I feel like someone punched me in the back

April 24, 2012 10:37 AM

I've been suffering muscle soreness/stiffness in my back for almost two months now. I thought it was related to walking (see my previous question), I've reduced my walking to almost zero and the pain persists. What could possibly be causing this and how can I nip this in the bud?

The tension is in my neck and upper back, mostly around my shoulder blades. It is particularly severe on my right side. It feels very similar to the way you feel after a really hard workout, except I don't work out. I was walking a lot to get exercise, and also doing yoga, but both of those activities exacerbate the pain, so I've stopped doing them. I've been to two chiropractors, one of whom said my muscles were so tight on my right side, she couldn't even properly adjust me. She also noticed a significant amount of "crunchy" scar tissue along my right shoulder-blade, which may be the result of the coughing bout I had in Feb/March due to a misdiagnosed respiratory infection. The coughing has been gone for over a month, but the pain continues. Some days I feel fine, almost normal, and others I can barely function. It hurts to lie down or sit up straight. I tried doing yoga and by the end, my entire back had tensed up so much, I couldn't even move. My yoga teacher, after feeling my back, told me to avoid any positions that required me to lie on my back.

Both my chiropractor and my doctor suggested that I take ibuprofen to reduce the swelling, which I have been doing. But I don't want to take ibuprofen for the rest of my life.

I've tried soaking in epsom salts, massage therapists, medicated heating pads and posture adjustment. These temporarily soothe the pain, but it always comes back.

Right now I'm wearing 4 icy hot medicated heating pads at work, so so I can make it through the day, and they're not doing anything. The warmth feels nice, but every time I try to sit up straight, I feel like someone knocked me in the back.

I am at a loss for what to do next. I've spent so much time and money on this problem and no one seems to have a good solution. I just want a normal life. I'm only in my mid 20s. What is going on?

posted by chara to Health & Fitness (14 answers total)

I'd go see a physiatrist. They'll likely send you for physical therapy.
posted by amro at 10:41 AM on April 24, 2012

Do you sleep on your side? If so - how firm is your pillow?

I ask because I have a bad habit; I sleep on my right side, but if my pillow isn't super-extreme-massive-hard-n-firm, I will hunch up my right shoulder so as to "bulk up" the pillow under my head. It caused all sorts of upper back pain before I figured that out.

You sound a good deal more advanced, so see the physical therapist first - but check out how firm your pillow is if you're a side sleeper.
posted by EmpressCallipygos at 10:52 AM on April 24, 2012

I get that same problem when I let myself slip into poor posture habits when I'm sitting, especially hunched over at my desk. Maybe try paying attention to your posture when you're sitting and see if straightening up helps?
posted by joan_holloway at 11:05 AM on April 24, 2012

Sounds like you're still recovering from your respiratory infection.
posted by KokuRyu at 11:11 AM on April 24, 2012

How much time do you spend at a computer? And do you use a mouse with one hand? I spend many hours a day at a computer and find I get all sorts of odd things going on in my neck and shoulders. I'm right-handed and use my right hand for the mouse, but oddly enough it's often my left shoulder that starts to burn as if I'd worked out with heavy weights. A quick googling reveals many many exercises for shoulder and neck tension that can be done at work, sitting at a desk.

I walk a few miles most every morning and lately I've put a more effort into swinging my arms and even doing other arm exercises as I walk. It seems to be helping.

sleep position, pillow, or the bed itself could also be culprits. Is there another bed you can sleep in for a few days? do you have other pillows? I'm very picky about pillows.
posted by mareli at 1:00 PM on April 24, 2012

What happens if you try to do some gentle stretching on the days when you're not in super awful pain from the get-go?

TBH this sounds a little like what happens to me after a severe upper resp infection (or also after a lower back strain) - my body is so used to tightening up before coughing (or moving) to reduce/prevent anticipated pain that I end up all in knots long after the initial cold or injury has passed.
posted by elizardbits at 1:01 PM on April 24, 2012

Buy yourself a foam roll, e.g. at amazon (the white ones are cheaper, the black ones last longer).

Lie on your back. Put the roll under your back, and perpendicular to the length of your body. And then roll, length-wise, over the foam roll, from the base of your neck to the bottom of your ribs.

I'd bet good money you'll hear a loud crack or two, and then feel much better thereafter. Google "migrating ribs".

