Question
I am inquiring about a recommendation of who to see about a back problem I have. I am 36yrs old. I am not overweight. I have a problem with my back when walking or standing for an extended period of time. the muscles in my mid back tighten and cause slight shortness of breath when it really fires up. I have beed to chiro and a back doctor that specializes in shots. An MRI reveals nothing except for a slight bulge in my T9-T10. His opinion was that the amount of bulge likely would not cause any problems for me but my tightness and pain is localized to this area. He said I could get a shot but could not tell me if I would get relief from the procedure. 90% of activities I have no problem but when this fires up it is very much a problem. The only thing that calms it down is to lay down and then in morning it is usually fine. Sometimes I notice if I rotate my right arm out and towards back I can feel slight pain in that same area. Any ideas of what to explore for treatment?

Answer
Find a good massage therapist or soft tissue specialist. If the MRI shows little evidence of anything that could be the main source of the pain, there is usually some kind of chronic soft tissue problem. The muscles and fascia can be the source of pain and can benefit from some kind of manual therapy (deep tissue massage, trigger point therapy, Active Release Techniques, Graston, etc). Spinal manipulation, joint mobilization and any exercises/stretches to address muscle imbalances would benefit you as well.

The best way to find a good manual therapy specialist in your area is to just ask around. Sports minded co-workers, family members, or other people you spend time with would be a great resource. If you ask around enough, a few names should pop up frequently - that's the one you should see.