nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2013-2404nnp-183Research ArticleArticlesСтатьиThoracic spine painБоль в грудном отделе позвоночникаIsaikinAleksey IvanovichIsaikinAleksey Ivanovich

Department of Nervous System Diseases

Department of Nervous System Diseases

alexisa68@mail.ruKavelinaA VKavelinaA V

Department of Nervous System Diseases

Department of Nervous System Diseases

-20131503201351NO1 (2013)7479Copyright © Isaikin A.I., Kavelina A.V., 20132013Isaikin A.I., Kavelina A.V.Isaikin A.I., Kavelina A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/183

Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific) pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis) may be the drug of choice in the treatment of musculoskeletal pain.

Боль в грудном отделе позвоночника, или торакалгия, — одна из частых причин обращения за медицинской помощью. В отличие от боли в шейном и поясничном отделах позвоночника, эпидемиология и семиотика боли в грудном отделе изучена недостаточно. Причины возникновения боли в грудном отделе многообразны: заболевания сердечно-сосудистой, желудочно-кишечной, легочной и почечной систем, поражения скелетно-мышечных структур шейного и грудного отделов, что требует проведения тщательной дифференциальной диагностики. Наиболее частыми причинами скелетно-мышечной (неспецифической) боли в грудном отделе позвоночника являются поражение фасеточных, реберно-поперечных и реберно-позвоночных суставов, миофасциальный синдром. Истинная корешковая боль встречается редко. Традиционно лечение боли в грудном отделе позвоночника сводится к сочетанию немедикаментозных и медикаментозных методов лечения. Препаратом выбора при лечении скелетномышечной боли может быть селективный ингибитор циклооксигеназы 2 мелоксикам (мовалис).

