Thoracic Spine: What It Is, Function & Anatomy (2024)

What are common causes of thoracic spine pain?

Because your thoracic spine is much more rigid and stable, your thoracic spinal area is much less frequently injured than your lumbar (lower back) and cervical (neck) spine.

Your back has many interconnected bones, nerves, muscles, ligaments and tendons that protect your spinal cord. Experiencing pain in your thoracic region (your upper and middle back) could be due to many conditions that can affect these tissues, including:

Muscle irritation or tension: Muscle irritation in your thoracic region is often caused by poor posture and prolonged sitting, which results in tightened muscles and pain.
Ligament sprains: A sprain is a stretching or tearing of a ligament. A sudden twisting motion in your thoracic area of your spine can cause ligaments in that region to overstretch beyond their limit. This can cause pain in your thoracic region.
Trauma: A fall or a direct blow to your thoracic region can cause pain. However, it takes a lot of force to fracture your thoracic spine due to its rigidity, as opposed to your cervical spine and lumbar spine. You could also experience pain in your thoracic region from ribcage injuries, which affect your thoracic nerves.
Overuse injuries: Overuse injuries are commonly caused by repetitive motions. They cause micro-injuries to develop, which can cause spinal pain. Repetitive lifting, bending and twisting motions can contribute to overuse injuries of your thoracic spine.

More common causes of thoracic spine pain that directly involve your spinal column include:

Spinal tumors: Spinal tumors are common and can form anywhere in and along your spine, but they most commonly occur in your middle and lower back. They’re usually a result of metastatic cancer. Back pain is the most common symptom of both benign (noncancerous) and malignant (cancerous) spinal tumors. Pain from a spinal tumor is usually aching and deep, and is persistent at night, sometimes to the point of disrupting sleep.
Spinal fracture: Although thoracic spinal (vertebral) fractures are less common than cervical and lumbar fractures, people who have osteoporosis are more prone to thoracic spinal fractures due to having weakened bones. A sudden twisting motion or sneeze can cause thoracic spinal fractures in people with osteoporosis.

What are degenerative changes of the thoracic spine?

“Degenerative changes of the spine” is the same condition as spinal osteoarthritis, spondylosis and degenerative disk disease. With age, the soft disks that act as cushions between your spine’s vertebrae wear down, dry out and/or shrink. This narrows the space between your vertebrae, causing certain issues.

What are the common conditions and disorders that affect the thoracic spine?

Conditions that specifically affect your vertebrae, spinal cord and/or nerve roots in your thoracic spine, include:

Kyphosis: Kyphosis is a spinal condition in which there’s a more forward rounding of your back, which leads to a “hunchback” or slouching posture. Kyphosis happens when the vertebrae in your upper back (thoracic spine) become more wedge-shaped. Types of kyphosis include congenital (appearing at birth), posture-related and Scheuermann’s disease.
Pediatric and adolescent scoliosis: Pediatric and adolescent scoliosis is a condition in which a child’s spine abnormally curves sideways or rotates. Scoliosis can range from mild to severe. Your thoracic spine is usually the most affected in scoliosis. Adults can also develop scoliosis.
Thoracic radiculopathy: Thoracic radiculopathy happens when there’s a pinched nerve root in your thoracic spine (upper back) that causes pain, tingling and/or numbness that wraps around to the front of your body. Your thoracic spine is the least common location for radiculopathy.

Other conditions that can affect any region of your spine, including your thoracic region, include:

Bone spurs (osteophytes): Bone spurs are bone projections (growths) that develop around cartilage or tendons. They typically occur near joints in your mid-back and upper back (thoracic spine) but are more common in your cervical and lumbar spine regions.
Herniated disk: This condition is a tear of the disks that provide a cushion between vertebrae. Intervertebral disks allow you to bend and move with ease. Herniated disks of your thoracic spine are rare compared to cervical and lumbar disk herniations.
Myelopathy: Myelopathy describes a collection of symptoms that result from severe spinal compression. When something compresses (squeezes) your spinal cord, it can’t function properly. That can lead to pain, loss of feeling or difficulty moving certain parts of your body.
Osteomyelitis: Osteomyelitis is a bacterial or fungal infection of the bone, in this case, the vertebrae of your spine. If left untreated, it can lead to the death of vertebrae.
Spinal cord injury: Most spinal cord injuries come from a sudden, traumatic blow to the vertebrae in your spine, including your thoracic spine. The fractured (broken) bones then damage your spinal cord and its nerves. In rare cases, an injury can completely sever, or split, your spinal cord. Your thoracic spine has a relatively narrow vertebral canal, which makes it prone to spinal cord damage.
Spinal stenosis: This condition happens when your spinal canal narrows. Less space within your spine reduces the amount of space available for your spinal cord and the nerves that branch off it. A tightened space can cause your spinal cord or nerves to become irritated, compressed or pinched.

What is the most common injury to the thoracic spine?

Vertebral compression fractures (VCFs) are the most common injury to the thoracic spine. They occur when a vertebra in your spine collapses, which can lead to severe pain, deformity and loss of height.

What are the symptoms of thoracic spine nerve damage?

Thoracic spine nerve and spinal cord injury symptoms depend on the type of nerve damage (incomplete or complete) and where the injury is along your thoracic spine.

The main symptoms are pain, weakness and/or tingling that radiates into your arms, legs or around your rib cage.

The following symptoms may also be associated with thoracic spine nerve damage:

Decreased sensation or loss of sensation in your arms or legs.
Difficulty breathing.
Loss of feeling in your genitals or rectal region.
Loss of bladder or bowel control.
Constipation.

Get immediate medical attention if you notice any of these issues after an injury.

How are conditions of the thoracic spine diagnosed?

First, your healthcare provider will gather your medical and medication history, ask you about your symptoms, perform a physical exam, and order tests and imaging studies.

Tests and imaging may include:

Computed tomography (CT) scan: This scan uses X-rays and a computer to produce detailed images of the inside of your body. A CT scan can show the shape and size of your spinal canal, its contents and the bone around it. It helps diagnose bone spurs, osteophytes, bone fusion and bone destruction from infection or tumor.
Magnetic resonance imaging (MRI): This test uses a large magnet, radio waves and a computer to produce detailed images. It can reveal problems with your spinal cord and nerves exiting your spinal column, spinal degeneration, disk herniation, infections and tumors.
X-rays: X-rays create pictures of your bones and soft tissues, using a small amount of radiation. X-rays can show fractures, disk problems, spinal alignment problems and the presence of arthritis.
Electromyogram (EMG) and nerve conduction studies: An EMG helps evaluate the health and function of your nerves and muscles. A nerve conduction study measures how fast an electrical impulse moves through your nerves. These tests help determine ongoing nerve damage and the site of nerve compression.
Myelogram: This imaging test examines the relationship between your vertebrae and disks, and outlines your spinal cord and nerves exiting your spinal column. It shows if a tumor, bone spurs or herniated disks are pressing against your spinal cord, nerves or nerve roots.

How are thoracic spine conditions treated?

Both nonsurgical treatment options, such as physical therapy and epidural steroid injections (ESIs), and surgery are available to treat many of the conditions that affect your thoracic spine.

Treatment options depend on the cause of your thoracic spine issue, its severity and your overall health. Together, you and your healthcare provider will determine the best treatment plan for you.