Thoracolumbar Syndrome

Abstract

Groin pain in patients can be caused by inguinal pathology as well as referred pain from spinal pathology. Thoracolumbar syndrome is defined by a dysfunction of the thoracolumbar junction referring pain to the dermatomes of T10–L2. Low back pain is the most common complaint and is usually associated with a rotational twisting motion. Pain is unilateral, located in the low lumbar region, and may radiate to the lateral thigh. Pain is often worse with extension. Referred pain to the groin follows the dermatomes of T12 and L1. Most radiological studies will be normal and the diagnosis is made clinically. Criteria for diagnosis include a positive pinch–roll test, posterior iliac crest point tenderness, localized tenderness over affected thoracolumbar segment, and tenderness in the facet joints at the affected level. Diagnostic nerve block over the painful facet joint can confirm diagnosis. Treatments include spinal manipulative therapy, corticosteroid injection around painful facet joint, nonsteroidal anti-inflammatory agents, and physical therapy. Surgical treatment is rarely indicated.