Abstract
A case of thoracic spine spasms secondary to a bleeding duodenal ulcer is presented. A 41-year-old male with 14-week history of thoracic spine spasm was treated with bed rest, spinal manipulation, physical therapy, medication, and a thoracolumbar brace. Subsequently, a provocative thoracic discogram performed at T9-T10 created periscapular pain and also reproduced the presenting thoracic spasms. Intradiscal electrothermal annuloplasty (IDET) was performed at the T9-T10 level, but without sustained relief. The patient presented to a spine center for evaluation. The diagnosis of thoracic discogenic disease was suspected. A second provocative thoracic discogram was performed and failed to reproduce his thoracic spasms. Three weeks after being referred to a chronic pain management physician, the patient presented to a local emergency room with hematemesis. An endoscopic evaluation revealed a bleeding duodenal ulcer. Following medical treatment of the duodenal ulcer with a proton pump inhibitor the patient had complete resolution of his thoracic spasms. This represents the first reported case of thoracic spine spasms as an initial presenting symptom of a bleeding peptic ulcer.
Original language | English (US) |
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Pages (from-to) | 97-100 |
Number of pages | 4 |
Journal | Pain physician |
Volume | 4 |
Issue number | 1 |
State | Published - Apr 17 2001 |
Externally published | Yes |
Keywords
- Hemorrhagic ulcers
- Intestinal ulcers
- Peptic ulcer disease
- Thoracic spine muscle spasms
- Thoracic spine pain
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine