Physiotherapy for nerve root compression in thoracic spine

A nerve root compression (radiculopathy) in the thoracic spine describes the narrowing of a nerve root in the thoracic spinal canal (belonging to the thoracic cavity) of the spine. Entering and exiting nerve fibers and fiber bundles in the spinal column are compressed. A herniated disc (prolapse), protrusion of the intervertebral disc (protrusion) or sequestration are possible typical triggers.

Another term for this clinical picture is nerve root syndrome. Depending on the localization, lumbar, thoracic or cervical nerve root compression is differentiated. A nerve root compression in the thoracic spine is represented by about 2%.

Physiotherapy

The physiotherapeutic treatment for nerve root compression consists first of all in pain reduction. The aim is to relieve the spinal column and pain-relieving measures such as electrotherapy, massages, stretching, relaxation baths and heat applications. More specific techniques such as sling table treatment, mobilization of the spinal column section without load or the “Mc-Kenzie” therapy can also be applied.

As soon as the extent of pain and movement is within an adequate range, the aim is to stabilize the abdominal and back muscles. Isometric exercises are often used for this. Very well known are isometric tensing techniques according to “Brunkow”.

Also classical concepts from the “Back School” or techniques from “Brügger” are used to improve posture and trunk stability. In the beginning, exercises in the supine, prone or quadruped position are optimal, since the intervertebral discs are put under minimal strain. The goal at this stage is to create muscular compensation for the bony (osseous) or joint-related (articular) deficits.

A combination of traction techniques (traction) can, as far as painlessly possible, improve the metabolic function of the intervertebral discs. Depending on the individual case, this must be adapted individually and pain-adapted. As soon as muscular stabilization is achieved and the patient is able to walk painlessly, an optimization of the gait pattern, posture and training for everyday life is aimed for.

Heavy lifting, incorrect bending, unfavorable sports, repetitive movement patterns, lack of fluid intake, lack of sleep and work ergonomics should be addressed by the physiotherapist and he should clarify in which area optimization possibilities exist. More detailed information can be found in our articles: Physiotherapy gait training Exercises for gait disorders Postural training As soon as muscular stabilization has been achieved and the person concerned is able to walk without pain, the aim is to optimize the gait pattern, posture and provide training for everyday life. Heavy lifting, incorrect bending, unfavorable sports, repetitive movement patterns, lack of fluid intake, lack of sleep and ergonomics at work should be addressed by the physiotherapist and he should clarify in which areas there is room for improvement.

More detailed information can be found in our articles:

Physiotherapy gait training
Exercises for gait disorders
Posture school

Brunkow stem guide Put yourself in supine position. Adjust both legs. Press the heels firmly into the pad.
Feet and toes are pulled towards the body. Tense the stomach. The arms push towards the feet.

The chin is brought towards the chest. Now hold the entire body tension for 10 seconds. Relax for 5 seconds and repeat the exercise about 5-10 times.

You should not make a hollow back or hold your breath during this exercise.
Breaststroke in prone position Get into prone position. The legs are stretched out. Now perform swimming movements like in the classic breaststroke.
The upper body must be lifted from the surface. Concentrate on large, cleanly executed movements. Repeat the exercise depending on your constitution.

Classic symptoms are intense pain in the compressed nerve root segment with a partially radiating character.

Paresthesia and paralysis can also occur. Furthermore, tension and back pain can often be observed. Paralysis (pareses) as well as atrophied back muscles can also be found.

Relaxed postures are therefore often found in this clinical picture. In addition, ischialgia, reduction of reflexes and functional disorders of the intestinal and bladder activity can occur. Compression of the spinal column during jumps, running up and down stairs, abrupt movements, laughing or coughing often leads to an increase in the symptoms.You can find more exercises in our articles

Stretching position with respiratory therapy In the supine position, stretch your legs and arms in a vertical line away from the body.
Hold this position for a period of 3-4 breaths. Now also relax for a period of 3-4 breaths. Afterwards the stretching takes place again.

Repeat this exercise according to your capacity.
Stretching on the wall Place yourself about one foot away from a wall. Now walk up the wall with your hands until you have reached a maximum extension of your arms and spine. Hold this position for about 20 seconds.
Now try to pull yourself further into the stretching position with your fingers.
Cobra exercise Put yourself in the prone position. Move into the forearm support. Only the upper body may lift off the floor, the pelvis remains on the support.
Hold this position for about 10 seconds. After a short break try to support yourself even higher by stretching your arms. Hold this position for about 10 seconds. Additional stretching of the head increases the intensity of the exercise.