Pain in the right posterior thoracic region

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Pain in the Right Posterior Thoracic Region Case History A maintenance man came to Caring Medical a few months ago complaining of pain in his right posterior thoracic region, aggravated with the use of his right arm. The pain began in earnest eight months prior, the patient thinking it stemmed from the many repetitive motions he made at work, such as hammering, sawing and painting. He rated the pain as an 8 on a scale of 10. A previous MRI showed a bulging disc and he was referred to a neurologist by his primary care physician, but he decided to come here first. The patient told us the pain seemed to begin in the area below his right shoulder blade, sending shooting pain to his right hip and neck, and causing his arm to feel numb. He found it difficult to grip tools, and actually could not work because of this. We treated him with normal Prolotherapy solution, adding 1 cc procaine to the syringes. We concentrated the injections to the right side of his mid thoracic area. He was told to try to use his left hand for some of his repetitive jobs and to return to the clinic in one month. Upon his return, the patient told us that his pain level was down to a three and he thought he was 70% improved. The numbness was completely gone in his right arm. We treated him for the second time using the same solution and told him to return to Caring Medical if needed. We called this patient for follow up and he told us he was doing well, He had no need for further treatment. CERVICAL 'RADICULOPATHY' SYMPTOMS SUCCESSFULLY TREATED WITH PROLOTHERAPY About once every two weeks a patient comes in worried because they believe they have a pinched nerve in the neck. Typically they have had an MRI which some some degenerative arthritis and degenerated discs in the neck and they have tingling in the arm and hand. So is this cervical radiculopathy or is this just a referral ligament pain pattern from the upper thoracic area. How do you tell? THE EYES I look at people's eyes. People who have a true 'nerve' being pinched, really can't smile. The pain is awful. The referral pain patterns of ligaments can be awful but not nearly as awful as a nerve being pinched. When the eyes loose their luster and the look on the persons face is 'panic' I think cervical radiculopathy. If the person is able to converse with me and laughs at my jokes, then there is a good chance they have a thoracic ligament problem. THE HUB A person who puts their hand between the spin and the scapula and says that is where their pain emanates from, I think thoracic ligament problem. In cervical radiculopathy cases, the person will point to a specific area of their neck causing the pain. Thoracic ligament problems can cause some neck pain as the case study indicated but typically the person will tell you this is a referral pain and the neck pain is minimal compared to the thoracic pain. NUMBINESS Cervical radiculopathy gives 'true' numbness. If a person senses numbness in the fingers but can feel everything, this is called numbiness. This is a referral symptom typically from thoracic ligament problems (generally thoracic #1-3). Numbness that is true, meaning the person has lost sensation in part of their hand or fingers, indicates a nerve problem. Then one thinks of cervical radiculopathy. BREATHING Cervical radiculopathy is not affected by breathing and vice versa. Breathing can aggravate thoracic problems and thoracic problems can aggravate breathing. Someone whose symptoms are affected by deep breathing, makes me think thoracic ligament problem. ARM MOVEMENT AGGRAVATION Believe it or not in my experience, when arm movement aggravates the symptoms, I think more thoracic ligament problem. Simple movements of the arm only occur by stabilization of the scapula. Stabilization of the scapula affects the upper thoracic segments more then it does the cervical spine. RESPONSE TO PROLOTHERAPY Thoracic ligament problems often feel better right away with Prolotherapy. Cervical radicular symptoms generally need a nerve block to feel better right away. Prolotherapy can be used with cervical radiculopathy but often you need other modalities also to treat the person. For people who have been told that they need surgery for cervical radiculopathy I would recommend that they get a second opinion from a Prolotherapist. You would hate to get surgery and not be better because your problem was a thoracic ligament problem and all you needed was Prolotherapy. The thoracic ligaments that can refer pain down the arm are those involved with Thoracic segements #1,#2, and #3. The ligaments that connect these vertebrae together and the ones that connect these vertebrae to the ribs (costovertebral ligaments).

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Ross Hauser, M.D. Dr. Hauser received his M.D. from the University of Illinois, Chicago; completed his residency at Loyola-Hines VA-Marianjoy Hospitals in Physical Medicine and Rehabilitation; and received his Bachelor of Science degree from the University of Illinois, Urbana-Champaign. Dr. Hauser is the Medical Director and co-founder of the physician-run, comprehensive natural medicine clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy. He, along with his wife Marion, have written seven books on the topic of Prolotherapy, a comprehensive book on the natural medicine approach to cancer, as well as a myriad of articles and newsletters for the general public. Read more Ask A QUESTION
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