Costovertebral Joint Pain Referrals

Costovertebral (rib) joints are just starting to be recognized as a source of pain. A recent provocative study demonstrated their referral patterns

BMC Musculoskelet Disord. 2008 Oct 15;9(1):140.
Thoracic costotransverse joint pain Patterns: a study in normal volunteers. Young BA, Gill HE, Wainner RS, Flynn TW. abstract
free article

Comment – It is interesting how big T2 represents – It has an upper and lower representation. Would have been nice to see referral from T1.Costovertebral pain may be part of midthoracic spinal instability. Diana Lee published an article (and part of a book) on this subject which she rates as “Instability of the thorax can be extremely debilitating but is a treatable condition”.

Man Ther. 1996 Dec;1(5):234-241. Rotational instability of the mid-thoracic spine: assessment and management. Lee DG. abstract
full article

Although I have come across articles on T4 and T12 syndromes, I have yet to see much literature on rib pains that are not related to ankylosing spondylitis.

Any help here?

michael kors tasche blau michael kors tasche blau

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3 Responses to Costovertebral Joint Pain Referrals

  1. dr belanger says:

    hi there, very good website.
    I have been hitting my head with these questions. But really, it is difficult to differentiate from other pain generators plus there are the costo transverse and the costo vertebral joints at each level. Diferentiation must be done. What do you think?
    I have wrote the following question to the authors of the article:
    Dear Drs.:

    Re Article:
    BMC Musculoskelet Disord. 2008 Oct 15;9(1):140.
    Thoracic costotransverse joint pain Patterns: a study in normal volunteers. Young BA, Gill HE, Wainner RS, Flynn TW.

    I am a doctor with a special interest in chronic pain. I am a member of the IASP. I have a pain blog at painmuse.org.

    Some years ago I wrote up the results of your article here:
    Costovertebral Joint Pain Referrals

    Recently I had a doctor write me and ask:
    “I have been hitting my head with these questions. But really, it is difficult to differentiate from other pain generators plus there are the costo transverse and the costo vertebral joints at each level. Diferentiation must be done. What do you think?” (From a Dr. Belanger).

    I haven’t a clue. I would anticipate a torqued vertebral segment, the facets of a torqued segment, the paraspinous muslces in spasm in sympathy, the ribs, and the intercostal muscles would all contribute. I also find the iliocostalis in spasm and the anterior pectoral and serratus muscles also in some spasm at that level. If we were to look at a rib level being twisted, in some cases, like Fred Mitchell has wrote, than it would be difficult not to have both costotransverse and costovertebral joints affected. How to differntiate the two is however beyond me… Could any of you leave a comment?
    Thank you.

  2. leandrea miller says:

    I have had rt side pain in my mid thorasic for years. it’s driving me CRAZY! no one can explain it. what type of specialist can I get to really look into this?
    ———————
    You need someone with training in Orthopaedic Medicine
    There is an American orgnization here:
    http://www.aaomed.org/
    click the “find a docotor”
    then put in your state
    it will give you a list.

    Unfortunately expertice can vary greatly and I’ve had people say they spent considerable money and were told very little…
    Good luck
    admin

  3. B.L. says:

    First I want to say that I am not a doctor and I am not giving any medical advise in any way or form. I am just explaining what I have been going through with being diagnosed with Forestier’s Disease for over the past 4 years now. I have osteophytes along the vertebrae-anterior longitudinal ligaments- bridging (ossification of the superspinous ligaments in the thoracic zone)-bilateral ossification of the superior costotransverse ligments (thoracic), and a few large bone spurs of the (radiate ligaments) that are pressing into the pleural membrane. I suffer from thoracic and lumbar pain on a daily bases, I also experience bilateral intercostal pain between the ribs. I have had x rays, mri’s and ct’s done.

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