Does persistent back pain/tightness ever get "cured"?
July 2, 2015 7:05 PM   Subscribe

I have had a persistently tight "knot" in my upper-right back for at least five years now, with the pain level varying over time. I've tried stretching, chiropractors, foam rollers/lacrosse balls, and massage off and on throughout the years. No permanent improvement. Will this ever get fixed, or will it be with me forever? Stories of hope would be much appreciated, and details + feelings of helplessness after the break.

It varies in levels of pain, from "that definitely feels tighter than my left side, huh" to "I can't move or straighten my neck without sharp pain." I'm currently in the latter phase, probably because of a couple cramped plane flights, some over-aggressive stretching, and handstands. I've previously gotten into this very-painful phase twice by bench-pressing after a few months off. A masseuse described the result as "in spasm." Staring at some anatomy diagrams, I'd guess it's the levator scapulae. The core of the tightness seems to be in the upper back near the shoulder blades, but when it's bad it extends in a line to my neck.

The last time it got really bad I went on a massage spree, getting six thirty-minute massages spread throughout the week. It helped make things recede back toward "that definitely feels tighter," and I was hopeful that maybe if I kept it up, I could cure this. But the remission back into full-blown pain has me almost in tears, feeling hopeless. Am I destined to carry this around with me forever? I do have scoliosis, which I know is permanent... is this related?

I've always wished for some kind of magical cure. Some masseuse who would just push things in the right way, release the tension or scar tissue or whatever, and I'd be normal again. (Once a masseuse said "you have a lot of scar tissue," did some roller thing to "break it up," and it felt better. For a while. I don't even know if scar tissue is a real thing.) Or that I'd be able to run through an MRI and they'd detect the problem and go do surgery, as scary as that sounds. Failing that, I'm willing to do some kind of concentrated program of stretching or exercises or something every day for a year... maybe lay off on any upper-body exercise like bench press or handstands that aggravates it... just tell me that it'll actually end up with me cured, instead of gradually improved.

Thank you for any insight you can provide.
posted by Jacen Solo to Health & Fitness (37 answers total) 16 users marked this as a favorite
When I had bad neck pain/knots, I was able to get rid of the severe pain by taking muscle relaxants a couple of times. After that, I had to do yoga to keep things relaxed. With regular yoga, I don't need massage anymore. I'd avoid the handstands etc.
posted by three_red_balloons at 7:10 PM on July 2, 2015

Best answer: Have you seen a doctor? Like a spine orthopedist? I had the same thing for a bit and after an MRI they found two herniated discs. Treatment went on from there and mostly fixed it.
posted by sanka at 7:11 PM on July 2, 2015 [8 favorites]

I used to have something very similar that I attributed to a broken shoulder from a horse riding accident, and some violence that affected my neck, plus a zillion hours on the computer.

I went to an (Australian) osteopath which is different from an American osteopath or chiropractor. She spent some time aligning my hips, then my shoulders, then my neck. She said so many back, shoulder and neck problems result from misaligned hips (I did also have hip pain).

After 10 visits over about 12 months, and a nightly practice during that time of tying my knees together overnight to keep my hips aligned (surprisingly comfortable actually) my huge painful knot in my shoulder disappeared and has not returned. I have had little knots, but they have been much easier to release with massage.

I am not sure of the difference between Australian osteopaths (at least 4yrs training) and American osteopaths but maybe it would be worth trying one.
posted by Thella at 7:15 PM on July 2, 2015

Best answer: I had similar pain and was found to have a herniated disc; I have had a regular yoga practice ( near daily) for the last three years, and the pain is 90% gone. Definitely would recommend that.
posted by bearette at 7:15 PM on July 2, 2015

To Thella's point: American osteopaths are doctors (D.O.) like allopaths (M.D.) and have nearly identical training and licensure (they prescribe drugs, perform surgery, etc.) with the added elements of body manipulation. Here's a description from the AOA. Osteopathic orthopedists are usually open to all sorts of treatments that range from massage to surgery.

If you know you have scoliosis, treatment by a physician seems warranted.

