What can be done to deal back pain due to improper posture?

Question

Hi doctor,

I am a 27 year old female. I am a medical student and have been experiencing some thoracic back pain for the last year or so. I have no history of back, cervical, or MSK problems. I have not had any imaging of my spine. Admittedly, I do not have the best posture. During most of the day, I am working and standing. I have a stressful lifestyle, but I am experiencing the pain even on vacation. I do not have weight loss, fever, chills, neurologic symptoms, etc. It distracts me from my daily life.

The pain is a constant dull ache or tension and is located medially, extending from C7 to the bottom borders of my scapulae. It feels like it is just lateral to my spinous processes, maybe in the laminar groove or maybe even at the zygapophyseal joints. At times I find that I can take a deep breath and even this causes my back to crack, although it is not painful. I regularly receive massages, which helped at first but no longer provide any relief. The only thing that provides relief is an extreme extension of my spine, often by lying on a pair of tennis balls, foam roller, or upside down from a chair. Even this does not feel like enough to relieve the tension. The maneuver that gives me the most relief is having my back cracked by a friend wrapping my arms around my shoulders and being picked up. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the comprehensive description and your picture marking out the point of pain (attachment removed to protect patient identity). A couple of possibilities are there.

First is this could be due to poor posture. From the picture this is subjective. You have a slightly rounded posture and shoulders protracted. Further, this can put your neck muscles out of synchronization and they too can fatigue and you can get fatigue pain which refers to the area between the shoulders. The other possibility is that this could be an inflammatory condition seems less likely. Management will include your CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), and vitamin D level check.

Visit a qualified manual therapist who can help you with your posture. Get strengthen your interscapular muscles, and your neck muscles, and set your shoulder that will help with proper upper body posture, release of any tight muscles, and even open up the interspinous spaces in your thoracic spine. You may need a thoracic spine x-ray AP (anteroposterior) and lateral at some stage. Meanwhile, try an anti-inflammatory tablet like Ibuprofen or Diclofenac.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.