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What Causes Thoracic Back Pain?
Question: I've had mid thoracic back pain for almost 4 months, have had many tests with no diagnosis. Have some questions about what comes next?
Brief Answer:
The pain may not be related to your spine.
Detailed Answer:
There are many causes for mid thoracic pain. It can be due to a local problem within your spine but can also be caused by problems within your chest and upper abdomen. A hiatus hernia and GERD can definitely cause such pain. You were sensible to stop your simvastatin as this can cause muscle pain. Have you been taking an anti-inflammatory medication as this could exacerbate your hiatus hernia and GERD?
Normal X-rays and an MRI scan of this region are extremely reassuring for local problems within the spine and I think you should be reassured by this.
Probably the commonest cause of pain in this region is mechanical back pain or a muscle strain. These symptoms can be helped with anti-inflammatory medication (which may be contraindicated in you because of the hiatus hernia and GERD), heat, massage and physiotherapy for core strengthening and mobility.
If you symptoms are ongoing then I would encourage your doctors to explore other causes of pain referred through to your back. One might start by organizing some blood work including liver function tests and an amylase and moving onto other investigations such as an upper abdominal ultrasound scan and possible a gastroscope.
I hope this information is beneficial to you.
Best wishes
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Have had regular bloodpanels run over past 36 months to check hepatic function as part of prescriptions that I normally take. No serious issues reported or flagged other than slightly high cholesterol and glucose. Recently showed up with low Vit-D levels and taking 50,000 UI once weekly for that. Have family history of gallbladder/gallstone issues and one uncle had pancreas issues also. Am concerned this may be pancreatic cancer/chronic pancreatitis. I drank heavy in 20's-30's, stopped completely for 3 years in early 40's and have since drank moderately. Haven't had any alcohol in almost 5 months. Should I ask GI Doc for endoscopic ultrasoun to look at pancreas? He thinks if there were a problem it should have showed up on CT-Scan/MRI/ultrasound, but I'm starting to really stress about this. Don't want to keep taking pain meds for much longer either.
Brief Answer:
Unlikely to be pancreatic cancer / pancreatitis
Detailed Answer:
If you have had an abdominal CT then an abnormality of your pancreas fall bladder would have likely shown up, did they give you IV contrast as this would help identify any issues? If you had pancreatitis your amylase would be high and you may also have diabetes with high blood sugar. your pain so far is only short lived and you have not been consuming alcohol during the period when your pain started. this could still be a musculoskeletal problem with your back and so I would treat it as such. if your symptoms still fail to improve then I would ask for another opinion from your dr regarding the pain. if there is something more serious going on then your symptoms will evolve over time making the diagnosis more obvious.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Yes, they ran the CT-Scan with/WO contrast. on XXXXXXX 9th. I'm not sure about amylase, but they checked Lipase serum levels on XXXXXXX 7th and they came back at 31 for a 0-59 range. My glucose serum level was 109 for a 65-99 range on a blood test on 03-14-14 )(fasted for 12 hours prior). The Vitamin-D 25-Hydroxy level tested on the same blood panel came back at 24.7 for a 30-100 range and they put me on 50,000UI Vitamin-D supplements once per week. My Dr also checked my creatine kinase levels to rule out rhabdomyolysis since many of the symptoms I've had can be associated with negative side effects of taking simvastatin. My vision has been getting worse for near field and I'm using reading glasses, but it seems that it's been more blurry than usual on several occasions. The Centrum multivitamin that I've been taking for 20 years has niacin in it, which is contraindicated with Simvastatin, but I think I'm grasping at straws with that becuase the symptoms came on suddenly on Dec 23rd. Is it possible for H-Pylori bacteria to find it's way into the spine?
Brief Answer:
Unlikely that HP would cause a spinal infection
Detailed Answer:
It's always possible but I've never read or heard of h pylori causing a spinal infection, so highly unlikely. A spinal infection would show up on an MRI scan and in your blood work.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Ok, Thanks. Any insight as to whether the high glucose serum in combination with low vitamin-D points to anything else? Also have started to have pain in my ribs on the right side that were broken in a dirtbike accident in 2007. They healed up after ~6-8 weeks and have never bothered me since then. Why would they start to hurt now in conjunction with the back pain?
Brief Answer:
No relation low vit D and high glucose
Detailed Answer:
High glucose and low vitamin D are not related to one another. low vitamin D is dietary and high glucose is due either to insufficient insulin production or insensivity to insulin.
the chest pain could potentially be referred from the anterior nerve roots in the thoracic spine which give sensation to the chest wall.
best wishes
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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