Thoracic & Rib Pain

Facet Joint Irritation

 

 

 

 

 

 

 

 

 

 

 

 

What is it?

Thoracic facet joint irritation is less common than cervical and lumbar facet syndrome and is probably related to restricted motion at these levels due to the rigidity of the thoracic spine. The facet joints become irritated and may cause pain, soreness and stiffness.

What does it feel like?

  • Pain in the back or radicular symptoms to the trunk or rib cage.

  • Pain and tenderness localized at the level of the involved facet joint.

  • Muscle spasm and changes in posture in response to the injury.

  • Loss of motion like the inability to bend backward, move sideways to the effected side, or stand erect, in addition to poor tolerance for sitting.

  • Standing and walking can be difficult if the irritation is severe.

  • Stiffness in the joints after a period of rest.

  • Pain with excess activity and relief with rest.

  • Localized swelling at the joint level may be present.

Why does this happen?

Patients often report increased pain with extension or prolonged periods of inactivity like sitting or standing too long. Changing positions often improves pain. Facet joint pain may feel worse in the morning and improve after moving around as the day progresses. However, for those who work sitting all day with poor posture, they may experience pain throughout the day.

Rib pain with Respiration

 

What is it?

Costotransverse disorders are disorders affecting or involving the costotransverse and costovertebral joints and ligaments which are often overlooked during examination for pain source localisation in this area due to possible visceral pain referral and the complexities of the thoracic neural network.

 

What does it feel like?

  • Pain may radiate to the anterior chest wall, along the rib, sometimes into the shoulder and sometimes towards the upper limb 

  • Pain with deep inspiration, coughing/sneezing/laughing

  • Increased pain with passive or active thoracolumbar flexion, rotation and side bending, lifting or twisting movements

  • Movement in adjacent thoracic vertebral and rib segments is usually restricted and may stimulate or exacerbate protective muscle spasm

  • Increased muscle tension in between the shoulder blades, either side of the spine and the neck and shoulders.

  • Referred pain originating from under the scapula and worsens with coughing, sneezing or deep breathing

  • Acute, atypical chest pain

Why does this happen?

  • Local joint compression may occur as a result of a trauma or muscle spasm

  • Repeated overhead or extension movements (lifting or working overhead) 

  • It is more common in women and can occur at any age

  • The costotransverse joint is known to be involved in patients with ankylosing spondylitis.

 

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