Patient: I am a 57 year old man, in excellent physical condition – work-out at gym 4x week and walk 3-6 miles 3x week. Recently, while walking – typically after about 3 miles, I get a very sharp pain in my back – just beneath the shoulder blade. This ONLY occurs while walking and the pain requires me to stop and stretch by grabbing my ankles from a sitting position. This temporarily relieves the pain, but it soon returns. On occasion, the pain will shift to the left side. Please advise possible causes.
Doctor: You might be,most likely, experiencing a mechanical upper back pain, produced by the straining of that segment of the s spine, you probably are not stretching adequately before beginning your physical activities and also maybe you do not have enough time to heal when you started training again added more stress to an affected area not totally healed. The conservative treatment of the upper back pain is basically relative rest of the spinal segment involved, avoiding all the activities that produce pain or discomfort, such as weight lifting. Also very important is the reeducation to keep a good posture at all times. Control of the pain and inflammation with Ice, transcutaneous electrical nerve stimulation (TENS), and anti-inflammatory drugs (such as ibuprofen). Keep a consistent exercise routine with stretching and extension-flexion which may reduce tension and stress to the spinal joints. A home program is developed within the tolerance and ability of the patient in order to encourage continued exercise after discharge from physical therapy.