Thoracic Arthritis of the Spine

The middle portion of the spine, which runs through the thorax, or the trunk of the body. The thoracic spine is between the cervical spine (in the upper back) and the lumbar spine (in the lower back) and is made up of 12 small bones known as vertebrae. Between the vertebrae sit gel-filled disks known as intervertebral disks that cushion the spine and help it move. Because of the size of these disks in the thoracic spine and because the thoracic spine is connected to the rib cage, it is less mobile than other parts of the spine.

What is thoracic arthritis?

As with all parts of the spine, the thoracic spine is susceptible to osteoarthritis (OA). As people age, their intervertebral disks tend to lose their cushioning ability, which can put more pressure on joints between the vertebrae known as facet joints. If the cartilage lining the facet joints wears away, the result can be back pain. Thoracic arthritis of the spine is usually treated conservatively with pain-relieving drugs, heat and cold therapy, and exercise. If the pain is severe, a doctor may recommend a facet joint block, which is the injection of an anesthetic drug into the affected area of the spine.

A common condition affecting the thoracic spine is kyphosis, in which an exaggerated outward curve develops in the middle of the back. When kyphosis affects children and teenagers, it may be related to poor posture or genetic factors. In adults, kyphosis can be brought on by spinal OA or by ankylosing spondylitis, an inflammatory type of arthritis that mainly affects the spine. It can also be caused by osteoporosis, or bone thinning, in the spine. People with spinal osteoporosis often have small fractures in the vertebrae, known as compression fractures, that can contribute to kyphosis.

Treatment of kyphosis depends on its cause, its severity, and its accompanying symptoms. Kyphosis related to osteoporosis, for example, is usually treated by addressing the underlying osteoporosis through drugs, diet, and exercise. Medicines may be used to relieve the pain of kyphosis, and braces around the back may also provide pain relief. Physical therapy can help strengthen the surrounding muscles, improve posture, and reduce pain. Surgery is recommended in only the most severe cases.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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