Thoracic Radicular Pain

Thoracic radicular pain most commonly presents after postherpetic neuralgia and thoracic surgeries. Other causes include neuropathic pain syndromes, musculoskeletal, intra-, and extrathoracic etiologies. Thoracic disc bulges rarely produce radicular pain and are more likely to cause pyramidal track symptoms. Pain can present acutely after trauma or insidious, as in neoplasms. Clinical diagnosis is based on history of trauma or skin changes and imaging to rule out other serious etiologies. Physical exam findings vary depending on the etiology. Treatment should commence with conservative therapies, including topical and systemic medications, and progress to interventional therapies and surgery, if indicated.