Upper Back and Shoulder Blade Pain
Burning, aching, tingling pain in your upper back or shoulder blade? You’re not alone. This is one of the most common reasons why people see a chiropractor.
About the Thoracic Spine
The region of the spine we call the upper and middle back is called the “thoracic” area. It’s a busy place. The thoracic spinal column protects your spinal cord just like in the neck (cervical region) and low back (lumbar region). The thoracic area is special though because it also has attached to it the rib cage. The ribs are curved bones that articulate with your thoracic vertebrae in the back then wrap around towards your chest. Before reaching your breast bone (sternum) the rib bones end and cartilage attaches the ribs to the sternum. This makes the rib cage somewhat flexible. The reason for the rib cage is to house the lungs and heart.
Because the ribs attach to the middle portion of your spine, the thoracic vertebrae are less mobile than your neck and back areas. It also adds one more level of complexity to the region. There are joints between the vertebrae like the rest of the spine, but also there are articulations between the ribs and vertebrae. So there is more that can go wrong.
Adding another level of complexity to the thoracic skeleton is that the shoulders are also attached.
The muscles of the upper back and shoulder blade area is also complex. There are many layers of muscles that attach the neck and upper back, the shoulder girdle and the upper and middle back, the ribs and the back, etc.
Joint Malfunction, Misalignment
Chiropractors locate joints that are not functioning properly. The joints can become partially fixated or stuck which limits mobility and can cause symptoms. Chiropractors call these malfunctions “subluxations.” You may have painful misalignments in the spinal joints of the thoracic spine causing your shoulder or upper back pain. It could also be a malfunction within the joint between the rib and spine. If you take a deep breath and that increases your upper back or shoulder blade pain then you may have a misalignment within a rib articulation.
Myofascial Pain
Your muscles are covered by a protective tissue called “fascia.” So myofascial refers to the package of muscles and corresponding fascia. Ever get a painful “knot” in your shoulder blade? That is considered a myofascial disorder or myofascial pain syndrome. These painful conditions develop over time due to injuries, postural stress and even emotional stress. The “knot” is an accumulation of fibrous scar tissue that clings to the fascia. These myofascial knots have many tiny nerve fibers surrounding them making them very tender. They can also refer pain from one place to another. So a knot, known as a myofascial trigger point, can be pressed in the upper back and it refers pain to the neck or face.
Chiropractic Treatment of Shoulder Blade Pain
First, your chiropractor will want to determine if your pain is due to joint malfunction or a myofascial problem. It could be both! Once the problem is identified through an examination, a treatment plan is designed.
For joint malfunction, the treatment is chiropractic adjustments. Your chiropractor will decide which motions are lost within the joint and perform a precise thrust to unlock the joint and restore motion. More than likely you will have many joints that are malfunctioning so there may be several adjustments to address all of the faulty joints. Adjustments are usually very quick and not painful.
Treating myofascial pain may involve different methods depending on the doctors treatment approach. There are many ways to relieve painful knots. In general, the idea is to break down the scar tissue that accumulates in the fascia. This can be done with massage using the hands or handheld tools or machines. The inflammation of the knots may be treated with electrical stimulation, ultrasound or laser therapy. Stretching exercises may also be performed.
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