Very bad pain around rhomboid area

by David
(toronto canada)

Good evening,

I am going on 2 months of uncomfortable stiffness by my rhomboid. First it started off in the right side, and then the pain has gone to the left, followed by an extremely stiff neck. I just awoke and was in pain one morning; I have no pain or tingling in arms or legs. I have recently got deep massage therapy, stretched and taking hot baths. The very experienced massage therapist and doctor don't think it's a disc problem, but after almost 3 months now, I am in extreme pain when the massage therapist touches the area on both sides near the rhomboid.

I am not working right now, and all i have been doing to resting; my condition hasn't got much better except the stiffness in my neck has got a tiny bit better.

The doctor ordered a CAT scan, and I am waiting for to get it. I am also seeing a physiotherapist for an ankle injury and he said suggested go back to working out which I obviously haven't done in 3 months. This has effected my life greatly and me going back to work, any advice on what tests to get and so on would be greatly appreciated.

I am seeing another physiotherapist about this condition this week, but it just seems hopeless to get any answers or proper advice.

Hello David,
Obviously the stiff neck is connected to this. The Dorsal Scapular nerve comes from C5 in the lower neck and supplies both the rhomboid and the levator scapula muscles.

Rhomboid area pain is difficult both to diagnose and to treat. It may come from your neck, a rib subluxation, a condition in the midthoracic spine, the lungs. So a sound diagnosis is the first step.

Your doctor obviously thinks it is a bony condition, hence the CT scan. But of what area is being taken? Midback or neck? A thorough clinical examination to decide whether this is from your cervical or thoracic spine is vital. If it's from your neck, and they scan your midback, they won't find the villain of the piece.

If it is a disc in the neck, an MRI would be more useful that CT.

We have a saying in our profession: "if yours is not a chiropractic problem, spinal manipulation won't help; but if it is, probably nothing else will help."

Time for an opinion from an experienced and thorough chiropractor? Toronto is loaded with them. Start talking to friends and family, and your doctor.

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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