The Frequency Of Thoracic Disc Herniation In Patients Presenting With Chronic Upper Back Pain And The Long-Term Follow-Up Results Of These Cases

Emine Dundar Ahi

Kocaeli Health and Technology University, Turkey

Biography :

Emine Dundar Ahi, MD, is a Phys­ical Medicine and Rehabilitation Specialist with over 10 years of clinical experience. She is cur­rently an Assistant Professor in the Department of Physiothera­py and Rehabilitation at the Fac­ulty of Health Sciences, Kocaeli Health and Technology Universi­ty. Her academic and clinical in­terests focus on musculoskeletal disorders, chronic pain manage­ment, and comprehensive reha­bilitation approaches. She has authored more than 20 national and international scientific pub­lications and actively contributes to both clinical practice and ac­ademic education through evi­dence-based, patient-centered rehabilitation strategies.

Abstract :

Chronic upper back pain is a frequent clinical complaint with multifactorial etiologies and a substantial impact on quality of life. Thoracic disc herniation (TDH), although considered relatively uncommon, may be an underrecognized cause of persistent thoracic pain. This study aimed to determine the frequency of TDH in patients presenting with chronic upper back pain and to evaluate long-term clinical outcomes fol­lowing conservative management. This retrospective study included patients who presented to the Physical Therapy and Rehabilitation outpatient clinic with chronic upper back pain and were followed for at least one year between 2016 and 2023. TDH was diagnosed using thoracic spine magnet­ic resonance imaging. Patients received medical treatment (analgesics and myorelaxants) alone or in combination with physical therapy. Gabapentin was added in patients with in­sufficient response and predominant neuropathic pain. Pa­tients with persistent pain despite these interventions were referred to the algology department for transforaminal epi­dural injection. Demographic characteristics, treatment mo­dalities, visual analog scale (VAS) pain scores before and after treatment, presence of neuropathic pain, and hernia­tion stage were retrospectively recorded and statistically an­alyzed. The frequency of TDH among patients with chronic upper back pain was 39.67%. Neuropathic pain features were identified in 86 patients (44.32%). A statistically significant reduction in VAS pain scores was observed after treatment compared with baseline in all patients (p < 0.001). None of the patients required surgical intervention during follow-up. Conservative treatment approaches, including medical ther­apy, physical therapy, and interventional pain management, are effective in relieving pain in patients with chronic upper back pain associated with TDH, reducing the need for surgi­cal treatment.