T Nation

Chronic and Painful Upper Back Issues


I have been dealing with chronic pain for almost 2 years now, and it has finally become unbearable. I wanted to see if anyone else has had anything like this, and how they handled it.

Two years ago I was training primarily in a crossfit-style exercise program (sub-20min workouts, sprints, heavy core lifts), and one day I decided to do a heavy bench press. I lifted, completed, and sat up, thinking to myself that it felt like I pulled something, I couldn't quite turn my head all the way to the right, and decided to call it a day.

It was a feeling like you slept on your neck wrong, with a knotty ball over my right scapula. I'd had similar things occur in the past, but they always went away in a day or two.

This issue has never gone away. Every single day since this event I have been in excruciating pain in my right scapula region, sometimes up my into my neck/skull. The symptoms include:
* knotty, rope-like bands in varying locations from day to day (rhomboids, sub-scapularis, upper traps, lower traps)
* occasional (about once a week) tingling/numbness in my trapezius area
* headaches/ shortness of breath

I started by going to a doctor who injected cortisone into the muscle and told me to go to physical therapy. Ultimately this did nothing. My next stop was an orthopoedic surgeon who diagnosed it as bursitis (despite being an injury that came on suddenly, and despite having symptoms that respond well to massage). I have since been to numerous physiatrists, chiropractors, PTs, massage therapists, and accupuncturists. The only things that seem to help with any regularity are:

  • rolling on a lacrosse ball
  • myofascial release massage (although it is only a temporary solution, and the pain comes back each week if I don't continue to go to sessions)
  • stretching (although this only helps to a small extent, and on days when the pain is very bad, it seems like no amount of stretching solves the problem).

Things that seem to have little effect are electro-stim, ultrasound, and movement-based therapy. I continue to have snapping and clicking in the area, on top of the extreme muscle tightness.

The only thing I have yet to pursue are botox injections into the muscle to halfway-paralyze them and prevent them from spasming. I find this idea pretty frightening due to the permanent weakness this would likely cause in the area.

Has ANYONE ever seen/had anything like this? If so, how did you deal with it? I'm at a total loss as to how to proceed, and the pain is at a point where I am struggling even sitting at my desk all day!

Thanks in advance.


I should add that I have stopped exercising altogether due to the pain it causes in the area. I haven't been back in a regular routine for almost a year now.


I should also add that I have had 3 MRIs (scapula region, cervical spine, thoracic spine) and everything has come up completely clear. This is the most perplexing part.


Sorry to hear things aren't going well for you.

If you could get some photos of you standing and or some videos of your shoulder moving it would help tremendously.

While I haven't had this issue myself, I have had a couple of clients who had.

Here is a girl who had a very similar sounding issue as you. This started with her after she was in a car accident. So, it was a traumatic event, not chronic, much like your. Watch her right shoulder blade: http://www.youtube.com/watch?v=ak7xd4M7Nqo

The faulty shoulder blade movement was causing her pain. After a few weeks (only a few weeks!) she was able to correct things quite well: http://www.youtube.com/watch?v=WHPrQ5LvJvs

And then after a couple of months her shoulder was able to kick ass: http://www.youtube.com/watch?v=MZ2Mubt3rUE


Hopefully this gives you some hope that you can alleviate your issue. Like I said, provide as many photos or videos as you can and I'll help you out as best as I can. I've had a couple people with a similar sounding issue but not all had the same issue causing the issue (if that makes sense :slight_smile: ).


BReddy -

I'm not sure pictures would help. I have full movement and rotation of my arm and shoulder. The only visible issue that I'm aware of slight winging of my right scapula. Also, my only painful movement is attempt to turn my head all the way to the right, which seems to pull on my levator scapula or rhomboid.

The areas surrounding the inner edge of my scapula are chronically ridden with muscle knots and feel like concrete, which result in extreme pain, and a tiny bit of swelling.

I've recently started taking Lyrica, and it has lowered the pain by about 70%, which is great. I can, however, still feel all the knots there, i just don't feel the pain. This makes me wonder if I'm really dealing with the issue properly.

I am wondering if something is wrong at the base of my levator scapula, despite the fact that no MRIs have shown anything anywhere.

If you have any suggestions on what could possibly be causing the issues, it would be greatly helpful.

In the case of the videos of the girl you showed - what was ultimately wrong with her?



Short update: After 1 week on Lyrica, I have gained a swift 8 pounds in my midsection. While this drug reduces pain significantly, the knots remain in my back (the nerves just dont fire), and I am putting on unwanted weight.