Pain in the upper back or mid-back can radiate into the shoulder blades or chest.
Causes
- Annular Tears – tears in the outer 1/3 of the disc which increase probability of disc bulges and herniations.
- Disc Bulge/herniation – an actual bulging of the disc in one area.
- Facet Joint Sprain or Locking – partial tearing of the ligaments surrounding the facet joints in the spine, or facet joints actually locking or being limited in their normal motion.
- Poor Posture – causing forward head, shortening of the anterior muscles of the neck and shoulders, lengthening and weakness of the posterior muscles of the shoulders and upper back.
- Subluxed Rib Heads – since the ribs attach to the spine and the sternum, certain injuries can cause a slight subluxation of the rib head at the spine leading to pain in the chest, as well.
All of these conditions contribute to muscle spasms since muscle spasming is the body’s way of protecting itself when something in the spine is injured or not functioning properly.
Treatment
- Ice – always on acute injuries of any type.
- No Heat – heat causes increased inflammation in acute injuries.
- Directional Exercise – to reduce disc involvement and inflammation.
- Stability Exercise – to increase upper back stability and postural stability.
- Modalities (passive physical therapy) – to decrease inflammation and muscle spasming.
- Spinal Decompression – to decompress discs, reduce bulges, assist healing and ensure proper tissue reformation.
- Mobilization – improves and increases joint mobility in the spine including facet joints.
- Postural Re-education – Treatment should progress into a more specific exercise program for directional exercise and stabilization.
Be wary...
Medication can cover up the existing mechanical cause of your condition, and rehabilitation that doesn’t include specific and extensive exercising, plus instruction on how to manage pain when not in the clinic won’t solve problems of pain.