Dorsalgia

Dorsalgia: what’s that?

Dorsalgia or thoracic spine syndrome describes uncharacteristic, mostly chronic pain in the chest, shoulder, neck and arm regions due to changes to or false posture of the spine.

The thoracic spine shows several differences to other sections of the spine: Due to the connection to the ribs, the thoracic spine is less mobile than the cervical and the lumbar spine. Damages to the intervertebral disc occur far more seldom in this region than in the cervical and the lumbar spine.

Some 62% of back pain is observed in the region of the lumbar spine, on the other hand the frequency of pain in the thoracic spine region is approx. 2%.

Dorsalgia symptoms

Generally, dorsalgia manifests as dull or pressing pain in the thoracic spine region (thoracic vertebrae). The muscles adjacent to the spine are very often painfully hardened. Due to the flexible connection between the thoracic spine and the ribs, motion and breathing-dependent pain is frequently incurred in case of blockages. Thoracic spine pain is often localised between the shoulder blades and can radiate in a girdle-shaped manner over the entire chest. The impression may arise that the complaints originate from the heart. The cervical and the lumbar spine can temporarily compensate changes in the thoracic spine region.
However, in the long-term dorsalgia also has consequences for the further spinal segments, i.e. neck pain and headaches may ensue as a result of cervical spine tension or pain in the lumbar spine region.

Dorsalgia diagnosis

A tentative diagnosis can often already be made based on the symptoms and the patient’s information (case history). The clinical examination is particularly important. Imaging can be important in some cases, here X-ray diagnosis when standing plays an important role, an additional MRI examination may also make sense.
Neurological clarification may be useful in some cases because, for example, an infection with the herpes zoster virus (varicella zoster virus) may be the initiator as it causes an inflammation of the intercostal nerves (intercostal neuralgia) with similar pain symptoms. Muscular disbalance can be diagnosed using electromyographic function analyses (electromyography).

Differential dorsalgia diagnosis

Not only the spine can cause chest pain: A heart attack or angina pectoris can cause similar pain to a thoracic spine syndrome. However, in case of a heart attack, normally further symptoms such as nausea, cold sweat and in particular amongst women nausea or vomiting are incurred. If ambiguous indications exist, examination by a physician should always take place.

How can dorsalgia be prevented?

Some possibilities exist which can contribute to the prevention of dorsalgia: These include regular exercise, strengthening of the stomach and back musculature as well as avoiding scoliotic postures. In this respect, attention should be paid to conscious exercise or mobilisation of the thoracic spine: for example changing your position more frequently, use of a height-adjustable desk or working dynamically, i.e. sitting and standing alternately when working.

In particular in case of scoliosis and Scheuermann’s disease and after accidents, strict implementation of special exercises under instruction from a physiotherapist normally makes sense. In case of arthrosis, protection against overstress, e.g. with supports and braces during work and in load situations, makes sense. Targeted exercises to mobilise the thoracic spine and strengthen the surrounding musculature can also help.

What therapy options are available for dorsalgia?

If no severe influences on the medulla exist, conservative treatment of the thoracic spine pain can be applied. Here, the adequate method of dorsalgia treatment must be adapted to the respective individual situation. Certain medication and the injection of a local anaesthetic can have a supporting effect. Basically, physiotherapy, osteopathy, heat or cold treatment and massages are appropriate means to relax the musculature and to improve the mobility of the thoracic spine and thus the pain symptoms. To accompany therapy, also a brace such as the BORT Corset or the BORT Corset Sport can be used. Also, posture training and specific exercises for the thoracic spine may make sense. If conservative therapy does not bring sustainable pain relief, specific pain therapy may also be a viable option.