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Thoracic (Mid‐back) Pain

Mid-back pain of longer than four weeks is usually due to an area of inflammation in the thoracic spine. This is usually caused either by a bulging disc or a nerve in the spine irritated by a bending and twisting motion. The pain can even wrap around your chest wall. After conducting a spinal examination and reviewing your prior studies, we can come up with a plan to pinpoint the source of your pain.

Facet Joint Syndrome

Herniated Discs

This page offers the answers to some of the most common questions related to pain occurring within the mid-back area, as well as the procedures used to diagnose and treat it effectively. Click on the questions to reveal the answers. Additional questions and answers about spine-related pain and our procedures are featured in the Ask the Doctors section.

How do you pinpoint the source of my pain?

We use a continuous x-ray machine and we place an anesthetic on the structure that we feel could clinically be creating the pain. This may be a disc, nerve or a joint. If you immediately notice that your pain is relieved as soon as we place the anesthetic on the disc or nerve it will give us an answer to the cause of your problem.

Can I have physical therapy before I see one of your physicians?

Certainly, but unless you know exactly what is causing your back pain, you might be getting the wrong kind of physical therapy. For example, a problem with a disk in your spine is very different than pain generated by a joint. If the physical therapist moves your body in the wrong direction during your therapy, they may actually make your pain worse.

Will your procedures make my pain go away for a long time?

Yes. A significant number of our patients achieve good relief for a long time. You probably have had back problems for a long period of time now. The reason why you’re experiencing heightened pain now is probably due to inflammation in the area that is generating the pain. Once the inflammation is gone, the pain probably will not return for a long time.

In the U.S., most people over the age of 40 have problems that appear in an MRI, but in fact don’t report any pain. This tells us that you can live with a herniated disk in your spine without any pain.

If my MRI is negative, is it still possible that I can have an irritated nerve in my back that is causing the pain?

Yes. An MRI is an indirect image of the spine and does not always show everything. In addition, an MRI usually is taken while you are laying down. Nerves can shift when you change positions, especially if your pain is worse with when you stand or sit. The disk can leak part of its “jelly” center—or nucleus—around the nerves, which can cause significant chemical inflammation and pain. Our procedures can dramatically reduce the pain and inflammation resulting in increased circulation and healing.

Will your procedure simply “mask” or hide my pain?

No, the goal of our procedure is to decrease the inflammation. The relief from your pain is achieved when we reduce or eliminate the inflammation.

Will this treatment prevent me from having to have an operation?

In many cases, it can prevent a patient from having to undergo an operation. Many people who have this treatment have sustained relief and studies confirm this.

However, if you still have pain and require surgery, our procedure will provide your surgeon with information about the exact location of your pain, which will enable a better outcome for your surgery if required.

Are there any new procedures that can alleviate back pain for a longer period of time?

Yes, we’re now using a radio frequency probe that eliminates certain types of back pain for years. Our physicians can tell you if this new procedure would be appropriate for your pain.

What happens if I need to have these procedures repeated?

These procedures can be repeated up to 2 to 3 times within 12 months. If you require more procedures, then we usually would recommend surgery for your situation. The good news is that our procedure will provide your surgeon with information about the exact location of your pain, which will enable a better outcome for your surgery if required.

I read a newspaper article about a new treatment for back pain that involves traction on a disk using a special machine that can even reverse disk herniations. Should I try this treatment?

Unfortunately, the “latest and greatest” spine treatments are easily peddled in America. Studies have shown that treatment for pain has a placebo response rate between 20% and 30%. That means that any “snake oil” or sugar pill will make about 25% of people feel better—at least temporarily.

About 80% of all initial back injuries also resolve spontaneously and most disk herniations will resorb in time without any treatment. So, it is easy to see how these new “treatments” can claim success by using a few patients who felt better. The same goes for magnets, many balms and tonics.

  • Texas Orthopedic Hospital
  • Fondern orthopedic group LLP
  • Spine Interventional Society