Herniated Disc Upper Back: Symptoms, Causes, & Treatments

If you're experiencing upper back pain, it might be a symptom of a herniated disc in the thoracic region. 

This article explains the connection between a herniated disc and upper back discomfort. We'll cover potential causes, diagnostic processes, and available treatment options. Additionally, you'll find helpful advice on how to prevent such issues from occurring in the first place.

What is a herniated disc in the upper back?

"Herniated" is related to the word "hernia," which is the protrusion of an organ through a defect in the structure which holds it in place.

Discs are the cushion-like pads that sit between the vertebrae – the bones that make up the spine.

The most common type of hernia occurs in the belly or groin, when a gap in the muscular wall of the abdomen allows a section of the intestine to push through. When a hernia occurs with a disc, part of the fibrous outer layer of the disc has become weak. This allows the gel-like inside of the disc to push outwards.

Imagine each disc in your spine as a jelly-filled doughnut. The dough is the outer layer of the disc, and the jelly is the center. Now imagine some of the jelly oozing out. This is what happens in a herniated disc.

Herniated discs are most common in the lower back (the lumbar spine), but can also occur in the mid and upper back (the thoracic spine) and the neck (the cervical spine). When they do happen in the upper back, it’s more likely to be in the lower end of the thoracic spine, which is the most flexible part of this region¹.

A herniated disc often produces no symptoms at all, and host hernias heal themselves and do not need surgery. However, in some cases the disc can put pressure on the nerves of the spinal cord and the gel center of the disc can irritate the nerves if they come into contact. If this happens in the upper back, pain or other symptoms can spread to the shoulders or neck. Early diagnosis helps treat the problem and avoid potential complications.

Thoracic herniated disc symptoms

A herniated disc, or herniated disc in the upper back, may produce various symptoms including pain, numbness, and weakness. The typical symptom is sharp, central back pain, which is aggravated by motion. Other symptoms of a herniated disc in the upper back include:

• Electric or burning pain that is localized to the back or around the chest or abdomen.
• Shock-like, sharp pain that may radiate down into the legs.
• Numbness and tingling that may be experienced at or below the level of the herniation.
• Weakness of the muscles that may cause problems with walking. In severe cases, the legs could become paralyzed and bowel and/or bladder dysfunction may occur.

The symptoms of a herniated disc in the upper back are often complex and can vary extensively from one person to another. They may even sometimes seem to resemble heart or stomach problems, which can make diagnosis a bit tricky.

However, a herniated disc that doesn't necessarily always lead to back pain, or any other symptoms. In one study, 90 people who were completely asymptomatic had an MRI of their thoracic spine. Thirty three of these people had a herniated disc, but no pain²!

Causes & risk factors

A herniated disc can occur for various reasons. Aging, injuries, genetics and lifestyle can all play a role, but it can happen to anyone.

The most common causes are as follows.

Degenerative disc disease

As you grow older, the intervertebral discs that cushion your movements naturally show signs of aging, in much the same way as your hair will probably turn gray and your skin will become wrinkled. This is known as degenerative disc disease. But, despite the name, it’s a completely normal and usually painless sign of aging.

Over time, the discs can lose some strength and resilience, becoming more susceptible to herniation. Picture this process like a rubber band that has been stretched too many times, becoming brittle and more likely to snap under pressure.

Trauma & injury

Unexpected events such as a car accident, a fall, or a particularly wrong step while engaging in a vigorous tennis match may produce significant shock to the spine. In some of these cases, the thoracic region can experience stress that leads to a herniation.

Genetic factors

Research indicates that your genetic make-up – what you inherited from your parents – can make you more susceptible to a herniated thoracic disc.

Typically, men, especially those between 40 and 60 years old, are more commonly afflicted with this burdensome spinal condition. This also suggests that there may be an intersection of genetic factors with gender and age-specific degenerative processes that can exacerbate the risk of experiencing a herniated disc in the upper back.

Lifestyle factors

Neglecting your overall health through certain lifestyle choices can significantly elevate the risk of herniated discs.

