Thoracic musculoskeletal pain successfully treated with local minimally invasive injection therapy
Introduction
I reviewed a lady in the Pain Clinic who had pain in the back, shoulders and neck. She was taking Etoricoxib, Tylex and Amitriptyline 10 mg. She had poor sleep of around 2 hours per night and in her past medical history, I noted she worked as a Sales Assistant in clothing. She stopped working around 5 years ago in 2006, after an industrial injury when a heavy load she caught caused he spine to flex and she was injured.
Examination findings in thoracic musculoskeletal pain
On examination she had florid thoracic facet joint tenderness bilaterally at various levels. She also had a number of different trigger points, both in her neck, back and shoulders, consistent with myofacial pain syndrome (fibromyalgia).
Treatment of thoracic musculoskeletal pain
Her Amitriptyline was increased to 25 mg nocte and she was put on the list for x ray guided thoracic facet joint injections and multiple trigger point injections. Three months following this set of injections, she reported a great improvement in her overall symptoms.
She still had some pain but she found it was bearable and she was able to participate more fully in her normal activities. She was keen to have the procedure repeated to try and get even more benefit and she will be reviewed following this.
