Thoracic Discogenic Pain Syndrome Follow-up

Updated: Aug 24, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Return-to-play criteria following thoracic disc herniation or thoracic discogenic pain syndrome require the athlete to be free of signs or symptoms due to the original injury, to have full range of motion, to have normal strength and flexibility, and to have healthy sport-specific mechanics. Athletes must be aware of their own limitations, a concept that is particularly important for individuals gradually returning to a competitive level of activity after an injury.



Trauma and strain due to sport-related injuries or other causes is implicated in only 20% of patients with thoracic disc herniations. In many of these cases, a twisting or torsional movement is involved. Minimizing forces on the spine through the use of proper mechanics in specific sporting activities is important. Additionally, strengthening the dynamic stabilizers of the spine to counteract the significant forces exerted on the spine during certain athletic activities is also important.

Maintaining proper flexibility plays a significant role in the prevention of injury in athletes of all ages. Additionally, an improvement in aerobic fitness can increase blood flow and oxygenation to all tissues, including the muscles, bones, and ligaments of the spine. Aerobic conditioning is a reasonable addition to any rehabilitation and prevention program.



The progression of symptoms in patients with thoracic disc herniation varies considerably. When seen in younger patients, traumatic disc herniations may later cause myelopathy. In middle-aged persons, in whom degenerative disc herniation is more common, the course of symptoms involving spinal cord compression is often more protracted.

In patients who present with unilateral symptoms, the progression of symptoms is often slower than that of patients who have a bilateral presentation. In any case, a patient without evidence of myelopathy should receive conservative treatment. A return to previous activity level occurs in approximately 80% of patients treated with nonsurgical measures. Patients with intractable pain, progressive neurologic deficits, or bilateral involvement often require surgical intervention.



See Prevention.