Deep Rhomboid Pain with breathing

by Amy
(Minnesota, USA)

Deep Rhomboid Pain with breathing suggests a subluxated rib head.

I have recently developed left side deep rhomboid pain. About 14 days ago it started and was extreme pain. I was not doing anything strenuous at the time of onset, but I did feel a tingling "pop" in that area. Within 30 hours of onset, my family took me to the Emergency Room, because I was suffering so greatly. They diagnosed it as "Rhomboid Spasms". I received muscle relaxers and pain medication, and sent home to rest with alternating heat and ice. I stayed home from work for one day after ER visit (desk job, but I use an adjustable standing desk and wear orthopedic support shoes). I have seen a massage therapist, who was able to reduce the pain, but it only lasted about 12 hours. Since then, I have used up all the awful pills, and have continued using over the counter pain meds (Aleve, Advil and Tylenol) to try and take the edge off this awful pain. My doctor has now prescribed steroids to see if that helps.

More about me:
-42 year old female, active, overweight but losing weight, I eat very low carb

More about my pain:
-It does not get better or worse with arm, neck or torso movement
-A deep breath makes the pain sharp
-When I am lying down the pain is minimal
-when I am sitting or standing, the pain is at its worst
-when I am walking, the pain decreases
-however, when I am walking, there is a deep ache in my left calf and the area behind my knee. I do not feel this leg ache when sitting or standing
-Heat and ice BOTH take the edge off

Let me know if you need any more info, but I am desperate to know what to do. I am miserable while working (I LOVE MY JOB), and the pain is making me very grumpy and hard to be around. I just want to lie down to get pain relief. Please help. What else can be the cause of this awful pain?

Apologies for the late reply, Amy. I've been on two weeks leave.

This really is a simple one; the key sign is that a deep breath gives you sharp pain. You have subluxated a rib head in the middle of your back. The primary problem has nothing to do with the rhomboid muscle.

I can virtually guarantee that deep pressure over the offending rib head, just lateral to the spine, will be very painful.

At this stage it may be radiating along the rib, under the armpit, under the breast to the sternum; if so I strong recommend that your chiropractor uses an "anterior thoracic" rather than a heavy P to A manipulation which may aggravate the pain.

This really is one of the simpler things we treat, Amy. You've been led a giddy dance by those are not up on a rib head subluxation.

If there are any complicating facts like a fever, cough, or old thoracic spine injury then an x-ray would be beneficial though this is rarely the case; you have a subluxated rib head. Almost guaranteed!

Let me know how you get on. By the way, apart from having treated thousands of similar cases, I've had it myself. You're not wingeing about nothing; it hurts! Perhaps print this out and take it to your chiropractor with you.

Well done on getting the pounds off; keep up the good work. Thank you for a very well presented case history.

Dr B

Comments for Deep Rhomboid Pain with breathing

Average Rating starstarstarstarstar

Click here to add your own comments

Nov 02, 2017
Rating
starstarstarstarstar
Rhomboid pain shooting down my left arm
by: Joey Pain

I have similar pain except for the breathing part; my rhomboid pain is on my left side and shoots down my left arm and gives it such a sharp and uncomfortable pain it feels like sciatica.

I've taken Gabapentin, Tylenol Extra Strength, Advil Extra Strength and cyclobenzaprine 5 mg; nothing seems to be working, I have to keep my head tilted to the right in order for the pain to not feel so severe, any advice that would help me is greatly welcomed.

Hello Joey,
First a BIG no-no. Taking many different medications like that simultaneously greatly increases the risk of a severe kidney reaction; and if they're not working anyway, then there's no point in further risking your health.

You are have a condition called a brachial neuralgia; a pinched nerve in the neck that supplies both the midback muscles and the arm.

The first step is to establish as accurately as you can which fingers are affected.

The second step is to get some x-rays of your neck, including 'obliques', followed by a MRI scan if it's an option financially. This is a difficult condition and the more information available to the clinician the better.

Then a careful and thorough examination; I can't promise you any easy road ahead; it often leads to surgery and is one of the more difficult things we treat.