Hold onto the roll for future problems. Or use it daily to prevent the problem. You can also use it to work the IT bands on the outside of your thighs (painful at first, but as they unwind, everything feels better).
posted by Quisp Lover at 1:25 PM on April 24, 2012

PS If you belong to a gym, they'll have one of those foam rolls around, and you can try it there.
posted by Quisp Lover at 1:25 PM on April 24, 2012

Changing up my desk setup and finding a good physical therapist (and following her advice) has done more for my painful neck, upper back, and radiating nerve pain down my arm than anything else. The physical therapist who gave me fairly generic advice and spent 50% of our sessions measuring range of motion, writing it down, and then demonstrating exercises to do at home was kind of useless. The one who spent a long time feeling out how muscles hurt during which activities, and whether specific stretches or manual manipulation could change that sensation, has been a godsend. Even though it's still been a slog, my arm is now almost pain-free, and I finally feel like I have real tools to manage and reduce the pain. My neck is still "crunchy," but four months in at ~1 session/week, the involved area is now much, much smaller, and tends more to tightness than pain.
posted by deludingmyself at 3:27 PM on April 24, 2012 [1 favorite]

We have identical backs! Go see a physical therapist - mine fixed me in about 2 weeks. The key thing is to avoid a hunched over posture, which is to do for desk workers. The ideal seated position is actually leaning back with firm support under your shoulderblades - use a rolled up towel held closed with rubber bands. Sitting up straight is the exact *wrong* thing to do.

The foam roller (described by quisp lover upstairs) is essential, as is focused massage. In fact, one massage and 3 days of 5x day foam roller practically cures me.

For stretches, think backbends and side stretches - *not* forward bends, which tend to be overemphasized in yoga. Stretch to open up your right side (eg, bend to your left). I would avoid forward bend altogether.
posted by yarly at 3:55 PM on April 24, 2012

Basically I'll second EmpressCallipygos. I too am a side sleeper, and I had a very similar problem last year. Inside my right shoulder blade felt like I was being stabbed for months. It went away when I bought better pillows.

I got a very firm feather one for the bottom (for support) and a firm down on top (to cradle my head), and I sort of bend them in a slight U shape so they go around my neck with my bottom shoulder barely underneath. This really supports and lifts my head and chin. Within two weeks, I felt better. On my old pillows, the weight of my head was sorting of squishing down my neck and shoulder, causing the bulk of the pain.

Once it started getting better, I did some sessions with a massage therapist that did really intense (I mean INTENSE) trigger point therapy, and that took care of it. I don't know if this is your problem, but it may be something you can try. I couldn't believe something so simple was causing me such debilitating pain, but it was.
posted by mostlymartha at 4:09 PM on April 24, 2012

except I don't work out.

That's most likely the source of the problem.

You should note that all of the therapies listed thus far are palliative, aimed at reducing the felt effects of ongoing tissue trauma. Any ameliorative solution, however, will likely be based around fixing the movement patterns that are causing said trauma: strengthening your posterior chain musculature, particularly your thoracic extensors, which I'm willing to bet will be overstretched and weak relative to their antagonist muscles in your chest and hips. This is a basic and overwhelmingly common postural problem, and is practically assured for young women not engaged in some form of regular strength training (yoga, pilates, zumba, etc. do not count: you have to pull something heavy to counteract the anterior tension accruing through day-to-day activity and learned posture).

A physiotherapist will be able to offer a full postural assessment and regimen of corrective exercise to address the root cause of the problem, with a minimal risk of exacerbating any injury. Short of that you can self-educate on the topic - many people find they're well able to fix basic thoraco-lumbar alignment issues with the working knowledge of functional anatomy that can be gleaned from online resources:

How To Fix Neck Pain, Upper Back Pain, Shoulder Pain, Rotator Cuff, and Tightness

Guide to fixing 'Computer Guy' posture

An everyday workout/warmup that you can use to fix your postural dysfunction
posted by Kandarp Von Bontee at 7:36 PM on April 24, 2012 [5 favorites]

Heat is not always great for inflammation, even though it feels good. Ice is better at reducing inflammation, which might allow for better healing.
posted by judith at 2:16 PM on April 26, 2012

Can you see a Physiotherapist?

Other ideas: back pain can be caused by too much sitting (at work, in the car); bending at the back instead of the knees to pick stuff up.
posted by Year of meteors at 3:56 AM on April 29, 2012