I'll also start (on preview, continue) the onslaught of yoga recommendations. Bikram yoga (or any heated yoga) can be very satisfying. I've found some fantastic and like-minded physicians through yoga studios.
posted by GPF at 7:32 PM on July 2, 2015

My problem was crippling pain in my hips and lower back, to the point where I could barely get out of bed, and had to have a heating pad on high for 20 minutes or so to relax my muscles. The deep core of pain you describe sounds horribly familiar and the only thing that's relieved it for me is yoga for at least 30 minutes a day.

I'd also suggest a spine specialist visit, and if they rule out any issues perhaps a referral to a physical therapist?

Also whatever is going on, handstands and weightlifting is way, way too much for your body right now. Baby steps - you want to work out the problem first, then get the muscles strengthened to protect against relapse. Or you may never be able to do strenuous exercise when it involves your back and neck, that's ok too.
posted by lootie777 at 7:40 PM on July 2, 2015

Best answer: I am a massage therapist. Massage therapists cannot detect scar tissue. Throw that message in the trash. [I'll spare the expletive laden rant on that for some other time and place. That shit makes me livid. Oops.]

We don't know what "knots" are, actually. One thing we do know is that muscles are driven purely by the brain, so if your levator scap muscle is tight, your brain is doing that for a reason. It may be due to stress. It may be due to lack of movement. It may be attempting to protect nerves or other structures in the area (don't let that last one scare you - that stuff goes on in the background all the time).

There are no magical cures, as much as we all want them. When people reply with what worked for them in threads like this it's generally from the following list: more and better movement (yoga has already been mentioned multiple times), movement induced by a practitioner or recommended by a practitioner (Thella holding his/her hips in a certain way while sleeping), reductions in stress, or simply time (people tend to get better over time).

I'll bring up scoliosis because it is often self diagnosed and over-diagnosed by practitioners (cough chiropractors) who want to medicalize the body to help maintain return clients. Unless you've been diagnosed by a doctor and have a pretty serious deviation I would't worry about it too much. No human skeleton is perfect - not even close, and the human brain is extremely good at rolling with the body it is housed in.
posted by MillMan at 7:44 PM on July 2, 2015 [31 favorites]

I had a chronic knot by my left shoulder blade for years - not as bad as yours but always present and it would hurt when I was stressed. Lat raises (not bench pressing, kind of the opposite of bench pressing) cleared it up after about a month. Your situation seems more serious than mine but if you're at the gym for yoga or something anyway, maybe try lat raises? I started out with an appropriate weight (15 pound dumbells) and did two sets of twelve on each side, kneeling/resting my opposite arm on a bench.
posted by Frowner at 7:50 PM on July 2, 2015 [2 favorites]

I struggle with similar pain, though perhaps not so extreme. I found I was exacerbating it by habitually sleeping on my side with my "bottom" arm extended up over my head. Changing one's sleep position is hard, but it helps with my shoulder knot.
posted by Pleased_As_Punch at 7:51 PM on July 2, 2015

I went to my GP when my back pain was bad and persistent (I tried massage first, which felt good but didn't really help). She asked questions and poked things. She ordered a CT scan, which my insurance covers well, and found out that my spine is in awesome shape (yay?) so no herniated discs. She referred me to PT. The physical therapists have been awesome; I'm learning stuff to do at home and how to strengthen my back muscles so that they can quit freaking out over being overextended through normal use.
posted by wintersweet at 7:52 PM on July 2, 2015 [2 favorites]

Response by poster: Thank you all. Please keep it coming! Also, if you could distinguish between "now it's gone forever" and "it's better and seems under control", I'd much appreciate it... The main thrust of my question was, is "gone forever" even achievable?

I have not actually seen a doctor for this, as obvious as that sounds now. I'll ask my GP about it right away, and also try to find more specialists, either from his recommendation or from ZocDoc.

The scoliosis was diagnosed by an actual doctor or three (it comes up in most of my physical exams, even when seeing various specialists for other conditions). I am not sure how serious it is, but it's obvious at least.