Having said that my second patient this morning reported he is about 20% better with a very similar problem, after only two treatments.

The rhomboid mid back muscle is supplied by the deep scapular nerve, pure C5 which also goes to the arm; here it would seem lies the problem.

Meantime be kind to your neck and upper back; don't carry heavy parcels or a briefcase in the left arm.

Two tests will confirm my suspicions; obviously making an internet diagnosis is highly suspect!

Does turning your head to the left and then looking up provoke upper back and perhaps arm pain? This is called Spurling's sign.

Is the upper limb tension test positive. You can find both these tests by using the Site Search function at Chiropractic Help. I wish I could be more positive; rhomboid pain shooting down the left arm is usually difficult.

Let me know how you get on and whether those two tests were positive.

Dr B

Aug 09, 2017
Rating
starstarstarstarstar
Similar Pain
by: Jason

I feel like I am having a similar problem. My left Rhomboid muscle hurts from deep within. Often pain is minimal while lying down and sitting down is the worst. The pain sometimes shoots to the front into my chest sternum. A couple of ribs are sore as well. Walking does not aggravate the pain neither does arm movements unless there is pressure on them in cases of lifting or exercising like doing push ups. When the pain does flare up after exercising, my Rhomboid muscle gets really sore causing me to avoid arm movements. The pain sometimes runs from the Rhomboid muscle into the edge of my shoulder blade. Also, it is not that I cannot move my arm, but rather I avoid moving it to avoid aggravating my Rhomboid muscle. This is only after exercising like doing push ups or if I go heavy on the band tensioners. Normally, arm movements do not cause me any grief.

So doc, if you could elaborate if this a rib head issue as well and if it indeed is, is there a specific scan (like a x-ray maybe) that can pin-point the problematic rib. Also, doc if you could explain or maybe post links to what a P and A adjustment and the Anterior Thoracic technique are, that would be great. Just trying to learn what these techniques are and if my chiropractor is following them or not. Thanks.

Hello Jason,
This is diagnostically a hugely difficult area; for example the rhomboid is supplied by C5, so it can be a neck issue; likewise a lung condition, various pathologies. Rule of thumb: if it's not getting better despite treatment, get a lung x-ray taken.

However, this certainly sounds from a distance like a rib issue; the subluxations are so small, but extremely painful, I know I've had it myself and treated tens of thousands, so can't be seen on x-ray or scans; they would rule out other pathology though, so certainly useful.

If the pain is referring along the rib to the sternum, then I find that a heavy adjustment in the middle of the back, P to A, posterior to anterior, just makes it worse.

An 'anterior thoracic' adjustment, usually done with you lying on your back, doc's fist under the offending rib, and with the two of you slightly embarrassingly face to face, thrusting from anterior to posterior is usually more effective. Also done sitting or standing.

If there's a painful spot over the rib-sternal junction then it's causing a costochondral subluxation and, if there's a palpable lump, what's knows as Tietze's syndrome. Find both using the Site sell function at Chiropractic Help.

Chronic rib issues can certainly be difficult, they respond but tend to occur; sometimes a monthly visit is the only option to keep it under control.

I hope this helps; perhaps type it out for your chiropractor.

Dr B

Mar 18, 2017
Rating
starstarstarstarstar
This is what I needed to hear
by: DBP

Wow, I have a rhomboid muscle strain that has now radiated to rib when breathing in; and pain under the breast bone to the sternum! Exactly the same thing. I'm hoping that physical therapy will help soon!

If it doesn't, consider a chiropractor; rib pain is one of the things that we excel in; but a heavy manipulation in the middle of the back is not a great idea; may make the chest pain worse.

Dr B

Click here to add your own comments

Join in and write your own page! It's easy to do. How? Simply click here to return to LOVE HATE.



Find a Chiropractor in your USA location

Zip Code or Location


Recommend your chiropractor
Would you like to recommend your
chiropractor to other people? If so, post
his or her details here.

Please note that all fields followed by an asterisk must be filled in.

Please enter the word that you see below.

  


Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.


Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.