Thoracic and Lumbar
CONDITIONS AND PATHOLOGIES OF THE THORACIC SPINE
CAFE' AU LAIT MACULES: Light brown colored birthmarks that can change in size, shape, and shade from birth until roughly 2 years old. These spots are generally associated with spinal neurofibromatosis, a genetic condition that causes tumors to grow on nerves and affect developement and growth. Sevarity can range from mild to disabled, depending on where the tumors are on the spine. Symptoms generally worsen with age. There is no treatment, but symptoms can be managed.
DISLOCATION/SUBLUXATION: Generally caused by high speed impacts (car accidents, falling from a height), dislocations can be devestating. Fractures usually occur as well during the impact, which can cause the spinal cord to be severed or severely damaged. Most patients do not recover fully from a spinal dislocation, but intensive therapy can be used to regain or relearn skills lost from the incident. If you suspect a spinal dislocation, do not move the victim. Hold c-spine and try to keep them calm.
THORACIC SPRAIN/STRAIN: Caused by overexertion of the thoracic muscles through heavy lifting, activity, or even coughing from illness. Depending on the sevarity of the injury, ice, NSAIDs, and light stretching are generally the first steps during treatment. Ultrasound, massage, and stim can all help to relieve pain. Bracing or taping would be ineffective due to the contriction it would cause on the lungs. Exercises that work the upper chest muscles and other back muscles would be appropriate to strengthen the surrounding area.
CONTUSION: This injury occurs due to blunt trauma, like being struck with a baseball. Contusions can be very mild and painless, to extremely painful. Treatment includes massage, ice, NSAIDs, or even ultrasound. If the patient plays a contact sport, a donut pad can be applied to the area to diminish impact. Make sure to document daily the progress of the contusion. If it becomes hard, then remove athlete from play immediately and refer to a specialist.
INTERVERTEBRAL DISC PATHOLOGY:
A tear in the spinal disc caused by excessive extension, a direct blow, or a twisting motion. The nucleus leaks out through the annulus and irritates surrounding structures. Pain with all motions and point tenderness between the vertebrae could indicate this condition. RICE and NSAIDs are recommended at first in conservative treatment, with surgery as an option as well. These can occur anywhere in the spine. In conjunction with this, NERVE ROOT COMPRESSION can occur.
KYPHOSIS: An excessive kyphotic curve caused by aging. Strengthening of the erector muscles can help improve posture as well as bracing.
SCOLIOSIS: Congenital abnormal curvature of the spine, laterally to medially. Signs and symptoms include visible/palpable curvature, overall back pain, uneven hips or shoulders, and uneven gait. Bracing, surgery, and rehabilitation can help decrease the curvature and decrease overall pain and discomfort.
FACET JOINT SYNDROME: Overuse or sudden, uncontrolled movements that cause inflammation of the facet joints. Stiffness, pain with movement, hunched posture and pinched nerve sensations could all indicate this condition. Rest, steroid treatments, ice or heat, and NSAIDs can all help reduce inflammation.
