Cervicothoracic Interspinous Bursitis is a painful condition of the upper back and neck.  A bursa is a fluid-filled sac that is present in many areas of the body.  After injury or overuse, these bursa can become inflamed and cause pain.  The pain of cervicothoracic interspinous bursitis is dull and aching.  It is usually confined to the midline area without much radiation outward.  It is worse with activity and relieved with rest.  Thrusting the neck forward will also tend to decrease the pain.  This condition is usually precipitated after extending the neck for prolonged periods.  The neurological exam is normal with the exception of localized pain in the area.  X-rays, MRIs and CT scans are useful to look for underlying anatomic problems that should be excluded such as disease of the spinal chord.  Electromyography and Nerve Conduction Studies are useful to exclude diseases of the muscle and nerves.  Blood work is used to look for auto-immune and collagen vascular diseases.  The treatment of cervicothoracic interspinous bursitis begins with conservative modalities such as heat, ice, rest and physical therapy.  Non-steroidal anti-inflammatory medications will decrease the pain and inflammation.  Injection into the area of a local anesthetic and a corticosteroid is also useful for treatment.