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Unresolving mid back pain

Jan 12th, 2014

Georgia asked The Guru for the following Physiotherapy Advice:

Hi guru,

I have had really bad back pain for years- it started in about 2008. I have visited the doctor many times, ive been told its due to the cold weather (I happened to visit the doctor in winter). I tried to live with it, using hot water bottles daily. When it got worse, I visited the doctor again- no results. I have had scans and MRIs as well as physical assessments and they seem to show nothing ?medically? wrong.

The pain is constant between my shoulder blades and is there all day, every day. I have been told this is thoracic pain. Its often a dullish ache unless I stretch, bend, tilt my head down (ie looking towards my feet) and then I feel a sharp pain, almost what I would expect a nerve pain to feel like.

I have done numerous exercises and tried various sleeping techniques; with pillow, without pillow, sleeping on hard surfaces etc but to no avail. I?m under 30 and I don?t think I should be suffering from this yet!

Please advise

Many thanks

The Guru Responded:

Hi Georgia

Don’t stress – you haven’t got a structural problem (hence MRI is normal), but you’ve got a functional issue.

If I poke you in the eye (!) you’ve got a sore eye. If you got to the doc he’ll find nothing wrong with your eye because I’m not poking it. If you see me again and I poke it, it’ll still be sore…

This is super classic pain, but is looked after miserably because the cause, rather than just the symptoms are not identified.

You’ve got a super stiff thoracic spine, and as it’s stiff it can’t generate any pain (because it doesn’t move) to compensate for this lack of movement you increase the amount of movement in your cervical spine – hence you look down it hurts.

You need some great treatment to make your thoracic spine move better. You’ll also need the anterior (front NOT back part) of your cervical spine assessed and treated. Posture re education is key, but try this.

Roll up a towel as if you’re going for a swim. Put it on the floor and put a pillow at the top of it like a “T” shape. The pillow(s) should be higher than the towel (just). Now lie on the towel (running down your spine) head on the pillow, shoulder off the pillow, towel runs from the nape of your neck to just below your bra strap, with your knees bent up.

This can’t be painful (if it is bale out!) and stay there for 10 minutes. Stand tall and lift your chest NOT sticking it out or taking a deep breathe. See how you feel tomorrow when you’ve repeated this every 3 or 4 hours.

You’re changing the cause, so should feel a difference in your symptoms….

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