The vertebral column consists of 33 -34 vertebrae.

Superiorly, the first 24 vertebrae, from the cervical, thoracic, and lumbar level are articulated and separated from each other by the intervertebral discs.

Inferiorly, at the level of the sacral area, there are 5 welded vertebrae and at the level of the coccyx (the bone located at the base of the spine) there are 4-5 joined vertebrae.

The vertebrae are connected to each other, thus creating the vertebral canal in which the spinal marrow is housed and protected.

They are the vertebrae that support the ribs. To simplify the mechanics of chest expansion during breathing, the thoracic spine is built in such a way that it remains firm and straight regardless of the action of the body. Ligaments, nerves, muscles, and intervertebral discs are additional components of the spine.

They are structures of fibrocartilaginous nature, placed between two vertebrae. They are essential for the movement of the spine and act as a ligament, tying one vertebra to the next, but especially have a role in the absorption of shocks significantly diminishing the impact between the vertebrae. The discs are round and flat, with a thickness between 9-11 mm and consist of two components, a fibrous ring and a pulpy nucleus.

It is much less common compared to cervical or lumbar disc herniation and is most often caused by the degeneration, dehydration and narrowing of the intervertebral disc as we age. An injury in the thoracic region of the back can also predispose to the appearance of a herniated disc.

If the herniated disc presses on a nerve root or a broken fragment of the disc penetrates the vertebral canal, manifestations such as:

➢ pain in the upper and/or middle part of the back and chest
➢ numbness and feeling of weakness in the upper and/or lower limbs
➢ headaches when sitting in certain positions
➢ problems with the bladder or intestinal tract

If the pain is mild or moderate, anti-inflammatory drugs help relieve the pain, but are indicated for short periods of time.

If the pain is intense, injections of corticosteroids (stronger anti-inflammatories) administered at the level of the painful area, in the epidural space (between the vertebrae and the spinal marrow), are useful for reducing pain and reducing inflammation around the nerve roots.

If the pain is also associated with muscle contracture, myorelaxant drugs help in this situation, but they are also recommended for short periods of time.

To reduce muscle contracture, heat is applied topically, in several sessions per day with a duration of 20-30 minutes. Always put a thin towel on the area where the heat is applied so as not to irritate the skin.

Ice applied topically, in six months of 15-20 minutes, several times a day, helps reduce pain and inflammation, as well as prevent tissue damage.

Always put a thin towel between the ice and the area on which it is applied.

It has an essential role in pain management and in treating a herniated disc.
Initially, programs of exercises and positions will be performed, aimed at:

➢ reducing the pain that most often accompanies the herniated disc
➢ improving mobility
➢ reducing the pressure on the nerve roots

As the proper exercises and positions are practiced, the pain will attenuate and the program of exercises can advance, aiming at:

➢ increasing stability, more precisely the ability to control the position and movement of the thoracic area
➢ increasing the muscular tonus for strengthening the back and preventing relapses and/or other injuries.

It’s necessary in few cases because thoracic disc herniation responds well to the treatment measures listed above.

The surgical approach is indicated in severe cases or in the situation in which a ruptured fragment of the intervertebral disc is pushed into the vertebral canal where the spinal cord is located. Through surgery, most of the time only the affected disc fragment is removed and only in a few situations, the disc is totally removed and replaced with an implant.

➢ Avoid activities that cause pain or affect the thoracic area

➢ Keep a proper posture, straight to alleviate the pressure on the intervertebral discs