For people recommending yoga, does that really cure specific instances of long-running pain? It sounds much more like an ongoing pain or tightness management strategy. I realize I'm speaking imprecisely, but targeted pain feels like it demands targeted solutions. Is that just bad intuition?
posted by Jacen Solo at 7:54 PM on July 2, 2015

Yes, definitely a physical therapist who can give you the appropriate strengthening / stability exercises and tell you what about your current routine may be exacerbating the issue. In isolation the presses and hand stands almost sound like doubling-down on the problem. I have a hunch that shoulderstands would help. An orthopedic surgeon or doctor of osteopathy (often also an orthopedic surgeon) might know which treatment modalities are appropriate better than a typical PT, as they tend to give the PT specific instructions. If PT doesn't help and an orthopedist suggests surgery after ordering a CT or MRI (doubtful) then see a neurologist for a non-musculoskeletal take
posted by aydeejones at 7:57 PM on July 2, 2015

I have a similar thing which seems to be a combination of a slightly twisted spine based on walking in a broken-ankle cast for a few months and some bad mousing habits. I have a doc who said there's no medical problem and a physical therapist who gave me a set of exercises to do when it gets bad (very specific stretches and some lying down with a towel under my back in a specific way, I sleep with a pillow under one arm which was also suggested). What makes it worse: too much mousing, driving or swimming. It will basically go away if I don't do any of those things for a few days. Most of the time I have mild soreness (rarely full-on pain) and I have done mild amounts of one of those things.
posted by jessamyn at 7:58 PM on July 2, 2015

Shoulder instability is super common and causes all sorts of compensatory issues
posted by aydeejones at 7:59 PM on July 2, 2015

Best answer: I transformed my upper back/neck pain by getting a SUPER firm memory foam pillow and by never ever using my phone when I was laying down (because it puts my neck and arm in exactly the wrong position). I went from having varying levels of pain every day to no pain ever.
posted by kate blank at 8:01 PM on July 2, 2015 [1 favorite]

Be careful about yoga. It's not a cure-all. I had a herniated disc in my lower back (caused by weight lifting) and my PT advised me to avoid certain yoga poses that would put pressure on my back in the wrong way. As for whether I'm cured, I have no pain when I do my (very simple) PT exercises regularly and am mindful of how I'm using my back. I frequently get lazy when I'm pain free, don't do the PT, and eventually the pain comes back. But I understand what's going on now when it happens and am able to stop the pain when it's mild by resuming PT.
posted by Mavri at 8:04 PM on July 2, 2015 [1 favorite]

I will send you down the rabbit hole of looking at what pain is.

Yoga is popular and it's certainly something that goes in the "more and better movement" category in the sense that it's going to put you through a ton of motions you would never get into otherwise, and that is food for your sensorimotor cortex. You do have to be careful with it and not treat it as something to push through - listen to your body, slow down and stop if it's hurting or getting worse.
posted by MillMan at 8:15 PM on July 2, 2015 [1 favorite]

Best answer: My similar relentless pain is, as with others here, related to disc herniation. It has gone away foreverish, in the sense that a twice annual cortisone shot will make it 100% better for 2 months, 75% better for 4, and 50-0% better for 6, depending on the season. Massage can help with some of the tightness but the only thing that has made it disappear completely is the cortisone shots, to the point where when I wake up in the morning it's hard to tell if I'm awake or still dreaming because being pain-free is so alien and confusing to me.

Flexeril has also been a total revelation wrt freedom from horrible muscle spasms. If you want to stay active, you have to time it carefully so you're not still having muscle weakness during workout times, though.

Don't go to any kind of person who will "manipulate" or "adjust" your spine/neck in any kind of way, as they are dangerous charlatans. See a real doctor who will do real tests like an MRI and see what's going on.
posted by poffin boffin at 8:18 PM on July 2, 2015 [2 favorites]

Also stuff like yoga and pilates can be helpful once you actually know what the problem is. Otherwise you risk exacerbating existing problems.
posted by poffin boffin at 8:19 PM on July 2, 2015 [3 favorites]

Best answer: I had terrible knots in my back for years and they didn't go away until I committed to seeing a massage therapist weekly for a year. It was expensive, but worth it and eventually after she worked the crap out of it, the pain went away. I still see her every two weeks, to keep things up. Other things helped too - stretches throughout the day (I get up every two hours and do a 5-10 minute stretch app on my phone), yoga I imagine would help if I could commit to it, and also surprisingly, getting pregnant helped a lot! The relaxin loosed up my muscles and made my back feel great! (I understand that this is not typical).

