Side Chest Pain After a Fall in Seniors: Why We Must Check the Thoracic Spine

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

For seniors over 70, even a minor slip or a light bump can lead to unexpected injuries. Often, patients visit our clinic complaining of pain in the side of the chest or along the ribs after a minor fall.

If X-rays show no rib fractures and internal medical issues are ruled out, we must immediately turn our attention to the Thoracic Spine (middle back). Here is why a spinal check is non-negotiable in these cases.

1. The Pathway of Intercostal Nerves: From Back to Front

The most common reason for "referred pain" lies in our anatomy. The intercostal nerves originate from the thoracic spine and travel along the ribs toward the front of the chest.

When a Thoracic Compression Fracture occurs due to a fall, these nerves can become irritated or compressed at the source. Instead of feeling pain only in their back, patients often feel a "sharp" or "stabbing" sensation that radiates around the rib cage to the side or front of the chest. To the patient, it feels like a rib injury, but the actual "electrical short" is happening in the spine.

2. The "Silent" Nature of Compression Fractures

In patients aged 70 and older, bone density is often significantly reduced (osteoporosis). This leads to specific diagnostic challenges:

  • Minimal Trauma: A fracture can occur from an impact as small as sitting down too hard or sneezing, not just a major fall.

  • Misleading Symptoms: Because the pain is felt in the chest or abdomen, the spine is often overlooked during the initial examination.

  • Imaging Blind Spots: Standard chest X-rays are designed to look at the lungs and ribs. Without a specific Thoracic Spine View, a vertebral body that has started to collapse can easily be missed.

3. Preventing the "Domino Effect"

Missing a thoracic fracture can lead to serious long-term consequences:

  • Kyphosis (Hunched Back): If a compression fracture heals incorrectly, it leads to a permanent forward curvature of the spine.

  • Secondary Fractures: Once one vertebra collapses, the structural integrity of the entire spine is weakened, significantly increasing the risk of adjacent vertebrae fracturing.

  • Decreased Mobility: Chronic pain leads to bed rest, which in seniors can quickly result in muscle loss, pneumonia, or cardiovascular complications.

💡 Dr. Son’s Clinical Advice

If you or your loved one experiences persistent side-chest pain after a fall—even if "the rib X-ray looked fine"—it is time to look at the spine.

At Son Rehabilitation Medicine & Chiropractic clinic, we look beyond the immediate area of pain to find the true source. Early diagnosis of a thoracic fracture allows for non-surgical interventions, bracing, and specialized rehabilitation that can prevent permanent deformity and restore quality of life.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net

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