Thoracic pain occurs in the middle section of the spine. Because the ribs offer protection from injury, and this part of the spine is relatively stationary, thoracic injury and pain is not especially common. When it does occur, one of several medical conditions could be to blame.
Risk Factors for Thoracic Pain
People most at risk for thoracic pain may share one or more of the following characteristics:
• More than 40 years old
• Have sustained an injury
• Have spinal deformities such as scoliosis or a narrowing of the spine
• Have arthritis
• Do heavy physical labor
• Abuse drugs
• Exercise rarely or not at all
• Are in poor physical shape
Conditions That Cause Thoracic Pain
One source of thoracic pain is stenosis, a narrowing of the spinal cavity that causes pressure on the spinal cord. Other sources of painful compression include injury, arthritis, scoliosis or tumors. Hematomas, or trapped clots of blood, can also compress the nerves.
A compression fracture is another source of thoracic pain. Most commonly, this type of fracture results from osteoporosis, a disease that makes bones thin and brittle. Compression fractures in the thoracic area may go undetected when they first occur, but they become gradually more painful. Sometimes, however, compression fractures cause immediate, cutting pain.
Thoracic spondylosis, also called osteoarthritis of the spine, is another possible source of pain. It may be the result of normal wear and tear on the spinal column. This condition, like osteoporosis, worsens with age. The majority of people 60 years and older have some symptoms of spondylosis, either in their lumbar, cervical or thoracic regions. Symptoms of thoracic spondylosis include:
• Pain in the middle back when bending backward
• Pain in the spine when moving it forward and back
• Loss of balance
• Loss of bladder/bowel control
Another thoracic irritant is post-herpetic neuralgia, a byproduct of shingles. Medical researchers believe that the chicken pox virus retreats to the sensory nerves of the spinal cord after the disease has run its course. Usually, it remains dormant, but a combination of factors, including stress, can reactivate the virus as shingles later in a person’s life. This may damage the spinal cord, causing tingling, stabbing pain, hypersensitivity to touch, and weakness or paralysis. Post-herpetic neuralgia may linger for several years. Typically, it emanates from one side of the thoracic region.
Thoracic conditions rarely require surgery. A pain doctor can help in developing a less invasive approach to pain management. Although some back pain dissipates as time passes, that doesn’t mean that people who are suffering must wait it out.
Prescription pain medication is one important resource for pain management. For severe discomfort, a pain doctor may prescribe a drug in the opioid family or a tricyclic antidepressant that regulates the way the body processes pain. Depending on the source and severity of pain, other pharmaceutical options are also available.
Physical therapy with a TENS – transcutaneous electrical nerve stimulation – relieves some people’s thoracic pain. A TENS machine attached to electrodes on the skin stimulates the affected area with minuscule electronic currents. These pulses interrupt the physical sensation of pain.
Thoracic epidural steroid injection is another pain management solution. The word “epidural” refers to the region surrounding the spinal cord. The injection numbs the thoracic area while reducing inflammation near the affected nerves to provide extended pain relief.
Spinal cord stimulation effectively addresses some types of thoracic pain. Like TENS therapy, this treatment utilizes electric current to disrupt pain impulses. Unlike TENS, the doctor inserts lead wires through the patient’s skin and positions them around the spinal cord. A small, portable generator connected to the lead wires sends electric current to the painful area. If spinal cord stimulation proves to be effective, the physician may implant a permanent generator in the patient’s body during a short surgical procedure.
Each person’s thoracic pain is unique, and a customized management plan is the most effective solution. Our clinical professionals work closely with each patient to address, manage and relieve chronic thoracic pain.