I'm sorry your in so much pain. If I were you, I'd do the following:
1. Go see doctor, get referrals, tests and pain meds.
2. If doctor leads nowhere, go see massage therapist and commit to a year at least
3. Start very gentle yoga
4. Find some stretches you can safely do for several minutes several times a day.
posted by Toddles at 8:27 PM on July 2, 2015

Oops, I forgot to add:
1a. Physical therapist for sure! They can definitely give you good exercises and stretches (I did this too and it helped)
posted by Toddles at 8:29 PM on July 2, 2015

Best answer: What you're describing sounds very much like a herniated disc, which I once suffered terribly from. I would advise that you see a doctor -- preferably a spine specialist -- who will likely order an MRI to confirm and assess the severity.

If you do happen to have a herniated disc or discs, there are very good treatment options available. Once the specific problematic discs are pinpointed, your doctor would likely prescribe physical therapy for you, which will involve stretching and exercises designed to strengthen your muscles around the disc to compensate for the bulging disc that's causing you pain. If that doesn't work, your doctor might suggest surgery to remove the offending discs.

Herniated discs are quite common, they aren't life-threatening and they aren't likely to leave you paralyzed or anything like that. But the pain they cause can be chronic and severe, unfortunately. The good news is that most people can be successfully treated with physical therapy and lifestyle changes (think: adjusting your posture and lifting heavy objects properly) and pain medicine as needed. For those few whose severe pain can't be alleviated by physical therapy (like myself, unfortunately), there's a good low-risk surgical option, which alleviated all of my pain literally overnight. In either case, my point is that there are an array of highly successful treatment options that should help you eliminate the pain.
posted by TBoneMcCool at 8:31 PM on July 2, 2015

"American osteopaths are doctors (D.O.)"

FWIW, the board-certified surgeon who did my spinal fusion was a D.O. (I noticed this at a post-surgical checkup.)

Also FWIW, a lot of doctors consider "allopathic" a denigrating term, as it was invented by someone who used it to claim those same doctors were not competent.

I'm perhaps an outlier. No manual or participatory treatment has worked for me. I have only ever had poor reactions to PT, both with & without concern for previous poor reactions, including a course with a specialist for long, slow changes. Massage never lasts; I go back every week and all the muscles are just as tight or knotted as the previous visit. I've had regular massage visits at the same time as PT, sometimes at the same clinic, and also when I was not in regular PT. No difference.

I've got several known issues; mild scoliosis, congenital shoulder malformation (didn't know till a shoulder doc saw shoulder x-rays though), and some kind of predisposition to spinal injury (I blew a disc when I was 27, other discs keep accumulating damage). It seems like we keep trying to treat all this with tools that don't work. The chronic pain never improves and stays improved. The tight muscles never let go. The knots don't go away and stay gone.

Muscle relaxants help.
posted by galadriel at 8:48 PM on July 2, 2015

Another option. The dysfunction in my right side originates from my left hip. What happens is that my neck and upper trapezius come in to stabilize when the left glutes and obliques do not do their jobs.

I see a physiatrist, she has been most helpful. I had trigger point injections and recommendations for an exercise program.

Suggest you get a referral to physiatry (PM&R) and they can look at the body holistically for rehab.
posted by crazycanuck at 9:02 PM on July 2, 2015

posted by Jacqueline at 9:02 PM on July 2, 2015

I really like this guy: Do It yourself joint pain relief. He holds that pain is often caused by tight muscles pulling your body out of alignment and demonstrates different ways to get muscles to release and which muscles to release. Maybe try it after you verify that it isn't a herniated disc.
posted by GregorWill at 10:09 PM on July 2, 2015

Best answer: I had something similar for more than 20 years before someone finally figured out that my upper-right (and sometimes upper-left) back pain was caused by the way I was sleeping.

I sleep on my back and on my side, and apparently when I sleep on my back, I have a tendency to push the top and back of my head hard into the pillow, which compresses the vertebrae in my neck and upper back.

