Pain Between the Shoulder Blades: A Case of Successful Treatment Without Medications
Introduction
A 39-year-old man visited the outpatient clinic with pain between his shoulder blades.
Complaints
The patient noted that the pain hindered normal movement and sleep; at night, he couldn’t find a comfortable sleeping position. The back pain occurred during inhalation, as well as when the man raised his right arm or turned. In the latter case, the painful syndrome radiated to the heart.
Sometimes, the pain briefly subsided.
The painful sensations intensified when the patient sat for long periods at work, turned, or bent, as well as during or immediately after sleep.
History
The patient mentioned that such episodes had occurred before, but the pain had never lasted so long. Doctors prescribed medications, which provided short-term relief. However, this exacerbation persisted for about a month, and medication did not affect the condition.
Initially, the man consulted a therapist. An ECG ruled out cardiac pathology, so he was prescribed a non-steroidal anti-inflammatory drug for 10 days and referred to a neurologist for further evaluation. The neurologist also found no abnormalities and prescribed a corticosteroid drug—a therapeutic medication block. It slightly relieved the acute pain, making it more diffuse and non-localized.
The patient was recommended to undergo an MRI of the thoracic spine.
The patient’s father and mother also suffered from back pain.
Examination
At the examination, blood pressure was 130/80 mm Hg. Breathing was normal, with no wheezing. The abdomen was calm. Sclerae were of normal color. The tongue was not coated. Pain intensity was 7 out of 10 (stylish).
The man felt tension and tenderness upon palpation of the back, especially to the left of the spine. Functional blocks appeared at the level of T4–T7 vertebrae, where spinal segments seemed to be stuck together, impeding free movement. Pain also occurred during leftward turns and bends.
Muscle strength, sensitivity, coordination, and tendon reflexes were normal. The patient was stable. The face was symmetrical, without pathological signs.
X-ray of the thoracic spine revealed Grade II (moderate) osteochondrosis.
MRI results showed:
- degenerative-dystrophic changes;
- wedge deformation of the T4–T9 vertebrae of degenerative nature (during the destruction process, they acquired a wedge shape);
- disc protrusions between the T6–T8 vertebrae.
Diagnosis
- Dorsopathy and thoracalgia (back and chest pain) against the background of Grade II osteochondrosis, wedge deformation of T4–T9 vertebrae, and protrusions. Prolonged exacerbation.
Treatment
The patient was prescribed a course of manual therapy No. 3 and the Lyapko applicator under the back twice a day for 30 minutes for a week.
After the first session, the pain began to subside. Each subsequent procedure enhanced the effect, and after a week, the painful sensations completely disappeared. The man returned to his usual lifestyle.
After achieving these results, he was recommended a course of therapeutic exercises and sessions with a massage roller. He was also advised to avoid physical exertion, especially axial loads on the spine (e.g., lifting weights).
At the follow-up examination after a month, there were no new complaints. The patient was advised to undergo another course of manual therapy in six months.
Conclusion
This clinical case demonstrates the high effectiveness of manual therapy for back pain. Nonsteroidal anti-inflammatory drugs do not always eliminate all causes of the disease, so pathology can be completely eliminated with a combination of other methods, particularly with precise movements by the doctor who controls the treatment process.
In this case, the main goal of the therapeutic method was to eliminate functional blocks and muscle spasms.