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Pain Management

Upper Back Pain

12/07/2007

Question:

I am 45 and since August I've been experiencing upper back pain. I woke up on August 25th with a very sharp pain between my left scapula and spine. Later on I did not have full range in my neck motion. Since August the pain between my scapula and spine has come and gone. I had three weeks of massage therapy at a pain doctor`s office. The therapist spread both of my scapula out to the sides as much as she could. After that my pain seemed to spread to the top and side of my scapula. She did not spread out the scapula for a week after I told her I was hurting. But during the third week of therapy she pulled my left scapula and started massaging under it. This time I stopped her quickly, but I still had the pain afterward like when she spread the scapula out to the sides. The pain has come and gone since therapy depending on how much I move my left arm. For instance, when I tried the exercises they taught me at therapy or hold my arms straight above my head, it has come back for a few days. My neck now has improved range but I still have some tightness on the left side of my neck and shoulder. Lately the pain between my spine and scapula is dull but underneath my left scapula I have a lot of pain. Do you know what could be causing this? I`m afraid to have more massages because it hurts so much under my scapula.

Answer:

Before ascribing the pain to muscle tension, one has to rule out other causes of pain in that area. Work-up for chest problems as well as thoracic and cervical spine problems is indicated. A second opinion with another physician may be helpful.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University