Once I learned how to stop myself from doing this--mostly by putting a pillow or part of one under my neck to prevent me from being able to push the top of my head back--the pain disappeared completely. Totally gone forever.
posted by yellowcandy at 10:55 PM on July 2, 2015

Best answer: I have a wicked knot in my upper right back that comes and goes, tied to how much time I am spending on my laptop. My right hand is my trackpad mousing hand. The pain was actually completely gone for a long while; I started gaming a bit recently (Steam sale!), and it's, not going to do that anymore--not on a laptop at least.

If you spend a considerable amount of time on a computer, take a close look at your setup and your posture. If you use a computer for work, next time you have a vacation, stay off your laptop--use your phone for emails if you have to, and see if that right shoulder knot goes away. When mine comes back from laptop misuse, it takes about a 5-10 days for it to go away after laying off the behavior that brought it on.
posted by neda at 11:21 PM on July 2, 2015 [1 favorite]

Best answer: I'm not a huge fan of the medical establishment, but this is exactly what medical imaging is good for.

If you have compressed, herniated or otherwise degenerated discs, you need to know before any course of treatment can be advocated.
posted by under_petticoat_rule at 12:01 AM on July 3, 2015 [1 favorite]

I have a similar issue, but the right side not the left. I'm currently seeing a physiotherapist about it. She gives me some massage and helps me do some stretches during the sessions and then gives me exercises and stretches to do at home.

According to her, my problem is caused by two things: 1. my spine is not quite normal. It's quite straight at the top, rather than slightly curved like it should be, apparently. 2. Certain muscles are weaker than they should be.

If your problem has similar causes, then I think you have to combine the massage with the right exercises to fix this properly. Otherwise you're just working out the knots without fixing the actual cause.
posted by kinddieserzeit at 1:28 AM on July 3, 2015

Best answer: I've got minor scoliosis (used to get Xrays for it when I was a kid, to be sure it didn't progress). I used to get pain in my upper right back.
I went to a doc who checked me out for more serious things (e.g. the herniated discs mentioned above), and then recommended PT. PT didn't help immediately, it took a few months, but at this point I am mostly pain free. According to the PT the problem was/is some complicated interrelated compensations I made in all sorts of movements (hips, knees, etc) likely due to the scoliosis.

I also made a few other changes-- I wear a sternum strap whenever I have a backpack on (I've actually rigged up some rope to do this a pinch before). I limit the weight I carry on my back in the first place (yay for dropbox and digital reference books, and roller suitcases for traveling). I am sure my workspace is set up as ergonomically as possible, and I mouse left handed at work and right handed at home so I get some balance.

At this point basically I am in no pain ever unless one of two things happens-- 1) I twinge it rock climbing (happens once or twice a year-- I lay off and do my PT exercises again and it gets better) or 2) I end up stuck on a long plane flight with someone sitting to my right. The contortions I make to avoid stabbing them with my elbow will leave me in pain for a few days-- again I do my exercises and it goes away (but yeah, I really try to not have anyone sitting to my right on planes).
posted by nat at 5:10 AM on July 3, 2015 [1 favorite]

I don't have time to read all the responses, so apologies for duplicate info.

Basically, you're unlikely going to find one magic bullet that will cure you forever, world without end, amen. You need to take care of your body routinely, not just when you have acute pain. If you do this you will likely have fewer episodes of pain. So, on to specifics:

First and most importantly, DO NOT rely on yoga to make you feel better. Especially hot yoga. I used to work for a chiropractor and a large minority of our clients were there due to injuries caused by yoga, especially hot yoga (which was a big fad in Seattle at the time). You can easily overstretch in a hot room and pay for it later. Also, most yoga classes are generic and will have everyone doing the same thing. If you must do yoga, do a one on one with a good teacher at least a few times, to learn what works for your body.

Second, I see from your profile that you are a desk jockey. Desk ergonomics are very important in reducing issues such as the one you're describing. Have any of the massage therapists (not masseuses for heaven sakes, please don't call us that!) you've visited discussed this with you? You need a large enough font size and a monitor that is eye height so you don't have to crane your head forward, a keyboard height that doesn't make you wear your shoulders as earrings, and you need to take frequent breaks. Work on a desktop not a laptop, or if you must work on a laptop, use a separate keyboard and place your laptop screen up at eye level. Use a timer to remind you to get up and move around every fifteen minutes.

