Rhomboid Muscle Tear

by Brandon
(Quebec, Laval)

I've been in constant pain in my upper back on my right side exactly where my rhomboid is; the first initial sign of pain was really dramatic, the pain was deep and very powerful; over time now it's been 3 months.

I've seen physiotherapists, and after all this time my back still aches and hurts and just won't heal; is there anything I can do to help it heal properly and fully?

Or am I bound to constant aching and soreness for the rest of my life?

Please let me know, none of my doctors here can help me I'm very desperate.

Hello Brandon,
Normally I wouldn't respond to a letter written in such crap not-so-smartphone grammar; today I've made an exception, and corrected it for you. If you were French I would understand.

A muscle tear suggests you were lifting something very heavy, far beyond your strength. Is that correct? If not, I question the diagnosis. If it's wrong, then of course you are not responding to the treatment.

Upper thoracic pain is notoriously difficult; it can be a referred pain from the neck via the dorsal scapular nerve. Then it may indeed be a rhomboid muscle tear. Or, it could be from a subluxated rib head below the rhomboid muscle, or from the thoracic spine itself.

Then it could be from a lung condition, are you a smoker? Or referred from one of the organs. The pancreas for example typically refers to the midback.

In short, when any condition is not responding to treatment, a fresh look at the problem is called for; by someone else. Your doctor perhaps, another physiotherapist, a chiropractor, or even an orthopaedic surgeon.

Your call.

Dr B

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Apr 22, 2019
by: Anonymous

You are very entitled. I wish you luck in dealing with your own deep emotional pain. Someday you will also be unjustly judged for a small failing.

When you spend more time correcting people's grammar - Google disavows pages and even the whole site if there's poor grammar - than it takes to respond to the question, then it does get a trifle irritating. Especially when I write in bold that if you script in poor English, foreigners excepted obviously, don't expect an answer.

When a Pakistani can take the time to write properly, better than an English speaking person, for a service I do not charge for, then there's something wrong.

You are quite right; at my site I am entitled to call the shots. In this case the person was in great pain, needed an answer, and I made an exception.

I make no apologies.

Dr B

Mar 24, 2018
Helpful comments
by: Anonymous

Normally I don’t comment on such sites. I must take exception, though. You are an arrogant asshole. A person is in pain and seeking help. Do you require a written essay?

Perhaps you are right. But there's a but, and it's a big one. Google downgrades sites written in poor grammar. One of the conditions, spelt out in BOLD, that if you want me to respond, you write from a computer.

If he was from Pakistan, I would not have the slightest difficulty correcting his English. I do it all the time.

But it's the Americans by and large, and in this case a Canadian who simply couldn't be bothered to write correctly. I get letters all the time fromm people all over the world who take the trouble to write in their best English.

I have 13 more letters today waiting for an answer. They generally take me ten to thirty minutes. Comprehendo? There's nothing in this for me, no payment, no glory. If I had to spend all my time correcting spelling and grammar, I'd be here until midnight.

I am the master of this ship, and will in future not answer any of those who do not abide by the rules, to satisfy persons like yourself.

I don't make Google's rules, but I have to abide by them. If that's turned me into an arrogant asshole, so be it.

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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.

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.