acute thoracic back pain

[gabrieljosh]

Shoulder and Back Pain are common because these areas are vulnerable to injury, such as sprains and strains. Other disorders that may cause back pain include herniated disc, degenerative disc disease, pinched nerves, scoliosis and sciatica. There is no way to avoid shoulder pain entirely. There are ways to make it less likely, though, such as regular stretching and taking proper advantage of ergonomically-designed furniture and office equipment.

[Physio Dace]

Hi,

If you've found the comparable spinal level (?T10 or thereabouts) then I'd start with very gentle or slow sustained mobilisations centrally thru the spinous process but directed laterally towards the painful side (usually most comfortable) and slowly redirect the angle more centrally and then towards non-painful side as pain allows. Gentle jiggles (?gr IV--) often work very well for Tx pain. The key is to position the patient in a non-painful position (most likely right side lying or prone on some flexion) and slowly work into less comfortable positions. Soft tissue massage either pre or post mobilisation tends to help alot too.

Low lumbar (R) rotations sustained may also work.

Good luck.

[Lachlan]

Often there are conditions which require time before physiotherapy exercises are effective.

From what you have described the patient would be too irritable to start moving around doing assessments. Pushing on their back or giving them exercises would most likely just aggravate their symptoms even more.

If i were to encounter that my advice would be:

-The patient should speak to doctor about more pain medications (anti inflams and muscle relaxants have evidence for acute back pain)

- Heat packs- May reduce some muscle spasm, unlikely to go deep enough to actually exacerbate any inflammation.

-Light soft tissue massage (if not too irritable and able to lay on their stomach, or even on their side if appropriate).

Im sure in a few days time the pain levels and irritibility would have settled to help you make an accurate diagnosis and treatment from there on out.

[thabiso]

Sometimes its difficult to go in and work on an area with cases of very bad pain. And I do agree, get a bit of reduction in the pain/irritability first. Cold (acute) or heat, IFT, or a gentle massage. That should allow you to get in and be more effective in your assessment and later treatment. The patient may benefit from a thoracolumbar support also (though I am not a fan for their continued use for too long-once they are over the initial bad pain curve I feel they should use it but rather develop good core stability)

all the best