Upper Back Pain - advice please

by Nicola

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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