Mechanical Upper Back Pain: Conservative Treatment

Patient

Q: I pulled my back muscle 8 months ago i believe its the rhomboid muscle. i pulled it lifting weights, i couldnt turn my neck when i woke up the next morning so i waited a week and i felt like i was back to normal and tried to hit the weights again and pulled it again but it hurt on both sides of my back this time. both rhomboid muscles felt like they was on fire for about 4 months i couldnt sleep or do anything it was horrible then it started healing but now 8 months later i still have pain not near as bad as when i first did it but it still feels like its on fire if i stand for too long or im doing something to put strain on it. its like it got to a point that it just wont heal anymore. When i wake up in the mornings my back feels really stiff then it feels kinda normal after an hour or so. I have had a x ray taken and nothing showed up and i have had a MRI and nothing showed up on that and i have been to the chiropracter and that didnt help i have also taken physical therapy and that only helped for a short period of time it felt better just for 2 hours or so after the therapy and went right back to hurting i have been to multiple doctors and they never give me a answer and tell me whats wrong

Doctor

A:   In the view of your imaging studies (X rays and MRI) are normal, ruling out any other structural spinal cause for the pain, most likely you are experiencing a mechanical upper back pain, produced by the straining of that segment of the spine, and the fact that you did not have enough time to heal when you started to lift weights 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 patient’s 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.

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