Thoracic spine treatment in Delhi

1. Dr. AmodManocha is a Senior Consultant and Head of Pain Management Services at Max Multispecialty Hospital, Saket. Dr. AmodManocha leading pain specialist in delhi offer Thoracic spine treatment and Chest wall Pain treatment in delhi. Phone : +91-987-187-4003 Email: info@removemypain.com Website: http://www.removemypain.com

2. Thoracic spine treatment in Delhi • This section covers pain anywhere between shoulders to the bottom of ribs. It can arise from • Inside the thoracic cavity (inside chest) • From the chest wall including the thoracic spine • Be referred from the neighbouring areas and structures such as abdomen, cervical spine. • Chest wall pain can originate from any of the chest wall structures including bones, joints, muscles, cartilage, ligaments, tendons, nerves, skin and soft tissue. It generally increases with arm movement and is accompanied by localised tenderness.

3. Some common conditions/situations leading to chest wall pain are • Prolonged unaccustomed physical activity. This may cause muscle soreness which can persist • Trauma/fall with fracture of ribs or vertebrae. In presence of osteoporosis even trivial trauma can lead to fractures. • Spine can be a source of posterior chest pain. Pain may arise from joints including those between the vertebrae (facet joints), between the ribs and vertebrae (costovertebral joints, costotransverse joints).

4. Infections such as Shingles commonly affect the thoracic area Rheumatological disorders such as rheumatoid arthritis, ankylosingspondylitis Post surgical pain arising after surgeries such as heart, lung, breast surgery Nerve injury or damage as a result of surgery, trauma or otherwise. Cancer which has spread to chest wall or bones

5. Nerve Root Block/ Epidural Nerve root block involves injection close to the nerves as they come out of the spine. It is used in conditions where there is compression/ pressure on the nerve as it comes out of the spine. Epidural space is present in the spine around the sac containing the spinal cord and the nerves. It extends from the back of the head to the bottom of spine.

6. Facet joint injection Spine has many vertebrae and these are linked to each other by small joints called facet joints. The main function of these joints is to provide stability while allowing some degree of movement. These joint commonly become painful and stiff as a result of wear and tear, inflammation or injury. The resulting pain is generally described as a dull ache, heaviness that may radiate along the chest wall.

7. Facet joint injection Spine has many vertebrae and these are linked to each other by small joints called facet joints. The main function of these joints is to provide stability while allowing some degree of movement. These joint commonly become painful and stiff as a result of wear and tear, inflammation or injury. The resulting pain is generally described as a dull ache, heaviness that may radiate along the chest wall.

8. Costochondral, Sternochondral & Manubriosternal joint injection These are performed under ultrasound/ x-ray guidance as an outpatient or day case procedure. The procedure involves injecting a mixture of local anaesthetics and a small dose of steroids. The steroid acts around the area it is injected and does not have the same side-effects as taking oral steroid tablets. Ultrasound helps to visualise the spread of drugs and reduce the chances of complications as the needle can be kept away from important structures such as lungs.

9. Intercostal Nerve Blocks & Radiofrequency Intercostal nerves and run in between two ribs to supply the chest wall. They carry messages from the chest wall to the brain and vice versa. Indications for intercostal block can be diagnostic or therapeutic. The procedure involves injecting a mixture of local anaesthetic and a small amount of steroid under ultrasound guidance. It the area involved is large then more than one nerve block may need to be performed.

10. Dorsal Scapular Nerve Block Dorsal scapular nerve originates from the neck (cervical spine) and travels between various muscles to reach the inner border of the scapula. Nerve entrapment/ injury can happen anywhere along the path and is more commonly observed in people performing regular overhead activities like painters, weightlifters etc.

11. Pectoral Nerve block, PECS and Serratus Plane block Pectoral nerve blocks or PECS block can be considered for persisting pain after breast surgery. These injections are performed under ultrasound guidance. Serratus plane block is useful in conditions such as pain due to multiple rib fractures. These blocks are more often used in acute pain situations. In chronic pain conditions they are used for diagnostic purposes and to break the pain cycle enabling patients to start physiotherapy.

12. Trigger Point Injections Muscles ability to contract and relax plays an important role in body functioning. When muscles fail to relax, they form knots or tight bands known as trigger points. In simple words trigger points are irritable areas/ bands of tightness in a muscle. Pressure over a trigger point produces local soreness and may refer pain to other body parts.