Thoracic back pain

Since learning about the various causes of chest wall pain I am continually amazed about the number of pain syndromes that I am diagnosing as originating from the thoracic spine. I wonder what I was thinking beforehand.

Comments from LW

RACGP Back Pain Course participant, Brisbane 1986

Thoracic (dorsal) back pain is common in people of all ages including children and adolescents. Dysfunction of the joints of the thoracic spine, with its unique costovertebral joints (which are an important source of back pain), is very commonly encountered in medical practice, especially in people whose lifestyle creates stresses and strains through poor posture and heavy lifting. Muscular and ligamentous strains may be common, but they rarely come to light in practice because they are self-limiting and not severe.

This dysfunction can cause referred pain to various parts of the chest wall and can mimic the symptoms of various visceral diseases such as angina, biliary colic and oesophageal spasm. In similar fashion, heart and gall bladder pain can mimic spinal pain.

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