торакалгияскелетно-мышечная больнестероидные противовоспалительные препаратыthoracalgiamusculoskeletal painnonsteroidal anti-inflammatory drugsReferences<div><p>Burt K.W. Summary statistics for acute cardiac isohemia and chest pain visits to United States Eds, 1995—1996. Am J Emergency Med 1999;17:552—9.</p><p>Knockaert D.C., Buntinx F., Stoens N. et al. Chest pain in the emergency department: the broad spectrum of causes. Eur J Emerg Med 2002;9(1):25—30.</p><p>Nawar E.W. National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary. Advance Data From Vital and Health Statistics, 2006.</p><p>Tueth M.J. Managing recurrent nonischemic chest pain in the emergency department. Am J Emerg Med 1997;15:170-2.</p><p>Yelland M.J. Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain? Aust Fam Physician 2001;30:908—12.Bass C., Mayou R. Chest pain. Brit Med J 2002;325:588-91.</p><p>Bass C., Mayou R. Chest pain. Brit Med J 2002;325:588-91.</p><p>Bonica J.J., Sola A.F. Chest pain caused by other disorders. The management of pain. Bonica J.J. (cd.). London: Lea and Febiger, 1990; 1114—45.</p><p>Bonomo L., Fabio F., Larici A.R. Non-traumatic thoracic emergencies: acute chest pain: diagnostic strategies. Eur Radiol 2002;12:1872—85.</p><p>El-Metwally A., Salminen J.J., Auvinen A. et al. Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. BMC Musculoskel Dis 2007;8:46.</p><p>Spalding L., Reay E., Kelly C. Cause and outcome of atypical chest pain in patients admitted to hospital. J R Soc Med 2003;96(3):122—5.</p><p>Briggs А.М., Smith A.J., Straker L.M. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskel Dis 2009; 10:77.</p><p>Moore M.J., White G.L., Moore D.L. Association of relative backpack weight with reported pain, pain sites, medical utilization, and lost school time in children and adolescents. J School Health 2007;77(5):232—9.</p><p>Подчуфарова Е.В. Боль в грудной клетке. Трудн пациент 2003;1(1):4—9.</p><p>Hagen K., Svebak S., Zwart J.A. Incidence of musculoskeletal complaints in a large adult Norwegian county population. The HUNT Study. Spine 2006;31(18):2146—50.</p><p>Balague F., Troussier B., Salminen J.J. Non-specific low back in children and adolescents: risk factors. Eur Spine J 1999;8:429-38.</p><p>Young B.A, Gill H.E., R.S Wainner, T.W. Flynn et al. Thoracic costotransverse joint pain patterns: a study in normal volunteers. BMC Musculoskel Dis 2008;9:140.</p><p>Murphy S., Buckle P., Stubbs D. Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon 2004;35:113-20.</p><p>Reigo T., Timpka T., Tropp H. The epidemiology of back pain in vocational age groups. Scand J Primary Health Care 1999;17:17-21.</p><p>Wong W.-M., Cheng S., Hui W.-M. et al. Non-cardiac chest pain. Med progress 2003;30:15-21.</p><p>Cohn J.K., Cohn P.F. Chest pain. Circulation 2002;106:530-1.</p><p>Kramer L., Rabanizada N., Haasenritter J. Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility BMC Fam Pract 2011;12:128.</p><p>Fruth S.J. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther 2006;86(2):254-68.</p><p>Stochkendahl М.Т., Christensen H.W. et al. Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial. BMC Musculoskel Dis 2008;9:40.</p><p>Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: ГЭОТАР-медиа, 2010;368 с.</p><p>Cockerill W.C., Ismail A.A., Cooper C. et al. Does location of vertebral deformity within the spine influence back pain and disability? European Vertebral Osteoporosis Study (EVOS) Group. Ann Rheum Dis 2000;59:368-71.</p><p>Korovessis P., Koureas G., Papazisis Z. Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Dis Tech 2004;17:33-40.</p><p>Korovessis P., Koureas G., Zacharatos S., Papazisis Z. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis. Spine 2005;30:247-55.</p><p>Bishop M.D , George S.Z Immediate reduction in temporal sensory summation after thoracic spinal manipulation. Spine J 2011;11(5):440—6.</p></div><br /><div><p>Burt K.W. Summary statistics for acute cardiac isohemia and chest pain visits to United States Eds, 1995—1996. Am J Emergency Med 1999;17:552—9.</p><p>Knockaert D.C., Buntinx F., Stoens N. et al. Chest pain in the emergency department: the broad spectrum of causes. Eur J Emerg Med 2002;9(1):25—30.</p><p>Nawar E.W. National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary. Advance Data From Vital and Health Statistics, 2006.</p><p>Tueth M.J. Managing recurrent nonischemic chest pain in the emergency department. Am J Emerg Med 1997;15:170-2.</p><p>Yelland M.J. Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain? Aust Fam Physician 2001;30:908—12.Bass C., Mayou R. Chest pain. Brit Med J 2002;325:588-91.</p><p>Bass C., Mayou R. Chest pain. Brit Med J 2002;325:588-91.</p><p>Bonica J.J., Sola A.F. Chest pain caused by other disorders. The management of pain. Bonica J.J. (cd.). London: Lea and Febiger, 1990; 1114—45.</p><p>Bonomo L., Fabio F., Larici A.R. Non-traumatic thoracic emergencies: acute chest pain: diagnostic strategies. Eur Radiol 2002;12:1872—85.</p><p>El-Metwally A., Salminen J.J., Auvinen A. et al. Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. BMC Musculoskel Dis 2007;8:46.</p><p>Spalding L., Reay E., Kelly C. Cause and outcome of atypical chest pain in patients admitted to hospital. J R Soc Med 2003;96(3):122—5.</p><p>Briggs А.М., Smith A.J., Straker L.M. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskel Dis 2009; 10:77.</p><p>Moore M.J., White G.L., Moore D.L. Association of relative backpack weight with reported pain, pain sites, medical utilization, and lost school time in children and adolescents. J School Health 2007;77(5):232—9.</p><p>Подчуфарова Е.В. Боль в грудной клетке. Трудн пациент 2003;1(1):4—9.</p><p>Hagen K., Svebak S., Zwart J.A. Incidence of musculoskeletal complaints in a large adult Norwegian county population. The HUNT Study. Spine 2006;31(18):2146—50.</p><p>Balague F., Troussier B., Salminen J.J. Non-specific low back in children and adolescents: risk factors. Eur Spine J 1999;8:429-38.</p><p>Young B.A, Gill H.E., R.S Wainner, T.W. Flynn et al. Thoracic costotransverse joint pain patterns: a study in normal volunteers. BMC Musculoskel Dis 2008;9:140.</p><p>Murphy S., Buckle P., Stubbs D. Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon 2004;35:113-20.</p><p>Reigo T., Timpka T., Tropp H. The epidemiology of back pain in vocational age groups. Scand J Primary Health Care 1999;17:17-21.</p><p>Wong W.-M., Cheng S., Hui W.-M. et al. Non-cardiac chest pain. Med progress 2003;30:15-21.</p><p>Cohn J.K., Cohn P.F. Chest pain. Circulation 2002;106:530-1.</p><p>Kramer L., Rabanizada N., Haasenritter J. Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility BMC Fam Pract 2011;12:128.</p><p>Fruth S.J. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther 2006;86(2):254-68.</p><p>Stochkendahl М.Т., Christensen H.W. et al. Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial. BMC Musculoskel Dis 2008;9:40.</p><p>Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: ГЭОТАР-медиа, 2010;368 с.</p><p>Cockerill W.C., Ismail A.A., Cooper C. et al. Does location of vertebral deformity within the spine influence back pain and disability? European Vertebral Osteoporosis Study (EVOS) Group. Ann Rheum Dis 2000;59:368-71.</p><p>Korovessis P., Koureas G., Papazisis Z. Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Dis Tech 2004;17:33-40.</p><p>Korovessis P., Koureas G., Zacharatos S., Papazisis Z. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis. Spine 2005;30:247-55.</p><p>Bishop M.D , George S.Z Immediate reduction in temporal sensory summation after thoracic spinal manipulation. Spine J 2011;11(5):440—6.</p></div><br />

The authors declare that there are no conflicts of interest present.