Pain is the most common symptom of a thoracic herniated disc and may be isolated to the upper back or radiate in a dermatomal (single nerve root) pattern. Thoracic back pain may be exacerbated when coughing or sneezing. Radiating pain may be perceived to be in the chest or belly, and this leads to a quite different diagnosis that will need to include an assessment of heart, lung, kidney and gastrointestinal disorders as well as other non-spine musculoskeletal causes. Within the spine itself there are also many other disorders that can have similar presenting symptoms of upper back pain and/or radiating pain, such as a spine fracture (e.g. from osteoporosis), infection, tumor, and certain metabolic disorders.