strategies such as medications. Physical therapy is an effective treatment for many patients. With a plan that includes manual therapy, exercise, and stretches, a certified physical therapist can help a patient alleviate pain while strengthening the muscles around the spine.

Medications for Thoracic Radiculopathy

Over-the-counter (OTC) or prescription oral medications may be sufficient to treat thoracic radiculopathy. These include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs): These are common OTC pain relievers that reduce discomfort and inflammation.
  • Muscle relaxants: These medications are used to treat the muscle spasms that can occur near a pinched nerve.
  • Oral steroids: Some patients may take corticosteroid medication, which can help quickly reduce inflammation around the affected nerve.

Interventional Procedures

If rest, physical therapy, and oral medications do not offer symptom relief, the next step is interventional treatments. Thoracic radiculopathy can be treated with injections such as:

  • Epidural steroid injections: This is an outpatient treatment that uses real-time X-ray guidance (known as fluoroscopy) to deliver anti-inflammatory steroid medication into the epidural space.
  • Nerve root blocks: A nerve block can deliver temporary pain relief by injecting medication to interrupt the pain signals that the nerve root sends to the brain.
  • Facet joint injections: This treatment delivers pain medication to the facet joints, which connect the vertebrae and help the spine bend and twist.

Surgical Interventions

While radiculopathy usually can be treated with conservative care, some patients with anatomic abnormalities that cause persistent pain and symptoms may be best treated by surgery. The goal of spine surgery is to relieve pressure off the spinal cord or compressed nerve root and thereafter, ensuring the patient can move freely and comfortably. Two options for spinal decompression treatment are:

Discectomy

The spinal column has a series of discs between each vertebra that provide cushioning and act as shock absorbers. Over time, these discs can dry out, shrink, and even move out of place, a condition known as a herniated disc. During a discectomy, a neurosurgeon or orthopedic spine surgeon removes the piece of damaged or diseased disc that is pushing against a nerve. Discectomy can be performed as a minimally invasive procedure or as an open surgery.

Foraminotomy

Foraminotomy is a surgical procedure used to widen one of the small openings in the spine where the nerve roots exit the spinal canal. The goal is to take pressure off the affected nerve root and reduce pain, tingling, numbness, and other associated symptoms. During this procedure, a neurosurgeon will remove a small portion of the bone around the opening known as the foramina. It may be performed in conjunction with discectomy or as a standalone procedure.

Laminectomy is a common spine surgery procedure in which a lamina section of a vertebrae is trimmed to relieve pressure off the surrounding neural structures. A thoracic laminectomy may also be necessary to access a different area of the spinal column or the spinal cord itself. An example of the need to perform a laminectomy for access to the spinal cord is in the event there is a tumor on the spinal cord.

 

All forms of surgery carry some degree of risk. However, discectomy, laminectomy, and foraminotomy are common procedures that can be performed safely in a hospital or outpatient setting. The CNSO surgical team will provide complete information on the risks and benefits of a particular procedure.

Recovery and Post-Surgery Care

Depending on the type of surgical approach used to treat thoracic radiculopathy, a patient may need to stay at the hospital for a night or two, or they may be able to go home the same day that the procedure is scheduled. Some swelling and soreness at the incision site is normal. Pain medication may be used to manage post-operative discomfort but is only necessary for a few days.

Most patients will work with a physical therapist as part of their rehabilitation plan. They also will have follow-up appointments with their neurosurgeon or orthopedic spine surgeon and the surgical team to remove any stitches at the incision site, ensure they are healing properly, and monitor symptom reduction and relief.

Preventive Measures

It may not be possible to prevent radiculopathy from developing. However, maintaining a healthy weight and staying physically active can reduce a patient’s risk. Recommended preventive measures include:

  • Practicing good posture when sitting or standing
  • Using proper lifting techniques and ergonomic practices to minimize stress on the spine
  • Getting regular aerobic exercise and engaging in strength training
  • Stretching before and after exercising
  • Quitting smoking

Coping With Chronic Thoracic Radiculopathy

Dealing with chronic pain can take a mental and emotional toll on the body, as well as a physical one. Those who struggle with chronic thoracic radiculopathy may want to talk with their doctor about support groups or other mental health resources that might be beneficial.

Frequently Asked Questions About Thoracic Radiculopathy

What Is the Primary Cause of Thoracic Radiculopathy?

Thoracic radiculopathy usually is caused by a narrowing of the space where nerve roots exit the spine. This can be the result of spinal stenosis, disc herniation, or bone spurs of the spine.

Can Thoracic Radiculopathy Be Managed Without Surgery?

Most cases of radiculopathy can be treated without surgical intervention. Rest, physical therapy, activity modification, weight loss, and pain medications often are effective treatment options.

How Long Does the Recovery Process Take After Surgery?

Recovery time will depend on the type of procedure used to treat radiculopathy. After foraminotomy, laminectomy, or discectomy, most patients can drive within a week or two and resume light work duties after about four weeks. Complete recovery can take a couple of months, and patients may need to modify activities for six to eight weeks, such as avoiding repeated bending or twisting motions while the spine heals.

Are There Any Natural Remedies for Pain Relief?

CNSO is dedicated to using non-surgical, opiate-free pain management strategies, such as physical therapy and injection treatments, that provide relief from chronic radicular pain.

Can Physical Therapy Worsen Thoracic Radiculopathy Symptoms?

Physical therapy generally alleviates radiculopathy symptoms by reducing pain and inflammation in the area, as well as improving strength, flexibility, and posture to help prevent radicular pain from coming back.

Trust CNSO for Thoracic Radiculopathy Care

To prevent long-term nerve damage and ensure proper medical guidance, patients should always see a spine specialist doctor or a pain management doctor if they are experiencing radiculopathy symptoms such as numbness, tingling, or shooting pains. Serving patients throughout northern New Jersey and the surrounding area, CNSO is the state’s most comprehensive spine care center. The experienced doctors and surgeons at CNSO treat a wide range of spine conditions that cause back and neck pain. The CNSO spine specialist will create personalized treatment plans for addressing each patient’s condition both common as well as less common conditions such as thoracic radiculopathy. CNSO offers multiple convenient locations so patients in northern New Jersey can receive care close to home. To learn more about radiculopathy treatments or to schedule an appointment, contact CNSO today.

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