chronic pain in rhomboid area for 5 months

by GL
(Seattle, WA)

The uncinate process and joints of Luschka in the lower neck are a common cause of rhomboid area and shoulder pain.

The uncinate process and joints of Luschka in the lower neck are a common cause of rhomboid area and shoulder pain.

I have chronic pain in my upper back on the right side in the area of the rhomboid muscles. The pain is exacerbated when I look down and turn my head to the right.

I have had a lot of massage, trigger point therapy, heat therapy, with no good result.

I do have a partial rotator cuff tear on my right shoulder.
I do a lot of computer work, and often carry a fairly heavy backpack.

Any ideas you have would be appreciated. I'm currently in Thailand but will be back in Seattle
(my home area is Woodinville, WA 98071 zip code) in early August.

Thank you so much.

Hello GL,
The upper thoracic area is a something of a diagnostic nightmare as there are so many potential sources of the pain.

I take you have no chronic cough, or are a smoker; if so that's the place to begin. A chest x-ray.

Then it could be a local spinal condition, or one of the adjoining ribs. Scheuermann's for example favours that part of the spine causing chronic upper back pain.

More likely, explaining the shoulder pain and exacerbation with movements of your neck is an irritation of the dorsal scapular nerve. It derives from C5 which gives a major input to the rotator cuff muscles as well as the rhomboid and levator scap.

A subluxation in the T2 to 4 area certainly could be a spoke in the wheel.

When you get home get an x-ray of your cervical and thoracic spine and find an experienced chiropractor. I hope this contributes.

Dr B


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