I am beginning PT for upper back pain I have been having around the shoulder blade. Below is a detailed summary of my treatment experiences thus far. I would greatly appreciate any and all advise on what to do next.
The following is a brief description of the discomfort I am feeling and what I have tried to do to help myself thus far with no success:
I started weight lifting again after a couple years in late September 2011. I started out light and gradually worked my way up to working out 6 days a week. 4 days lifting and 2 days doing cardio such as running or biking.
Over the course of three months I was gradually increasing my reps and weight. I also had begun doing a significant amount of back exercises including squatting, which I had never done before in my life. However, I only lifted up to 100 lbs.
On December 20, 2012, I was more significantly sore than usual. I figured I had just overdone my workout. However, this discomfort continued. And I had a tugging / pulling type pain in around my right shoulder blade.
I figured I just needed to rest and my body would heal itself. However, this did not happen. When I would try to work out, the next day following I would find myself significantly sore especially at the bottom of my right shoulder blade toward the armpit. (Diagram)
So, in mid January I realized I needed special care. I proceeded to get chiropractic care as I have had success with it in the past for other problems. After two initial visits, I did not find myself improving and the tightness of my upper back and shoulder blade continued. Indeed I felt even sorer after one session. I believe the “agitation” of the shoulder blade area gives me pain. I waited a couple of weeks to see if my body would heal on its own.
However, It did not. So I decided to seek help from a regular medical doctor. This one in particular was a D.O. Doctor of Osteopathic Medicine. I felt he was very thorough and ruled out a lot of possibilities. But he admitted he did not know what exactly was wrong with me. Note both he and the first chiropractor tried to move my muscles, arms and joints in a certain way to see if I had any discomfort. In the vast majority of all these tests, I never respond as experiencing pain. The pain is not something that comes right away; it comes later often the next day. Another time I experience pain is when I am driving, especially when I am stepping on the gas. When I step on the brake and my body lurches forward, I start to feel better. I also have noticed I feel better when slouching down in my truck versus sitting straight up. My theory is that there is less weight and gravity pushing down on the area that is causing me pain in these instances.
My visit to that doctor did not help me resolve my problem, so in late February I decided to seek a different chiropractor that could give me a second opinion. I also asked him to do an x ray of my spine to check for problems. The X-ray seemed quite normal save for a minor curve in the spine to right at the top. (drawing)
I proceeded for treatment from this professional because he seemed quite knowledgeable. And I ended having four sessions from this person. Yet I still have discomfort in the tissue surrounding my right shoulder blade. I admitted this concern to the chiropractor and we talked about the possibility of getting a trigger point injection as he did notice a large trigger point near the bottom of my shoulder blade.
I proceeded to get a trigger point injection from a doctor in Dodgeville. During that visit, he noted that my right shoulder blade felt somewhat different from my left shoulder. I didn’t quite grasp what he was explaining but he indicated the trigger point injection is only something to try, as many people feel better only for a few days, and some none at all.
In my case I did not feel any improvement from the injection whatsoever. In fact, I felt worse the next several days. It was just like after I had the massage. The subsequent days were more painful. It seems that the more I “disturb” the trigger points, the more discomfort I have.
Both my chiropractor and the doctor who did the trigger point injection recommended I consider physical therapy as another treatment option.
Given what I have tried so far, I find there are several options given my situation. The first of which is physical therapy, which is why I am here today. Another option that has been suggested to me is acupuncture. However, given that “disturbing” the areas that are bothering me seems to bring increased pain, I am hesitant to pursue that option at this point.
I suppose an MRI is an option as well, which is expensive, and there is no guarantee that anyone is going to find anything wrong from the results of the scan.
So, with that in mind, I find the best options are either resting my arm, to a level which I haven’t done yet, strengthening certain muscles near the shoulder, as perhaps some other muscles are over pulling certain areas causing my pain, or stretching exercises that could alleviate some of the pain as perhaps there are tendons or ligaments that are torn or strained from my working out.
However in regards to trying any of the options I am nervous about doing so because I do not know what the specific problem is, and if I exercise or stretch the wrong way, I think I will continue to experience pain the way I have been the last three months.
Again, my goal here today is to hopefully gain a better understanding of what my problem is given my symptoms and history and, hopefully, physical therapy can be a solution to my discomfort and better well being.
What makes it worse?
-Sitting in a vehicle (especially when pressing the accelerator such as at a stoplight when turning green. Sore at top of shoulder blade and also side in between spine.)
-Trigger Point Injections
-Lifting weights (sore at bottom of shoulder blade the next couple days)
- Soreness occasionally decreases as the day goes forward. Driving home is often more comfortable than driving to work.
What makes it better?
Lying down on my stomach
-Bending towards my right side
-Bending my neck back toward my shoulder blade.