Question
Hi:

I'm a 56 YO male, until recently in excellent health, not overweight, not anything, and never having any significant pain, or injury, and if I did, it would heal quickly.  Not this time.

There was no specific moment of injury; I noticed a pain in the left back just between the top of the shoulderblades, that got worse due to marathon overtime sessions at a computer in dim light, but not too bad...~10/12-26/11.  Took occasional ibuprofen and it almost went away, and it got better through ~11/4/11.  Then I got a bad cold, all's I did was rest and sleep, and the back pain became very severe literraly overnight, and has been about that way, virtually every waking moment since (most time without pain was 4-5 hours on one day, but pain came back).  I did nothing exercise-wise to have caused this, the only temporary relief is ice/heat, and a little bit with physical therapy and traction.  Drugs (NSAIDS, muscle relaxants, codeine, oral prednisone) have had no effect.  Doctor notes moderate abnormality in neck but not upper back where pain is; and he said that abnormality does not explain the intensity and constancy of the pain.  The only other unusual is recent high blood pressure.  Cold is over and done with.  Back pain is not.  I have not worked significantly in nearly a month (cannot even do desk work).  I never take time off for pain but this is off the charts;  Feels like a large knife stabbing in the back, all the time;  also some wierd dull feeling deep in left shoulder socket and outer wrist going to ring finger.  Never had that before either.

Ideas (on something to try to get a slight amount of improvement; things NOT to do; tests; other)?  I'm going to a chiropractor tomorrow. Right now I'm limited to the phys therapy exercises, 3X a day, and short walks.  Anything else?  Oh yeah, just started some supplements - boswellia, glucosamine-MSN, and fish oil.  

Screaming Ouch x 1,000,

Steve

Answer
Dear Steve,

I am sorry to hear about your pain. I cannot examine you, and I cannot see your pictures or your lab work, so everything that I have to offer is pure speculation.  As such, here it is:

1) Rule out heart and gall bladder issues. You can do this with your primary care physician/MD and some lab work.  You should also consider stomach, lung, and pancreatic conditions. Diseases of the organs can cause back pain.

2) Once you have found that all lab/imaging work is negative, you are correct in giving chiropractic manipulation a try. Many times mid back pain is relieved through manipulation of the spine.  This is a very low risk method of trying to ease your pain.

3) Cervical spine degenerative changes at C6/C7 can cause neurological irritation that can cause pain in the arm, middle finger, and into the area just inside the shoulder blade in the upper back. Do not discount the neck involvement until you have had a good physical examination, including but not limited to performing a maximum cervical compression test and cervical distraction test.  You should also be evaluated for symmetrical strength in the upper extremities, and normal skin sensations to pinwheel, touch, pressure, etc.

I hope that this gives you some ideas of things to look for.

Keith Biggs, DC
http://www.eastmesachiropractor.com