Hello! Thank you for asking on HCM! I read your question carefully and would like to explain that his symptoms seem to be related to radicular pain, caused by a displacement of the thoracal spine disks, leading to irritation and inflammation of the nerves that originate in this region of the spinal cord. I would recommend consulting with the neurologist for a careful physical examination, a nerve conduction study and thoracic spine MRI or CT scan to examine better for possible compression of the spinal cord. Divalproex is usually helpful in nerve pain. This may be a reason why he has not had any problems since the fractures. I recommend performing valproate plasma levels, to see if he is being treated in therapeutical doses. Regarding the treatment, I recommend discussing with your doctor the possibility of increasing divalproex dose (based on the plasma levels results), or adding another antiepileptic drug (pregabaline or gabapentine) to your therapy. Hope to have been helpful! Greetings! Dr. Iliri