Thoracic spine radiculopathy: treatment options

Patient

Q: I have constant mid back back that radiates into my chest and rib cage. Shocking sensations, pins and needles, and aching. I had an MRI which relieved 3mm broad based disc bulge at t5-6, 3mm posterior disc bulge at t7-8, 3mm posterior disc bulge at t8-9 with effacement of the CSF collar, 5mm posterior disc bulge at L1-2 with thecal sac narrowing. I had nearly 6 months of physical therapy, 2 epidural injections, manipulation and traction. Nothing seems to resolve this, am i now at the point of surgery or is there another alternative. This was said to be a repetitive strain injury of the thoracic spine.

Doctor

A:    Degenerative disc disease produces changes in the vertebrae that along with the bulging disc are causing a nerve compression which is the cause of the pain. The treatment options depend on the age, severity of the pain, neurologic symptoms present and if you have some other associated health issue. The first approach is conservative as a Physical Therapy program aimed to control pain and inflammation along with anti-inflammatory medication, if there is no improvement and with time the pain is getting worse and intractable you should get a reevaluation by an orthopedic surgeon to decide if Surgery might be consider as a treatment option for you to avoid more damage to the impinged root nerves and possibly improve the pain.

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