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The pain sounds neuropathic. What is the distribution of the pain? Does it follow a spinal nerve? Is it only on one side?
I can think of 2 causes of this pain. The first is that the cold sets off inflammation in the back which then invoives the nerve. It would not show up on investigations like XRays or CT Scans, as it is inflammatory in nature. The second possibility is that there is preexisting damage to the nerve and you have a condition of sensitisation called “Allodynia” in which a no noxious stimulus can cause pain.
The are needs to be examined for a neurological deficit when you are NOT having the pain. If there IS, the the second cause you be more likely. If there ISN'T, then the first cause is more likely. The treatment would be to either prevent or lessen the inflammation, with Non Steriodal Anti Inflammatory Medicine or to use an agent for neuropathic pain, depending on the diagnosis.
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Exercise Physiologist, Physiotherapist
Hi,
You mention you have Sheurmann's disease. There are structural changes to your spine, with likely the most loading through the thoracic spine - likely at, as you mention,T8.
The burning pain in colder weather may be related to local nerve impingement. The pain may be increased due to sensitisation of the nerve from you having Sheurmann's for several years. This is the allodynia (increased pain to another wise ‘normal’ stimulus) that Dr Leow mentioned.
Even though you can localise the pain, the spine is a ‘chain’ and improving mobility of as much of the spine as possible is likely to help. You mentioned exercises… what have you been advised to do? There are three stretches that are likely useful - cervical retraction, thoracic extension and lumbar extension.. You can look these up. A McKenzie trained physiotherapist would be able to help you with these.
Another important strategy is supported posture. Use of a pillow or lumbar roll in the small of the back when sitting helps to alleviate ‘pressure’ on the painful area, helping to reduce sensitisation of the nerves.
Any further questions, I'm happy to help.
Regards, Neil
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I agree with the above advice, however another cause to be consider would be dysfunction in one of the posterior rib joints. This condition tends to be more prevelant during colder months, perhaps related to an increase in coughing due to common colds. If the pain is exasperated by taking a deep breath than a rib restriction is a possiblity. This condition is easily treated however it does tend to reoccur.
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