Ignoring the importance of a healthy diet can promote inflammation and can hinder your body's natural healing processes. Smoking is also an important risk factor.

Regular exercise might be one of the most important lifestyle factors. Gentle aerobic exercise, such as swimming, can improve blood flow and boost your overall health, which in turn can promote disc health.

Heightened stress levels can also increase your chances of back pain by reducing disc cell regeneration and heightening the sensitivity of your nervous system -– a process that is known as central sensitization. While these factors may not cause disc herniation directly, they can increase the risk. They will also exacerbate the pain responses if you already have a herniated disc³.

Diagnosing thoracic herniated disc

In many cases, you don’t need to have specific scans or tests to get effective treatment for your back pain. However, your doctor might recommend medical imaging techniques, such as MRI and CT scans, which can be used to view the spine and identify whether you have any injuries, whether it's a compressed nerve or an encroached spinal cord.

Treating thoracic herniated disc

Non-surgical treatment

Herniated discs often improve by themselves, without the need for surgery or other treatments. To help your recovery, and manage your symptoms, you can try the following methods:

• Activity and education: Learning about your body and your pain is often the first step on your journey to recovery, and will allow you to understand how to use physical activity and exercise to reduce your symptoms and make you stronger and more resilient over time.
• Physical therapy: Any exercise that increases your cardiovascular health, strengthens your body, and improves your flexibility can help to relieve your discomfort. And the best part is that any movement is good for you, so choose something that you enjoy.
• Stress management: Studies have shown that stress has a negative impact on regeneration of intervertebral disc cells and can also heighten our perception of pain⁴. Regularly practicing mindfulness and relaxation techniques can minimize thoracic herniated disc pain.
• Weight control: It’s not all about the number on the scales, but chat to your doctor or a nutritionist if you have questions about your weight and overall nutrition. Decreasing the load on your spine might make a difference.
• Medications: Simple pain relief can be used to manage the symptoms of a herniated disc. Anti-inflammatory drugs (such as ibuprofen) reduce swelling and inflammation around the nerve roots, while analgesics (such as paracetamol) help manage pain levels. Muscle relaxants may be used to ease muscle spasms.

Surgical treatment

Some people may require invasive treatment methods to resolve their symptoms. The most common surgical procedures include:

• Microdiscectomy: This procedure is used if a fragment of disc is compressing a nerve. The surgeon uses a microscope and precision tools to remove the fragment. Most patients are released on the same day or the following day.
• Anterior Cervical Discectomy and Fusion (ACDF): This surgery is performed to treat herniated discs in the cervical spine (the neck). The surgeon makes an incision in the front of the neck to reach the affected disc. The disc is removed, and a fusion procedure may be carried out to maintain spinal stability.

Prevention of thoracic herniated discs

The best defense against thoracic herniated discs is understanding the risk factors and taking appropriate preventative measures.

We’re often told that poor posture can cause back problems, but is it true? Well, it turns out that posture doesn’t actually impact the health of our backs. If you think about it, you probably know a few people who seem to have terrible posture, but who don’t experience pain, and probably one or two people who always stand up straight and yet do have some issues.

So what’s going on? 

If you feel that your workstation is awkwardly set up and you’re holding yourself in an uncomfortable position for long periods, taking a bit of time to set things up more ergonomically can make you more comfortable during your working hours. However, research shows us that rather than focusing on being rigidly upright, it’s more important to move regularly. If you work at a desk, take regular breaks to walk around, or spend time at a standing desk. If you’re on your feet a lot, try shifting your weight from one side to the other and taking breaks when you can.

Incorporating regular exercise into your routine, including general movement and exercises that strengthen the muscles around your spine, can both reduce and prevent pain.

By understanding and implementing these preventative strategies in your daily life, and focusing on enhancing your overall health and wellbeing , you can significantly decrease the chances of developing a thoracic herniated disc. Prevention is always better than cure, and taking care of your spine will greatly benefit your overall health and wellbeing.

When to seek medical attention

If your symptoms are new, or you are facing the challenges of back pain related to thoracic disc herniation that don't improve with time or lifestyle changes, it is important to consult a healthcare provider.

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