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Thoracic zygapophyseal joint pain patterns. A study in normal volunteers
P Dreyfuss1, C Tibiletti, S J Dreyer
1Neuro-Skeletal Center, Tyler, Texas.
Spine
|April 1, 1994
Summary
Thoracic zygapophyseal joints can generate local and referred pain in asymptomatic individuals. This study mapped pain referral patterns from these joints, providing preliminary diagnostic insights.
Area of Science:
- Pain medicine
- Spinal anatomy
- Diagnostic injections
Background:
- Cervical and lumbar zygapophyseal joints are known pain generators with established referral patterns.
- Thoracic zygapophyseal joint pain referral patterns have not been previously documented.
Purpose of the Study:
- To determine if thoracic zygapophyseal joints act as pain generators.
- To investigate pain and referral patterns following stimulation of thoracic zygapophyseal joints.
Main Methods:
- Nine asymptomatic volunteers received 40 fluoroscopically guided intra-articular injections into thoracic zygapophyseal joints.
- Injections used contrast medium only, with pain quality, intensity, and distribution meticulously recorded.
Main Results:
- 72.5% of injected thoracic zygapophyseal joints produced distinct pain or sensation.
- 27.5% of injections did not evoke pain despite adequate capsular distension.
- Consistent referral patterns were observed, with significant overlap between zones.
Conclusions:
- The thoracic zygapophyseal joints are confirmed as potential sources of local and referred pain.
- A preliminary pain referral diagram for the thoracic zygapophyseal joints has been developed.