The thoracic spine, or mid back, is the largest section of the back and includes 12 vertebrae, with an intervertebral disc in-between each. The vertebrae are the bony building blocks of the back and spine. They are designed to protect the spinal cord, provide support and structure to the spine, and carry the weight of the head, neck and trunk. The vertebrae of each section of the spine are slightly different and specific to the function of that area.
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Facet joints are synovial joints, which have a smooth shiny contact surfaces called articular cartilage. The articular cartilage allows the bones to slide freely over each other with reduced friction and stress. Each joint is also surrounded by a protective sleeve called a capsule, and is lubricated by synovial fluid. The facet joints can become irritated and inflamed producing pain and dysfunction.
Each thoracic vertebra has a pair of ribs, one on each side. The twelve ribs form the thoracic cage and serve to protect the vital organs of the body (lungs, heart, liver, kidneys etc.) The nerves of the thoracic spine provide sensory and muscle innervations to the trunk and part of each arm. Additionally, the internal organs of the body supply these nerves.
The thoracic spine has less movement than the cervical and lumbar spine. The greatest amount of movement is forward bending or flexion. The ribs limit side bending and rotational, or turning, motions of the mid back.
Degenerative joint disease is a common cause of back pain. The spinal facet joints, like other synovial joints of the body, are susceptible to wear-and-tear, degeneration, inflammation and arthritic changes. Inflammation and degenerative changes to the facet joints may result in pain, loss of motion, and severe encroachment or pinching of the nerve exiting the spinal column. Common causes of facet joint irritation include the following:
The symptoms of the degenerative joint disease will depend on the location of the joint and what structures are affected. Symptoms can vary from mild to severe and may mimic the symptoms of a disc problem:
Treatment of degenerative joint disease or injury will depend on the severity of the condition. When treating acute back problems:
In addition to performing a thorough examination your physician may order the following tests to make a more concise diagnosis:
Your physician may recommend several medication options individually or in combination to reduce the pain, inflammation and muscle spasm that may be associated with facet joint injuries.
In the case of conditions that do not respond to conservative care, surgery may be indicated. If you continue to experience some of the following symptoms:
Injections like facet injections, nerve blocks or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.
Surgical Procedures to reduce the affects of degeneration on pain producing structures of the spine.
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Dr. Eric D. Freeman is a top-rated, best-in-class pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New Jersey and the country. He is an award-winning expert and contributor to prominent media outlets.
Dr. Eric D. Freeman has been recognized for his thoughtful, thorough, modern approach to treating chronic pain. He has been named a “top pain management doctor in New Jersey” and one of “America’s Top Physicians” for advanced sports injury treatments.
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