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Thoracic Pain

Discussion in 'Pain Medicine' started by mehul_25, Mar 22, 2007.

  1. mehul_25

    mehul_25 Dude!!! 10+ Year Member

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    Jun 25, 2000
    Washington DC
    Any thoughts on treatment for thoracic pain (T5-7) spinous process tenderness, left paraspinal spasm, no new compression fractures. Thoracic ESI previously unsuccessful.
     
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  3. lobelsteve

    lobelsteve SDN Lifetime Donor Lifetime Donor Classifieds Approved 10+ Year Member

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    Canton GA
    T4-7MBB with little data to support it.
    Dreyfuss ISIS 1997 Science Newsletter reviewed thoracic pain.
     
  4. Ligament

    Ligament Interventional Pain Management Physician Lifetime Donor SDN Advisor Classifieds Approved 10+ Year Member

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    Assuming your diagnostic workup is benign, consider sending to PT to mobilize the spine and stretch the paraspinals. Have an Osteopath or Chiropractor manipulate/adjust the T-spine a couple times to see if it helps. If not, then move on to more invasive, costly, and dangerous procedures!

    EDIT: sorry mehul, I just remembered you are a physiatrist so you probably already tried the above.

    If the thoracic MBB are of no use, could consider thoracic discogram as a diagnostic tool. If you don't want to do that (considering the very difficult anatomy at those levels), could try paravertebral blocks in the hope that in the process of blocking the gray rami and sinuvertebral nerves you might get some lasting relief if you are lucky.
     
  5. Disciple

    Disciple Senior Member 10+ Year Member

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    Oct 18, 2004

    Inject supra/interspinous ligaments, PT program based on scapular stabilzation, rib mobilization, myofascial release.

    If unsuccessful inject thoracic facets/costovertebral joints.
     

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