You ignore this advice at your peril. You may feel OK some of the time using poor ergonomics, but you are setting yourself up for an episode of pain.

If you have an enlightened workplace, perhaps ask for a sit stand desk. Or try sitting on a yoga ball, which will force your body not to get locked into one position, but constantly make micro adjustments.

You need to be mindful of your muscle health *before* you're in acute pain. I'm reiterating this because so many people ignore this fact.

Heat, especially moist heat, can be helpful for spasmy muscles. When you are at work or traveling, try using self-adhesive heating strips from the drugstore. They give mild heat for quite a few hours. At other times you can use microwaveable beanies. If the heat source is more than just warmish, use it for only 20 minutes or so at a time.

Scoliosis absolutely does matter and likely contributes to your issues. Muscles are attached to bone, so if the bone of your spine is curved more to one side or the other, the muscles on the curved-to side are more compact than they'd normally be, and the muscles on the curved-away from side are more stretched and will likely hurt.

If you have a leg length difference, a gait problem, or the like, the effects of that absolutely can travel up your body because your body will make all sorts of adjustments. There's one in particular that is definitely relevant here: our body will always endeavor to set our eyes so that we have a straight horizon. So if, for example, say your right leg is shorter, and your right hip and shoulders are dipped down, your eyes will still be level and thus the muscles on your right neck and shoulder will be stretched out.

A good PT can help you figure out what the structural or functional causes might be and help correct them via orthotics, exercises, stretching.

It is sometimes the case that the muscle or muscle group that hurt are actually not the primary culprit, but are being bullied by the antagonist muscles. In your case, your shoulders are probably rounded forward and you probably have tight pectoral muscles from hunching over a computer all the time. Did the massage therapists work on your pecs? Give you pec stretches to do? Suggest kinesiotaping for posture?

Did you see competent medically oriented therapists? Don't go to some cut rate place like Massage envy.

You also very likely have trigger points, based on your description of where the pain is and where it travels. Have your therapists mentioned this? You may already be working on them when you use that lacrosse ball, but an informed an organized way of working them out would likely be beneficial. And again, you probably need to work on them periodically when you ate not in pain, not just wait until you are and to damage control.

Oh yeah, last thing, the symptoms you describe are very unlikely caused by a herniated disk. There is basically no relationship between herniated disks and pain. I suppose you could get imaging done, just to know, but realize that plenty of people have herniated disks and no pain, and plenty of people don't or very mild and are in tons of pain. Don't look for a holy grail there.
posted by mysterious_stranger at 5:38 AM on July 3, 2015 [5 favorites]

In my experience, one-sided computer-use-related neck and shoulder pain is almost always due to working for extended periods with a screen that is not squarely in the centre of my visual field.

Your seat is at the right height if, when you're sitting with your feet flat on the floor, your thighs are level and your butt can go back as far as the seat will let it.

Your keyboard is at the right height if, when you're typing while sitting as above, your forearms are level.

Your screen is at the right height if, when sitting as above, the top of the screen is at your eye height; it's properly centred if looking straight ahead means you're looking at its vertical centreline.

Using a laptop means you have a choice between a keyboard that's too high or a screen that's too low. Either choice will cause grief for your neck and shoulders.

If the pain is on the same side as your mouse hand, a gel wrist rest is a wise investment.

You need to take care of your body routinely, not just when you have acute pain. If you do this you will likely have fewer episodes of pain.

This. More so as you age.
posted by flabdablet at 6:43 AM on July 3, 2015

Nothing was working for my mom's neck spasm. Finally, her boss, a dermatologist, agreed to try injecting it with botox. It was like a miracle cure. It comes back once or twice a year and they do it again. And since they put the rest of the dose in my mom's face, my mom now looks forward to the spasm, because she comes away looking 10 years younger.

I don't recommend injecting poison in your neck but I do recommend a good acupuncturist. Still needles but healthy ones. And yes, yoga, done correctly and daily, can cure you forever.
posted by myselfasme at 7:38 AM on July 3, 2015

Monitor height should be set so when you look straight ahead, your eyes are about 1/3 of the way down, not at the top. Basically, if you find yourself craning your neck, adjust it. Ideally you should spend much of your time with your head balanced over your neck, letting gravity do most of the work of supporting it.

