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HomeAnswersInternal Medicineback painWhat could cause chronic back pain with pain in the ribs and thoracic spine?

What is the reason for having back pain along with pain in the spine and ribs for several years?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Nagaraj

Medically reviewed by

iCliniq medical review team

Published At April 16, 2023
Reviewed AtMay 11, 2023

Patient's Query

Hello doctor,

I need you to interpret an MRI scan. I have had back pain, and pain in the thoracic spine and ribs for the past few years. I doubt that they might have not taken the MRI of the correct location. Hence I need someone to check it.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

I suggest you follow the instructions as mentioned:

  1. Can you share the MRI (magnetic resonance imaging) film?
  2. Is there an MRI report also? If yes, please send it as I have to correlate both.
  3. Did you take an MRI of the spinal cord?

Kindly follow up with the answers.

I hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I took the MRI last year. I do not think they scanned the correct area or at least not fully. The pain is towards the end of the thoracic spine between ribs 12 to 9 approximately. The discomfort is towards the left of the spine, and it is like a sensation of something constantly under stress or tension. I have to bend to my right laterally to get some relief.

Even though I have the MRI film, I am not able to upload it. So I am attaching a screenshot hoping that you will be able to download it. There is a report too, but I do not think it is a comprehensive report. Looking at one image, I feel there is severe curvature in my thoracic spine, but the report just mentions scoliosis in the cervical spine. I will try attaching the report and also upload some pictures to illustrate where I feel the pain.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

I went through your reports (the attachments removed to protect the patient's identity). In the meantime, I suggest you answer the following questions.

  1. Is your pain still the same or has it changed, increased, or decreased?
  2. Does this pain occur on one side of the body or both sides of the spine?
  3. Do you feel any abnormal sensations in your legs?
  4. Do you feel any discomfort when you bend forward or backward?
  5. Are there any restrictions on your spine movements?
  6. Is there any bulge or swelling at the site?
  7. Did you have any trauma at anytime at the site?

Kindly follow up with the answers.

I hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I have answered all your questions.

  1. The pain has remained more or less the same since I first started experiencing it about a few years ago.
  2. I cannot see any obvious bulge or swelling. But I experience a lot of discomforts while bending forward or while maintaining that position for a long time. For example, if I lean forward to brush the floor I experience a lot of tension in the left region of the back towards the end of the thoracic spine, over the lower ribs.
  3. I get some temporary relief while bending to the right laterally or while stretching the rhomboids.
  4. The pain and constant tension are just on the left side of the spine over the lower ribs, near the spinal erectors. I do not feel any pain on the right side or directly on the spine.
  5. There are no restrictions on movement.
  6. I have fallen off my bike a few times. I also used to lift weights, but not very heavy. And I do squats and deadlifts just for recreation. The maximum was about 90 kilograms and has not lifted much in 3 years.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

I saw the image (the attachment was removed to protect the patient's identity).

It looks like you have scoliosis to the left. The area covered for the scan is correct as in the spinal cord you do not find the lesion at the site of pain. It is usually two to four vertebrae higher. In your case, scoliosis is in the region of the lower cervical and higher thoracic vertebrae. Hence, you are feeling discomfort at the lower levels. As you have not developed pain till now, your nerves are not yet affected and there is no compression or pressure effect on the nerves. The cause needs to be evaluated and the progression depends on the underlying cause. I suggest you meet a neurosurgeon or spine surgeon for a full evaluation. With advancements in medical technologies, I am sure it can be managed surgically.

I hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I thought they would also do an MRI over the lower ribs as the pain extends out there too.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

The pain you are experiencing in the ribs could be one transferring from nerves or due to the pressure effect. By looking at your reports, I feel it is because of the pressure effect than nerve compression. If a nerve is involved, you would have had severe pain.

I hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I wake up feeling unwell and devoid of energy every day. I rarely drink alcohol and do not smoke, but I feel a hangover. I think my acid reflux does not help and also had tightness in the left chest area for two months. I requested blood tests one month back, but I have not got an appointment still.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

I suggest you consult a specialist doctor.

Hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I would ask you further doubts if I have any.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

You can ask any further doubts.

I hope this has helped you.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I doubt if you can see anything on my X-rays and CT scan that would indicate the cause of pain in the left lower thoracic area. These scans were taken during the last few years. When I look at my chest X-ray, I feel one of my lower ribs on the left side is at a strange steep angle. Let me know your thoughts on this.

Kindly help.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

I went through the images (attachments removed to protect the patient's identity).

There is no problem with the rib on your left side. It is the diaphragm lining that is superimposed on the last rib. Ribs cover the lungs and from the front, they take a curve to some extent. You may be perceiving this as a sharp bend. Your other scans are also coinciding with the MRI (magnetic resonance imaging) and chest X-ray findings. I do not see a major curve in your vertebrae and spinal nerve roots are not affected to a great extent. So I suggest consulting a specialist doctor.

Thanks and regards.

Patient's Query

Hello doctor,

Thanks again for taking the time to look at the images. I appreciate it. I will try to visit a spine surgeon in person. Earlier I was able to go for deep tissue back massage and physiotherapy twice a week, which helped a lot with pain.

Thank you.

Answered by Dr. Nagaraj

Hello,

Welcome back to icliniq.com.

You are welcome.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Nagaraj
Dr. Nagaraj

Diabetology

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