The thoracic spine forms the posterior portion of the thoracic cage (rib cage), which houses and shields the heart, lungs, and major blood vessels. The kyphotic curve of the thoracic spine — a natural outward curve of approximately 20–40 degrees — balances the inward lordotic curves of the cervical and lumbar regions to maintain upright posture. When this kyphosis becomes excessive, it creates the rounded-back posture known as hyperkyphosis or “dowager’s hump.”

Because of the rib cage’s stabilizing effect, thoracic disc herniations are far less common than in the cervical or lumbar spine — accounting for only about 0.25–0.75% of all disc herniations. However, when they do occur, they can cause chest pain, mid-back pain, and in severe cases, thoracic myelopathy from spinal cord compression.

Dr. Alok Sharan is a Castle Connolly Top Doctor and NY Magazine Best Doctor who has treated hundreds of patients with thoracic spine conditions over his 20+ year career. He is fellowship-trained at NYU Hospital for Joint Diseases and serves as Deputy Editor of Clinical Spine Surgery, with over 100 peer-reviewed publications on spinal surgery outcomes.

Most thoracic spine conditions are initially managed conservatively with physical therapy, activity modification, and pain management. When surgery is required, Dr. Sharan evaluates each patient for minimally invasive approaches including:

Thoracic Laminectomy / Decompression — removal of the lamina to relieve pressure on the spinal cord or nerve roots. Where appropriate, Dr. Sharan uses regional anesthesia through his awake technique for faster recovery and same-day discharge.

Kyphoplasty — a minimally invasive procedure for vertebral compression fractures in which a balloon is inflated to restore vertebral height before bone cement is injected. This can provide dramatic and rapid pain relief. Located at 35-37 Progress St., Suite B5, Edison, NJ 08820, Dr. Sharan’s practice is accessible from throughout New Jersey.

Why is the thoracic spine less prone to herniated discs than the lumbar or cervical spine?

The rib cage provides significant external stabilization to each thoracic vertebral segment, greatly reducing the range of motion and mechanical stress placed on the discs. This stability is protective — though it also means that when a thoracic disc does herniate, the spinal cord is at greater risk because the canal is narrower at this level.

What is Scheuermann’s kyphosis?

Scheuermann’s kyphosis is a structural form of hyperkyphosis that develops during adolescence when the vertebral bodies grow unevenly, creating a wedge shape. Unlike postural kyphosis, it cannot be corrected simply by standing up straight. Severe cases may require bracing or, in rare situations, surgical correction.

Can a compression fracture heal on its own?

Many vertebral compression fractures heal with conservative treatment — rest, bracing, and pain management — over 6–12 weeks. For fractures causing severe pain or progressive collapse, kyphoplasty can quickly restore vertebral height and provide pain relief. Dr. Sharan will evaluate imaging to determine the best approach.

How is thoracic back pain different from lower back pain?

Thoracic pain typically has a different character — often a sharp, band-like pain that may wrap around the chest, or a persistent aching in the mid back between the shoulder blades. Lower back (lumbar) pain more commonly radiates into the buttocks or legs. Call (732) 898-3950 for an evaluation.