Thoracic herniated disc exercises are an interesting topic for many reasons. First off, herniated discs in the thoracic region are rare to begin with and are almost always asymptomatic when they do occur. Second, exercise therapy seldom does anything to resolve truly problematic disc pain concerns, although it can work extremely well for the epidemic incidence of misdiagnosed herniated discs.
Finally, the thoracic spine does not need to flex as much, or as often, as other spinal areas. The thoracic region is also so well balanced and protected, with large and stable vertebrae and the added infrastructure provided by the ribs, that it is difficult for any care provider to speculate that the muscles here are inadequate to support the spine, which is always a common explanation for the benefits of exercise therapy.
This discussion takes a detailed look at the use of exercise to treat upper and middle thoracic herniations in the vertebral column.
Regardless of the seemingly illogical nature of using exercise therapy for disc pain, it is still prescribed far more than almost any other conservative option. Physical therapy has fostered great misconceptions in the back pain arena, stating that the verified benefits of herniated disc exercises prove it to be the most enlightened treatment technique.
However, how exercise works is not all too clear to even the best trained medical propagandist. Most therapists will detail how strong muscles will help support and protect the spine, but these tales are nothing more than fantasy. There is no proof of any such nonsense in the medical literature, and yet, exercise therapy does work so well in so many cases. Why?
Other doctors will claim that exercise will increase the healing response, but there is no evidence that increased metabolism in the affected area can resolve intervertebral herniation.
Exercise will not reverse intervertebral degeneration or cure a prolapsed annulus fibrosus. Exercise will not repair a damaged nucleus pulposus or take pressure off any compromised neurological tissue.
This being said, many patients do receive considerable, albeit usually temporary, relief when using targeted physical therapy for thoracic disc pathologies. Let’s explore some logical explanations for this occurrence.
One theorized reason why exercise and stretches work well for providing almost universal short-term benefits from herniated disc pain, and virtually all forms of chronic back pain, is not anything related to the efficacy of the therapy itself. The reason it works is simply because most back pain is grossly misdiagnosed as coming from a structural spinal irregularity, when all along the symptoms are sourced by soft tissue concerns, such as a regional ischemic syndrome.
When you consider this possibility, now the reason why exercise works so well is obvious. Pain exists in the muscles and exercise helps to target these structures with positive benefits. Ischemia is an oxygen deprivation condition and active exercise and stretching are well documented to increase region circulation and therefore oxygenation of the involved tissues. Although the effect is temporary in every case, exercises will relieve ischemia. Now the explanation makes more sense. Too bad more therapists have the right goal in mind, but the wrong reason for doing it.
Exercise is great for the body and encouraging patients to perform fitness-based activities is far better than loading them up on dangerous drug treatments. However, patients must be better educated concerning the limits of exercise therapy and should not expect their herniation to suddenly resolve simply by participating in physical therapy. This is an unrealistic goal.
That being said, there is no reason to think that the herniation necessarily needs to resolve in order for the pain to stop. Many disc abnormalities are not symptomatic and others can stop creating symptoms, even when they remain or worsen degeneratively with continued aging.
For patients with verified structural disc pain and nerve impingement or spinal stenosis issues related to intervertebral pathology, exercise often escalates the symptoms, helping to reinforce the validity of the diagnosis.
We are outspoken advocates of all forms of exercise. We believe that any constructive method of pain relief is far superior to any risky or pharmaceutical approach. However, we also have a serious problem with the way patients are treated in certain aspects of the disc pain treatment process.
We find many patients are misled or simply never informed about the gross limitations of exercise therapy. We continually receive letters from patients who have completed their course of physical therapy and wonder why they still have pain. This fact tells us that doctors are not doing their jobs correctly and patients are being mishandled in the treatment industry. Unfortunately, this is business as usual in the back and neck pain arena.
We encourage patients to get involved in exercise therapy to help them to live better, become healthier and manage their pain. We do not encourage patients to place too much hope for a complete cure for any pain that is actually coming from a thoracic herniation. Patients might have better results from exercise if their pain has been misdiagnosed, which is a terribly common problem within the treatment sector as a whole.
We also encourage patients to diversify their types of exercise therapy and to find activities that they enjoy. Calisthenics and other typical physical therapy methods are fine, but patients will stand to gain far more from interest-based activities that might be integrated into life far into the future. These pastimes include swimming, tai chi, Pilates and yoga.
Please share your own results of exercise treatment on our herniated disc forum. Your experiences will assist other patients in finding the best path towards a cure.