The Thoracic Spine

The thoracic spine is in the middle section of your spine (your “back bone”) as shown
above. It consists of 12 vertebrae (making it the longest section) and they are labeled T1 through T12. It
begins at the base of your neck and ends with the bottom of your rib cage. Your thoracic spine
is quite rigid and stable making the least common area to experience injury along your entire
spine. The curves of your spine are important for balance and helping you stand up right. The
thoracic spine has a “reversed c-shape” which is called a kyphotic curve, whereas the cervical
spine and lumbar spine form your normal “c-shaped” curve, known as a lordotic curve.
There are four major functions of this section:

1. Protects spinal cord and the branching spinal nerves- All the stacked
   vertebrae of your spine form a protective central canal/column that protects your
   spinal cord while the branching nerves pass through the “vertebral foramen”
   which are large holes in the center of the vertebrae.
2. Provides attachment for your ribs- These vertebrae are unique for this very
   reason as it’s the only part of your spine where the ribs directly attach, except for
   the last two ribs (11 and 12) as those are referred to as “floating ribs” because of
   no direct contact to your spine.
3. Supports both your chest and abdomen- While your thoracic spine helps
   stabilize your rib cage, your rib cage also helps support your thoracic spine and
   together they help protect your heart and lungs. The thoracic joints are tight
   enough to protect but also loose enough to allow these vital organs to function
   properly, especially when breathing!
4. Allowing movement for your body- The intervertebral disc, we mention in your
   cervical region continue into the thoracics and, provide cushion and flexibility in order
   for you to twist and bend without sacrificing the supportive strength of your
   vertebral column. Your thoracic region has the greatest range of rotation out of
   the whole spine but has the least flexion and extension.

Next, we’re going to go through the thoracic nerves; what they control and what might be
affected if there is a nerve issue within this area. The major organs that the brain uses thoracic
nerves to transmit signals to are your lungs, heart, liver and even small intestines.

1. T1 & T2 nerves- These two nerves branch into the top of your chest as well as
   into your arms. T1 also plays apart in the brachial plexus, a complex structure of
   nerves in your shoulder that will carry movement and sensory signals from your
   spinal cord to your body.
2. T3-T5 nerves- These branch into the chest wall and together help control your
   lungs, diaphragm, and rib cage. In other words these nerves help you breathe!
3. T6-T12 nerves- The last six nerves play a role in your upper back and abdominal
   muscles. The nerves along with specific muscle groups help you with posture
   and balance. They even help you cough.

The conditions and disorders of your thoracic spine are very similar to the ones we
mention and discussed in your cervical spine. Some conditions that can take place within your
thoracic spine and surrounding structures are:

• Muscle tension/irritation
• Ligament sprains
• Trauma (however it takes a lot of force to injure the thoracic spine as compared
  to your cervical and lumbars. Rib cage injuries can also cause thoracic pain).
• Overuse injuries
• Spinal tumors
• Degenerative changes (spondylosis, osteoarthritis, and DD all can take place but
  are more common in the cervical and lumbar spine).
• Bone spurs, disc herniations, myelopathy/radiculopathy, spinal cord injuries and
  stenosis are also relevant and were discussed in more detail in the previous
  article if you’d like to refer back to it.

Two of the most common thoracic disorders are:

• Hyper-kyphosis: Occurs when the kyphotic curve is more pronounced,
  giving you a “hunched back” appearance or more slouched looking. This
  takes place when the actual vertebrae become more wedged-shaped
  rather than square. The condition can be congenital (appearing at birth) or
  acquired (with age or injury).
• Pediatric/Adolescent Scoliosis: Occurs when a child’s spine curves or
  rotates sideways at an abnormal angle. It can range from mild to severe
  (where bracing or surgery may be needed). The lumbar spine can also be
  affected but the thoracic is the most common. Adults can also acquire or
  develop scoliosis.

The main symptoms of thoracic injury or nerve damage are pain, tingling/ or weakness
that radiates into your arms and even legs, and also rib cage. Some other common symptoms
associated are:

• Loss or decreased sensations
• Difficulty breathing
• Loss of feeling in your rectal or genital region
• Loss of bowel or bladder control
• Constipation

If you or someone you know is experiencing these symptoms, especially after a recent
trauma or injury, please seek medical attention. The way these disorders and conditions are
diagnosed is through a thorough examination and sometimes further testing or imaging is
needed. All forms of imaging needed (x-ray, CT, MRI, etc.) were further explained in the last
article so refer back to it for more information on those and how they can help diagnose.

What are some ways you can keep your thoracic spine healthy? Below I will list a few
tips you can easily start applying to your life today!

1. Allow your spine to fully rest while you sleep: Choosing the right pillows and
   mattress can make a huge impact on how restful you sleep and allowing your
   spine to be supported yet comfortable. Always try to sleep with your spine in a
   neutral position by utilizing pillows as needed (a pillow between the knees can
   help balance out the pelvis).
2. Strengthening the muscles in your back and abdomen: These muscle groups
   also known as your “core muscles” need to be flexible and strong in order to best
   support your spine.
3. Limit your sitting time and practice good posture: Try not to sit for too long
   along with taking frequent breaks if you have to be sitting. The discs in your lower
   spine are loaded with more weight while you’re sitting than when standing.
   Practicing good posture while both seated and standing is important for
   supporting the natural curves of your back that we mentioned earlier.
4. Wearing supportive shoes: Wearing the right shoes can help your spine
   remain in proper alignment. Talk to your doctor about which shoes may be best
   for you or if orthotics/inserts would be a better option. (We also already have an
   article all about proper shoes if you wish to look back and take a read).
5. Maintain healthy bones: Vitamin D and calcium are both so important to have in
   your diet in order to ensure your bones are strong and healthy. Ask about
   supplement recommendations as well as the proper dosage needed for you.

If you or anyone you know may be experiencing one of the above mentioned issues,
please contact us for a further evaluation or if you have any further questions, we would be
happy to help!