“Spondylosis” is a complicated diagnosis, broadly describing dynamic, interdependent degenerative changes involving the discs, vertebral bodies, and/or facet joints that develop in response to stress, compounded by time. (1-3)
As a group, thoracic complaints are much less common than symptoms in the neck or low back. (17% versus over 64%) (4) Complaints related to thoracic degeneration follow a similar pattern. Although degenerative change in the thoracic spine is fairly common (71% of asymptomatic men and 48% of asymptomatic women over age 40), pain from those degenerative changes is relatively uncommon- accounting for only 2% of all spinal degeneration-related complaints. (5,6)
The explanation for the higher incidence and intensity of spondlyosis-related complaints in the cervical and lumbar spine is likely due to the increased mobility and biomechanical demands of those regions. (6,7) Not surprisingly, thoracic degeneration also shows a predilection for the most mobile segments: T9-T12. (8)
Kirkaldy-Willis and Benard (9) describe a “degenerative cascade” that begins when repetitive microtraumas initiate small circumferential annular tears. These initial “sprains” may or may not be painful, based upon the degree of innervation of the annular lamellae (outer fibers are highly innervated, while inner fibers lack nerve supply). Weakening of annular fibers allows for diffuse circumferential bulging. Tears that coalesce create “channels” allowing nuclear migration. Continued microtrauma is associated with separation of the annulus from the vertebral end plate, thereby compromising disc imbibition and nutrition. The disc thins from cumulative stressors and by the loss of its normal viscoelastic properties over time. Loss of disc height also reduces the discs ability to absorb impact and leads to disproportionate loading of the facet joints resulting in degeneration and relative instability. As a concurrent hypertrophic response, the body lays down additional bone in the form of osteophytes on the anterior and lateral vertebral body margins. (10) Posterior vertebral body osteophytes may cause central or lateral recess stenosis. (11)
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What we do in our office to help this condition:
1. Perform a detailed exam, assessing the alignment of the spine. Improper alignment in any areas of the thoracic region may be detrimentally affecting the torso, ribs, or even internal organs.
2. As indicated, adjust areas of spinal subluxations (misalignments), restoring proper alignment and nerve system function, which facilitates healing.
3. Apply electrical stimulation and heat to the muscles of the upper and lower back. Applying an electrical current helps strengthen muscles, block pain signals, and improve blood circulation.
4. Prescribe stretches and exercises in conjunction with chiropractic care to strengthen the soft tissues of the upper back, core, and low back.