Interventions in Chronic Pain Management. 2. Diagnosis of Cervical and Thoracic Pain Syndromes

Freedman MK, Overton EA, Saulino MF, Holding MY, Kornbluth ID. Interventions in chronic pain management. 2. Diagnosis of cervical and thoracic pain syndromes.This self-directed learning module highlights approaches to the investigation of common cervical and thoracic conditions. It is part of the chapter on chronic pain management in the Self-Directed Physiatric Education Program for practitioners in physical medicine and rehabilitation. The differential diagnosis of cervical and thoracic syndromes as well as cervicogenic headache is reviewed. The need for a comprehensive history and physical examination is emphasized. Indications for diagnostic tests including magnetic resonance imaging, computed tomography scan, bone scan, diskography, radiographs, diagnostic injections, and electrodiagnostic studies are discussed with the idea that testing should be performed and interpreted with the specific clinical presentation in mind.Overall Article ObjectiveTo discuss the differential diagnoses for and investigation of common cervical and thoracic conditions and cervicogenic headache.