Disc herniation in the thoracic spine can cause a variety of symptoms. Small herniations can cause local thoracic pain. Larger protrusions can compress the nerve root and cause radicular pain manifested by radiating pain around the chest wall with some associated numbness.
Finally, a big enough central herniation can cause myelopathy or compression of the spinal cord. This can produce symptoms of numbness, weakness, imbalance and weird dysesthesias (water trickling or bugs crawling) in the legs.
The physical examination for myelopathy would demonstrate long tract signs (see website). If those are not present, the chance of myelopathy drops considerably.
Without myelopathy present, thoracic disc herniations should always be treated conservatively as surgery to resolve this disorder is not a small undertaking.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.