Chronic Upper Back Pain Between Shoulder Blades associated with weighted hyperextensions

by Jon
(Cincinnati, OH)

How many coloured foods do you enjoy daily?

How many coloured foods do you enjoy daily?

Chronic Upper Back Pain Between Shoulder Blades associated with weighted hyperextensions suggest a reevaluation of your program.


For the past 8 months I have battled with upper back pain between my shoulder blades and below. I am 29, weigh 205 lbs, 6'1", and am in pretty good shape. The only thing I can possibly contribute my pain to is doing weighted hyperextensions in the gym? Did not have immediate pain after the work out session - no other recent injuries. Here are the steps I have taken and information I can share.

Chiropractor for 2 months - no progress
2 doses of oral steroids - no progress
Thoracic Xray - Shows mild arthritis and scoliosis
Thoracic MRI - T1-T2 partial disc desiccation.
T9-T10 disc desiccation. Tiny posterior osteophyte complex.
Physical Therapy for ~3 months - I would find immediate relief from "manuals" but the pain would return the next day.
Steroid injection in muscle around T10 - no change
New chiropractor for 1 month - no progress
Spinal injection in T9/T10 - no change.
New chiropractor/acupuncture for 2 months - no progress
Prescribed Backlofen and Diclofen - I've seen some progress from this, but have been off it recently due to other medication.
Neck MRI - C5-C6 Disc desiccation and mild disc narrowing anteriorly. Broad Based mild posterior disc bulge touches but does not compress cord. AP thecal sac dimension is 10 mm in the midline. Cervical curvature is reversed at this level suggesting muscle spasm.
C6-C7 - Miniml Schmorl's node in the left side of the superior C7 endplate.

I continue to see a acupuncturist and chiropractor, and see benefits immediately following the visit. But the next day I'm back to the same levels. Since getting the neck MRI, I have tried neck stretches and have noticed benefits from that. When I put my neck down to my chest, my upper back is tight. No pain when moving my neck in any motion, or even my back.

I've noticed the following things to cause increase pain. Holding weight in front for long periods of time (holding my 3 month old), sitting down. I don't have tingling in my fingers but, in my limited research, I wonder if this could be a nerve issue stemming from C5-C6?

Hello Jon,
Obviously you've got everyone scratching their heads, including yours truly.

Firstly a few general comments. The purpose of the gym is to make you healthier, not miserable. As a general rule, we see a lot of injuries from the gym; I'd reassess your whole program with an expert for starters; perhaps go much lighter with more repetitions.

Weighted hyperextensions put a lot of pressure on the facet joints of the spine; I see little benefit and high likelihood of injury.

Secondly, loss of the cervical lordosis means you've had an old whiplash injury. That's confirmed by the fact you have C5-C7 abnormalities on x-ray and MRI. Old car accidents, whiplash, falls from horses and so on leave their mark. This gives some credence to your belief that the midback pain may be coming at least in part from your cervical spine; the dorsal scapular nerve that supplies the rhomboids and levator scapular is a pure C5 nerve.

My recommendation would be to continue with the treatment you find most effective, and stay away from the gym for the present. Perhaps take to the skipping rope, dull I know, but effective.

What's clear is that no treatment is being effective; so you have to figure it out; writing letters like this is the start. Keep thinking, talk to lots of people. Keep saying to yourself, the purpose of gym is to make me healthy.

I hope this makes some small contribution to an obviously complex subject.

Think food too by the way. Are you on a high protein diet to build a Mr Atlas physique? What is the ratio of omega 6/ omega-3 like? How many coloured foods to you eat daily? How many bagels, colas and other crap do you enjoy?

Good luck, let me know how you get on.

Dr B


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