This question was answered on Mon 12, Jul 2010 05:07am by Dr.Kokil Mathur

I have two painful vertebrae between the shoulder blades - T6 & T7Painful when pressed.Painful/aching every night after 3 to 4am.Pain can spread around the rib cage.Affected by the cold or by lifting heavy objects - always worse the next day(not the same

    
Asked by shoes (Male; 70; None apart from this pain.; Relevant drugs:None ) on Mon 12, Jul 2010 02:13am

I have two painful vertebrae between the shoulder blades - T6 & T7 Painful when pressed. Painful/aching every night after 3 to 4am. Pain can spread around the rib cage. Affected by the cold or by lifting heavy objects - always worse the next day (not the same day) In the past some relief on the beach with the sun (not now especially if there's a breeze) It's in exactly the same place as a back injury I had - a fall from a great height when I was twelve years old (I'm now 70 but still fit apart from this) The fall seems to have been discounted as the cause as MIR scans show absolutely nothing in this area. It is usually suggested that it's the muscle around these vertebrae, but manipulation/massage makes it worse and muscular relaxants or any other medications do nothing. I had steroid injections into the spine in UK, but this did nothing. I am now in France and the doctors here haven't come up with anything which helps the pain.

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Answer by Dr.Kokil Mathur  on Mon 12, Jul 2010 05:07am:

Hi! Welcome to the forum. My first thought would have been pinched nerve in this area or a disc prolapse or maybe even a spinal tumor. However MRI would have ruled these out. The next possibility is ankylosing spondylitis (though this is not a typical joint to be involved), since the pain worsens at night after lying down, or by chill and lifting weight. This is a genetic condition. Medicines, physiotherapy, exercises and drugs to suppress immunity are the mainstay of treatment. Manipulations and massages will have to be in line with the muscle strained and done otherwise will cause more harm than good. It could also be due to a wrong posture while sleeping. Trying out a different posture or sleeping on hard bed without pillow may help. Other causes of tenderness at spine at particular level could be Pott?s disease or tuberculosis, metastasis from cancer, localized cancer, and osteoporosis (quite likely at your age). It could also be nerve impingement or disc prolapsed, if the MRI was done long back, it may not have caught it. Ask for a repeat MRI if one was done long back, and a CT scan if possible to visualize the bone better, ESR, bone density test and rheumatoid factor etc should be done if not done already. Possibility of a repeated attack of shingles should be evaluated as the pain spreads along your ribcage. Though fibromyalgia causes widespread pain, it can in some cases cause a very localized pain. Possibility of duodenal ulcer, pancreas or gall bladder problems causing referred pain between shoulder blades too should be assessed. Please discuss all these possibilities with your treating doctor. Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

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Comment by Dr Kristine Miguel on Mon 12, Jul 2010 07:09am:
Hi. Pain along T6 and T7 may result from herniation, nerve entrapment or destruction. I agree with Dr Kokil that MRI of the spine should have detected any of these if present. If MRI was normal, do you feel pain when breathing? Pain at the T6, T7 or T8 levels can suggest pleurisy, costochondritis, or slipping rib syndrome. Further investigation may be needed to determine the cause of your problem. Take care.

Comment by Perplexed on Wed 02, Nov 2011 07:20pm:
My wife, 74 years old, has the identical problem as Shoe. Osteoporosis was hastened by infusion of steroids (predisnone and decadron) over a 3 month period to treat her for low platelets. Suddenly, 4 months ago she developed severe sharp pain in the rib cage on both sides from the back to the breastbone. This pain has become chronic. Initially she was diagnosed with costochrondritis, however, MRI's and CT scans found fractured and collapsed T6, T7, and possibly T8 vertebrae that are believed to be inpinging the nerve. She has seen 3 orthopedic surgeons, 2 neurosurgeons and 2 pain specialists, including Mayo Clinic. Soft bones and age preclude surgery and nerve blocks are not an option as the area is too close to the lungs. The word is that pain management is the only option, but she is sensitive to narcotic pain medications in effective doses and lower doses do not help much. It is all a Catch 22 situation. What kind of quality of life can a person have in this condition?

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