Conditions

Understanding Thoracic Radiculopathy

Thoracic radiculopathy occurs when a nerve root in the mid-back (thoracic spine) becomes irritated, compressed, or inflamed. These nerves travel from the spinal cord around the chest and abdomen, so irritation can cause pain that wraps around the chest wall or upper abdomen — often mistaken for heart, lung, or abdominal problems.

Typical symptoms include:

  • Sharp, burning, or shooting pain radiating from the mid-back to the chest or front of the abdomen
  • Tingling, numbness, or altered sensation in a band-like pattern around the ribs
  • Localised back stiffness or discomfort between the shoulder blades
  • Worsening pain with coughing, sneezing, or twisting movements

Common causes include thoracic disc herniation, spinal arthritis (spondylosis), facet joint changes, or occasionally shingles (post-herpetic neuralgia). Because symptoms can mimic heart or abdominal conditions, thorough specialist evaluation is essential to confirm the spinal origin of pain.

Wessex Pain Clinic

How We Diagnose

At Wessex Pain Clinic, our consultants perform a detailed clinical assessment to understand the pain pattern and identify potential nerve involvement. This includes a careful neurological examination to assess sensation, muscle strength, and reflexes. We often use MRI scanning to visualise the thoracic spine and pinpoint the affected nerve root.
Wessex Pain Clinic
Lifestyle and Complementary Therapies

Thoracic spine pain often improves with attention to posture, core strength, and movement patterns. Our physiotherapy and rehabilitation specialists focus on restoring balanced movement, improving spinal flexibility, and reducing strain on the mid-back. Hydrotherapy can be particularly helpful for gentle, supported movement.

Our pain psychology partners offer strategies for managing chronic nerve pain, stress, and sleep disturbance. When appropriate, we coordinate with neurology or surgical colleagues for integrated care.

At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Medications

We may prescribe:

  • Anti-inflammatory drugs (NSAIDs) to reduce swelling and inflammation
  • Neuropathic pain medications such as gabapentin, pregabalin, or duloxetine to calm nerve irritation
  • Short courses of analgesics for acute flare-ups


Medication is carefully tailored and reviewed to ensure optimal relief with minimal side effects.

Interventional Procedures
If symptoms persist, we offer image-guided thoracic nerve root blocks — targeted injections of local anaesthetic and corticosteroid to reduce inflammation around the nerve. In complex or resistant cases, we liaise closely with spinal surgeons for possible decompression procedures when structural compression is confirmed. For persistent cases, radiofrequency modulation may be considered to reduce ongoing nerve irritation.
Thoracic radiculopathy is best managed through a comprehensive, multidisciplinary approach, addressing both the nerve irritation and the surrounding spinal mechanics.

Treatment at Wessex Pain Clinic

Treatments