spinous process pain

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ED50

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I see a few patient's a year who have very focal pain over their spinous process. Imaging is clean so as best as I can tell it is a myotendinous injury. Any of you all see this? Treatment recs?

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interspinous ligament injection
 
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baastrup's disease. if the spinous processes are touching, you can inject the pseudojoint. i dont think you will get all that much mileage from a TPI or interspinous injection. maybe if there is an acute injury
 
I see a few patient's a year who have very focal pain over their spinous process. Imaging is clean so as best as I can tell it is a myotendinous injury. Any of you all see this? Treatment recs?

Lateral XR may show IVF degen with approximation of the spinous process yielding baastrop. There is bursa there or IS sprain. You can do an interspinous injection with the needle not past the spin Plano at line and inject and withdraw. I usually hit the inferior tip where SS ligament touches the laminate and you can inject there as well if you want to palpate and do like a TPI but deeper. Usually PT, nsaids, SMR improves over time conservatively
 
RF for Baastrups works reasonably well.
 
It’s called life syndrome haha… i get pain in those areas occasionally when I work out hard or do something weird around the house.. I suppose baastrups is possible as well..
 
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you should see findings on xray and definitely on MRI if it is Baastrups.

if it is Baastrups, it not likely resolve. at least, not for a while...
 
I always found it entertaining how we will come up with the most articulate and sometimes convoluted diagnoses for our patients but when it's us it's a crick.
Yes, I hate it when my staff tells me something hurts and I'm like I don't know maybe just take some ibuprofen?
 
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When it kills me, right before I die, I will know I was wrong.
GettyImages-174674454-told-you-i-was-sick.jpg
 
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