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Pain in the thoracic spine, intercostal neuralgia

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Symptoms of pain in osteochondrosis of the thoracic spine

Symptoms of back pain haunt a person in adulthood and are associated with his lifestyle. Patients with symptoms of pain in osteochondrosis of the thoracic spine, as a rule, lead a sedentary lifestyle (working at a computer, long-term driving, studying, breastfeeding, etc.) or hypothermia. Less often, pain symptoms appear in patients with mobile work, as well as in those leading an active lifestyle (swimming, gymnastics, fitness, etc.).

Localization of typical painful trigger points in fibromyalgia (muscle pain) in the thoracic spine.

Complaints in patients with a symptom of pain in osteochondrosis of the thoracic spine are as follows:

  • pulling pain between the shoulder blades
  • burning between the shoulder blades
  • pain in the region of the heart and under the chest when moving and at rest
  • girdle pain between the ribs in the armpit
  • pain in the thoracic region during prolonged sitting at the end of the day or after sleep etc.

Pain in the thoracic spine is primarily muscle in origin. When examining patients at an appointment with our specialists, we always find trigger points in the most typical places in the muscles of the thoracic spine and the chest in general. The intercostal muscles and the extensor muscles of the spine hurt most often with osteochondrosis of the thoracic spine. Less commonly, pain can be localized in the adductor muscles of the shoulder or pectoral muscles.

Also, the source of pain in the thoracic spine may be the origin of the tendon, ligament, joint capsule, vertebral body, or its processes:

  • pain in the thoracic spine in the projection of the intervertebral joints
  • pain in the thoracic spine at the points of attachment of the rib head to the vertebral bodies
  • pain in the thoracic spine at the points of attachment of the rib head to the sternum

These sources of pain (tendon, ligament, joint capsule, vertebral body, or its processes) in the thoracic spine are most often associated with trauma to these structures of the spine and the chest as a whole (falls, sudden heavy lifting, awkward movements).

Decreasing the height of the discs and vertebral bodies increases the deformity of the spine, causing pain in the thoracic region.

Decreasing the height of the discs and vertebral bodies increases the deformity of the spine, causing pain in the thoracic region.

 

Symptoms of pain in intercostal neuralgia

Symptoms of pain in intercostal neuralgia are burning around the chest in the projection of the ribs of pain. By origin, these pains with intercostal neuralgia can be of a viral or traumatic nature. Very often, patients themselves confuse intercostal neuralgia with muscle pain against the background of osteochondrosis of the thoracic spine.

With a viral infection, herpes zoster (varicella-zoster, "shingles") is actively dividing the virus itself in the myelin sheath of the intercostal nerve. Pain in intercostal neuralgia as a result of herpes is piercing, "dagger" in nature in contact with seemingly healthy skin in the intercostal space. Before the onset of pain in intercostal neuralgia as a result of herpes, during the incubation period, the patient will experience itching at the site of the virus.

In intercostal neuralgia, as a result of herpes zoster, painful blisters appear on the skin above the projection of the intercostal nerves.

After maturation, there is a rash of blisters on the skin, filled with a clear liquid and extremely painful when clothing or bedding touches them during sleep.

Traumatic injuries of the chest, leading to compression or irritation of the intercostal nerve sheaths, manifest as acute local or girdle pain along with the intercostal space. These pains can radiate to the chest from the side of the damage to the intercostal nerve.

 

Diagnostics of the symptom of pain in the thoracic spine

Diagnosis of osteochondrosis of the thoracic spine and intercostal neuralgia is not difficult. When examining patients, sources of pain are revealed during palpation, functional tests (examination in motion), and examination of the skin. In case of doubt about the diagnosis of osteochondrosis of the thoracic spine and intercostal neuralgia, additional hardware methods for examining the thoracic spine and chest can be prescribed.

Multispiral computed tomography (MSCT) of the thoracic spine.

According to the results of a doctor's consultation, if necessary, a patient with a symptom of pain in osteochondrosis of the thoracic spine of intercostal neuralgia may be assigned the following additional diagnostic procedures:

  • X-ray of the thoracic spine
  • CT scan of the thoracic spine
  • MRI of the thoracic spine
  • blood test for viral infection

 

Treatment of the symptom of pain in the thoracic spine

Depending on the severity of the manifestations and causes of pain in osteochondrosis of the thoracic spine and intercostal neuralgia, the patient may have the following therapeutic actions:

  • drug therapy (NSAIDs, analgesics, hormones, antiviral drugs, B vitamins)
  • therapeutic injections - injections of drugs into painful intercostal and paravertebral muscles
  • manual therapy (soft muscle, osteopathic technique)
  • physiotherapy (physiotherapy UHF, TENS, etc.)
  • exercise therapy
  • acupuncture
  • surgical treatment

In the intervertebral (facet) joints with osteochondrosis of the thoracic spine, therapeutic blockages can also be performed. Blockages are used when conventional treatment for thoracic spine pain and intercostal neuralgia is not consistently beneficial.

The use of acupuncture is very effective in the treatment of pain in osteochondrosis of the thoracic spine and intercostal neuralgia.

Manual therapy of the thoracic spine.

To carry out a therapeutic injections for osteochondrosis of the thoracic spine and intercostal neuralgia, sufficiently low doses of an anesthetic (novocaine, lidocaine) and cortisone, diprospan or kenalog, injected into the lumen or near the affected joint, as well as in the projection of painful muscle seals and points of passage along the intercostal nerve intercostal space.

In the case of pain in the muscles or ligaments and capsules of the joints in osteochondrosis of the thoracic spine, the duration of outpatient treatment can be 1.5-2 weeks, starting from the moment of the onset of acute pain.

Therapeutic injections are used to relieve pain in the thoracic spine and intercostal neuralgia.

In the case of pain in viral intercostal neuralgia (especially in the elderly or debilitated patients), outpatient treatment of neuralgia may last from 0.5 to 1.5 months.