What is Thoracic Spine and Chest Wall Pain

The term "thoracic spine and chest wall pain" refers to discomfort or suffering felt in the middle and upper back regions, specifically in the thoracic spine area, which encompasses the 12 vertebrae located between the neck and lower back. It can also encompass pain originating from the chest wall structures, such as the ribs, muscles, and connective tissues.

Types of Thoracic Spine and Chest Wall Pain

• Muscular pain: Discomfort arising from strained or overworked muscles in the thoracic region.

• Rib-related pain: Pain originating from the ribs, often due to fractures, inflammation (costochondritis), or rib joint dysfunction.

• Spinal disc-related pain: Pain from spinal stenosis herniated discs, or degenerative disc disease affecting the thoracic spine.

• Nerve-related pain: Pain that is caused by a compressed or irritated nerve, such as thoracic radiculopathy or intercostal neuralgia.

• Postural pain: Discomfort arising from poor posture, such as kyphosis (excessive rounding of the upper back) or scoliosis.

Common Conditions under Thoracic Spine and Chest Wall Pain

• Thoracic sprain or strain: Overstretching or tearing of muscles or ligaments in the thoracic region. 

• Costochondritis: Inflammation of the cartilage connecting the ribs to the breastbone.

• Thoracic herniated disc: A thoracic herniated disc is a rupture of the intervertebral disc that causes nerve discomfort and pressure.

• Thoracic spine arthritis: Degenerative changes or inflammation in the facet joints of the thoracic vertebrae.

• Thoracic compression fracture: A fracture in one or more of the thoracic spine's vertebrae is called a thoracic compression fracture.

Causes of Thoracic Spine and Chest Wall Pain

• Poor posture or ergonomics.
• Trauma or injury, such as from sports activities or accidents.
• Repetitive motion or overuse injuries. 
• Degenerative conditions, like arthritis or disc degeneration.
• Irregularities in the structure, like kyphosis or scoliosis.
• Inflammation or infection of the chest wall structures.
• Vertebral fractures due to osteoporosis or trauma.

Symptoms of Thoracic Spine and Chest Wall Pain

• Aching or dull pain in the middle or upper back.
• Pain that worsens with movement or certain positions.
• Radiating pain along the ribs, chest, or arms.
• Muscle stiffness or tightness in the back.
• Tenderness or sensitivity to touch in the affected area.
• Difficulty taking deep breaths or breathing deeply.
• Numbness, tingling, or weakness in the arms or fingers (if nerve involvement is present).

Diagnosis of Thoracic Spine and Chest Wall Pain

Accurate diagnosis of thoracic spine and chest wall pain involves a thorough evaluation by a healthcare professional. Diagnosis methods may include

• Medical history assessment: Gathering information about symptoms, medical conditions, and potential triggers.

• Physical examination: Palpating the affected area, assessing posture, and checking for tenderness or abnormalities.

• Imaging tests: X-rays, MRI scans, or CT scans may be ordered to visualize the spine, ribs, or soft tissues.

• Diagnostic injections: Local anesthetic injections into specific structures can help identify the source of pain.

• Electromyography (EMG) or nerve conduction studies (NCS): These tests evaluate nerve function and identify any abnormalities.

What parts of the spine cause Chest Pain

The following structures may be to blame for chest pain from the spine

• Thoracic vertebrae: Intervertebral discs, facet joints, or the surrounding ligaments and muscles can all cause pain in the thoracic vertebrae.

• Nerves: Irritation or compression of nerves in the thoracic spine can transmit pain signals to the chest wall.

How do you know if Thoracic Spine and Chest Wall Pain is serious

Determining the seriousness of thoracic spine and chest wall pain requires professional evaluation. However, certain signs may indicate a potentially serious condition, including

• Severe, persistent, or worsening pain.
• Pain accompanied by difficulty breathing or shortness of breath.
• Chest pain spreading to the arm, neck, jaw, or abdomen.
• Bowel or bladder dysfunction.
• History of trauma or recent injury.
• Arms or legs experience numbness, tingling, or weakness.
• Heart rate fluctuations, fainting, and chest discomfort are all related.

Interventional Pain Management of Thoracic Spine and Chest Wall Pain: 

Interventional pain management techniques can be beneficial in addressing thoracic spine and chest wall pain. Some common interventional treatments include

• Facet joint injections: These injections deliver corticosteroids and numbing medications into the facet joints to reduce inflammation and relieve pain.

• Epidural steroid injections: Administered into the epidural space surrounding the spinal cord, these injections can alleviate pain caused by disc herniation or spinal stenosis.

• Radiofrequency ablation: A procedure that uses heat to disable nerves responsible for transmitting pain signals, providing longer-term pain relief.

• Intercostal nerve blocks: Local anesthetic injections target the intercostal nerves, reducing pain originating from the ribs or chest wall.

• Spinal cord stimulation: Involves implanting a device that delivers electrical impulses to the spinal cord, altering pain perception and providing relief.