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Quantifying Pain Location and Intensity with Multimodal Pain Body Diagrams
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Published on: July 7, 2023

10. Thoracic pain.

Maarten van Kleef1, Robert Jan Stolker, Arno Lataster

  • 1Department of Anesthesiology and Pain Management, University Medical Centre, Maastricht, The Netherlands. maarten.van.kleef@mumc.nl

Pain Practice : the Official Journal of World Institute of Pain
|May 25, 2010
PubMed
Summary

Thoracic radicular pain and facet joint pain affect about 5% of patients. Treatments include conservative measures, and for persistent pain, pulsed radiofrequency or radiofrequency ablation of specific nerves offers effective interventional options.

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Area of Science:

  • Pain Medicine
  • Neurology
  • Spinal Surgery

Background:

  • Thoracic pain, encompassing radicular and facet joint pain, presents a diagnostic challenge in pain clinics.
  • Understanding the distinct characteristics of thoracic radicular pain and thoracic facet joint pain is crucial for effective management.

Purpose of the Study:

  • To describe and discuss the symptoms, assessment, differential diagnosis, and treatment options for thoracic radicular pain and thoracic facet joint pain.
  • To review the evidence supporting interventional treatments for these conditions.

Main Methods:

  • Literature review and analysis of pain management experiences.
  • Discussion of conservative treatments including medication, TENS, and physical therapy.
  • Evaluation of interventional treatments such as radiofrequency procedures.

Main Results:

  • Pulsed radiofrequency treatment of the dorsal root ganglion (DRG) is recommended for thoracic radicular pain (2 C+).
  • Radiofrequency treatment of the medial ramus of the thoracic dorsal rami is recommended for thoracic facet pain (2 C+).
  • Interventional procedures require specialized skills and centers, particularly for treatments above Th7.

Conclusions:

  • Conservative management is the first line of treatment for thoracic pain.
  • Interventional radiofrequency treatments offer effective options for refractory thoracic radicular and facet joint pain.
  • Specialized centers are recommended for advanced interventional procedures in thoracic pain management.