What is the nature of thoracic cage pain in a female patient in her 60s with undiagnosed scoliosis (scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine)?

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From the Research

Rib cage pain in a female in her 60s with undiagnosed scoliosis typically presents as a chronic, dull aching or sharp pain that may worsen with movement, deep breathing, or certain positions, and prompt medical evaluation is necessary to determine the underlying cause and appropriate treatment. The pain often occurs on the side of the curve's convexity where ribs are more prominent and compressed. For management, I recommend starting with over-the-counter pain relievers like acetaminophen (500-1000mg every 6 hours, not exceeding 3000mg daily) or NSAIDs such as ibuprofen (400-600mg every 6-8 hours with food) for short-term relief, as suggested by general medical knowledge. Physical therapy focusing on core strengthening and posture improvement is essential for long-term management, as shown in a study published in 2021 1. Heat therapy (20 minutes several times daily) can help relax muscles, while gentle stretching exercises can improve flexibility. The pain occurs because scoliosis creates uneven pressure on the rib cage, leading to muscle strain, nerve compression, and potential arthritis in the costovertebral joints where ribs connect to the spine. Importantly, this woman should seek medical evaluation promptly as undiagnosed scoliosis at this age could indicate adult degenerative scoliosis, which may require specific treatment approaches including possible bracing or, in severe cases, surgical intervention, as discussed in a study published in 2005 2. A recent study published in 2021 3 highlights the importance of considering scoliosis as a potential cause of pleuritic chest pain, and thorough physical examination of the anterior and posterior chest wall is key to identify underlying scoliosis in otherwise fit patients presenting with sudden onset of pleuritic pain.

References

Research

The adult scoliosis.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2005

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