I forgot to mention nutrition. While not the cause of your pain, ensuring you get and absorb enough minerals may help support healthy muscles.

And forgot to mention sleep position as well, glad other people did. Ideally you use pillows and bolstering such that your spine stays in normal alignment and your shoulder isn't squished up under you if you're lying on your side. Pillow between the knees when side lying, correct height of pillow under your head, maybe also a front pillow to grab. Pillow under the knees and thin or no head pillow when sleeping on back. No stomach sleeping!
posted by mysterious_stranger at 9:53 AM on July 3, 2015

Best answer: Short answer: yes, it absolutely, definitely can get better and even go away fully.

Longer answer/story: I had problems (read: pain) with my shoulder, neck and back - all on the left side. It ranged from a pinching feeling to intense pain. This went on for many, many years (like, close to a decade). I would treat the sore area with ice, or heat, or some sort of rub and it would get a bit better, but it always came back. I was in some degree of pain 95% of the time.

My doctor recommended yoga and that ended up making it worse. He then told me that I needed to work on relaxing (ha!). In the meantime, I was getting more and more depressed about my inability to do anything - either because it was actively hurting or because I was afraid of making it hurt. If someone had offered me surgery, I'd have taken it without hesitation. The only thing keeping me from begging for pain meds at various times is that I work with people who have addictions and many of them started down that path due to pain!

Earlier this year I went to physiotherapy (because it was covered under my health care plan at work and because I figured "what the hell!") and it changed my life. I discovered that the pain was being caused by a bunch of different factors - not just one knotted muscle. I had some muscles that were really tight, some that were too loose or weak, some that weren't supporting my shoulder properly, shitty posture, and some nerves that were impinged. Basically, my icing/heating/stretching was treating the symptoms and not the cause. Sometimes I was making things worse by stretching too much in the wrong way - despite getting some temporary relief!

Initially I went several times per week and it was fairly passive on my part - my physiotherapist (who I have lovingly re-named "Vice Grip Hands") would essentially shove all my various body parts into alignment (not chiropractic - things like holding my shoulder where it should be and not where my body wanted it to be), do some stuff to release impinged nerves, dig her elbows into muscles, and otherwise beat the crap out of me. I'd literally have tears running down my face - but oh, man, it felt SO GOOD when she was finished. I could move without pain for a while! Then she'd ice/heat/massage the area and send me home. Repeat a few days later.

Once I started to get a full day of relief - no pain! - after each appointment, I shifted to seeing her twice a week. Gradually she was giving me more exercises to do to strengthen certain muscles, relax others, keep my various parts in good shape. I'd do some exercises with her, she'd do all her magical work, and I'd go home and do more exercises.

I got down to once per week, then once every-other week, and, more recently, finished seeing her altogether.

I am now spending 95% of my days pain free. On those other days, I can attribute my pain to doing something stupid - sitting slouched at the computer for too long without stretching properly. Sleeping in a position that's just ridiculous. Carrying something heavy without being attentive to good form. It's gone by the next day or, at most, 2 days later - like a normal injury!

The thing about physio is that you have to do a lot of work - the daily (and sometimes multiple times per day) exercises are crucial. I am much more aware, now, when a muscle is getting tight and I immediately do the exercises and stretches to loosen it up - so it won't get painful. I am much more conscious of how I'm moving and even how I'm sleeping.

A year or two ago, I would have told you that this was impossible - that I could be pain-free. Yesterday, for the first time in years, I actually went swimming and wasn't in pain. I'm now working to build up some of the muscles in my shoulders and arms!

So yes, it is definitely possible to get rid of the back pain and tightness. YMMV, since your body isn't necessarily the same as mine, but keep exploring and keep looking for what might help!
posted by VioletU at 11:55 AM on July 3, 2015 [4 favorites]

The core of the tightness seems to be in the upper back near the shoulder blades, but when it's bad it extends in a line to my neck.

I experienced back pain that was identical to this. I spent years visiting doctors and physiotherapists and massage therapists, but ultimately it was resolved by my dentist, because it was referred pain from TMJD. It's a long shot, but it's worth checking if you have any of the other symptoms.
posted by PercyByssheShelley at 8:26 PM on July 3, 2015

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