Chronic Upper Back Pain Between Shoulder Blades associated with weighted hyperextensions

by Jon
(Cincinnati, OH)

How many coloured foods do you enjoy daily?

How many coloured foods do you enjoy daily?

Chronic Upper Back Pain Between Shoulder Blades associated with weighted hyperextensions suggest a reevaluation of your program.

For the past 8 months I have battled with upper back pain between my shoulder blades and below. I am 29, weigh 205 lbs, 6'1", and am in pretty good shape. The only thing I can possibly contribute my pain to is doing weighted hyperextensions in the gym? Did not have immediate pain after the work out session - no other recent injuries. Here are the steps I have taken and information I can share.

Chiropractor for 2 months - no progress
2 doses of oral steroids - no progress
Thoracic Xray - Shows mild arthritis and scoliosis
Thoracic MRI - T1-T2 partial disc desiccation.
T9-T10 disc desiccation. Tiny posterior osteophyte complex.
Physical Therapy for ~3 months - I would find immediate relief from "manuals" but the pain would return the next day.
Steroid injection in muscle around T10 - no change
New chiropractor for 1 month - no progress
Spinal injection in T9/T10 - no change.
New chiropractor/acupuncture for 2 months - no progress
Prescribed Backlofen and Diclofen - I've seen some progress from this, but have been off it recently due to other medication.
Neck MRI - C5-C6 Disc desiccation and mild disc narrowing anteriorly. Broad Based mild posterior disc bulge touches but does not compress cord. AP thecal sac dimension is 10 mm in the midline. Cervical curvature is reversed at this level suggesting muscle spasm.
C6-C7 - Miniml Schmorl's node in the left side of the superior C7 endplate.

I continue to see a acupuncturist and chiropractor, and see benefits immediately following the visit. But the next day I'm back to the same levels. Since getting the neck MRI, I have tried neck stretches and have noticed benefits from that. When I put my neck down to my chest, my upper back is tight. No pain when moving my neck in any motion, or even my back.

I've noticed the following things to cause increase pain. Holding weight in front for long periods of time (holding my 3 month old), sitting down. I don't have tingling in my fingers but, in my limited research, I wonder if this could be a nerve issue stemming from C5-C6?

Hello Jon,
Obviously you've got everyone scratching their heads, including yours truly.

Firstly a few general comments. The purpose of the gym is to make you healthier, not miserable. As a general rule, we see a lot of injuries from the gym; I'd reassess your whole program with an expert for starters; perhaps go much lighter with more repetitions.

Weighted hyperextensions put a lot of pressure on the facet joints of the spine; I see little benefit and high likelihood of injury.

Secondly, loss of the cervical lordosis means you've had an old whiplash injury. That's confirmed by the fact you have C5-C7 abnormalities on x-ray and MRI. Old car accidents, whiplash, falls from horses and so on leave their mark. This gives some credence to your belief that the midback pain may be coming at least in part from your cervical spine; the dorsal scapular nerve that supplies the rhomboids and levator scapular is a pure C5 nerve.

My recommendation would be to continue with the treatment you find most effective, and stay away from the gym for the present. Perhaps take to the skipping rope, dull I know, but effective.

What's clear is that no treatment is being effective; so you have to figure it out; writing letters like this is the start. Keep thinking, talk to lots of people. Keep saying to yourself, the purpose of gym is to make me healthy.

I hope this makes some small contribution to an obviously complex subject.

Think food too by the way. Are you on a high protein diet to build a Mr Atlas physique? What is the ratio of omega 6/ omega-3 like? How many coloured foods to you eat daily? How many bagels, colas and other crap do you enjoy?

Good luck, let me know how you get on.

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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