Upper Back Pain - advice please

by Nicola
(UK)

I feel a painful "catching" sensation at a point in my upper back (somewhere around T2-T5) a few times a day when I lift my right arm to open high up cupboards since about March this year. I have had some fairly mild whiplash injuries in the past affecting that area but I think this problem started when I had to pull on a door handle that is a about shoulder height very powerfully to overcome a sticking catch a few times a day.

It was not for a couple of weeks that I realised this might be the cause of the pain and fixed the door. I think the intensive training that I did for the Etape du Tour, a 90-mile alpine cycling event that I did in July, may have exacerbated the problem. I certainly felt the bumps in the road traveling through the handlebars to that area.

I have all but given up cycling for the time being due to this and taken up pilates which I enjoy.

I feel the "catching" when I raise by arms above my head and lean to one side for a stretch during the pilates class.

I went kayaking for the first time in years today and felt the catching straightaway when I began paddling forwards but it didn't bother me at all when I paddled backwards. I've been to two chiropractors one of whom I know is definitely fantastic at her job and has sorted out many back problems for me. Neither could find much wrong except that I was a bit "locked up" around there. I would be very grateful for your advice. Since my chiropractors haven't found much wrong, I am wondering if I should treat it with specific exercises or remedial massage. Help gratefully received. Thanks.

Hello Nicola,
This is a difficult one, firstly because you are fit and muscular problem would surely have passed over, secondly because you've seen two chiropractors and done Pilates and thirdly because it's a difficult area any way.

Why is it difficult? It can be a referral from the neck via the dorsal scapula nerve. It can be dorsal joint, a facet problem or a rib condition. And lastly it can be a referral from something internal.

Does deep breathing ever hurt? Do you have any tenderness where the ribs join your sternum?

Does turning your head hurt?

My thoughts are that it probably has to do with the scapular rhythm, so I would be looking at the shoulder as well. Or the rhomboid or levator scapula muscles, but this is all pure surmise.

Since it's more than six months, I would recommend an xray of the area, and perhaps a good medical exam.

Let me have answers to the above questions.

Dr B

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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.



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