upper back ache

[bBarnabus]

I have been suffering from muscular aches between the shoulder blades for a couple of weeks now. I seem to have a muscular knot particularly on the left. It doesn’t seem to want to improve. Could this be a polymialgia phenomenon? I have had pain in the shoulders and around the hip but not here before.

[PMRpro Ambassador]

Myofascial pain syndrome? I have had similar pains for years, both long before PMR and alongside it. It is felt by some experts to be part of the pathology of PMR. I find targeted treatment aimed at releasing/mobilisation of the trigger points and attachments that are inflamed helps a lot. Personally I prefer manual techniques even though they often result in what feels like a short-lived PMR flare as the cytokines that are present in the tissues are released into the blood stream before being washed out of the system. The Pain Clinic here practises a very Germanic treatment called needling - subcutaneous injection of lidocaine which stimulates the underlying muscles to relax. Strangely, I find I feel worse for a few days a few days later - obviously something changes before it improves. Never thought about it before.

jrheum.org/content/46/12/1552

[bBarnabus in reply to PMRpro]

Thanks for that. Do you think I should increase my steroid intake while I have this pain

[PMRpro Ambassador in reply to bBarnabus]

It doesn't really help me - it is a very localised problem, often due to a knot of inflamed muscle fibres in a large muscle that is irritating a nearby nerve or the rest of the muscle and causing it to spasm. I find a flooding dose of ibuprofen (800mg) with food and a hot water bottle over the site of the pain works better to relax the spasmed muscle. Physios here work on the knots to release them and that really does work.

[bBarnabus in reply to PMRpro]

A flooding dose only or back it up with a continued dosage?

[PMRpro Ambassador in reply to bBarnabus]

Depends on whether that flooding dose works 100% and if you have a strong stomach! I find the 800mg lasts almost a full 24 hours once it kicks in. If the pain returns I take a 400mg top-up but whatever, I seem to use far less ibuprofen to keep comfortable.

[scrambledegg]

This is such a coincidence! I too have had a big “knot” in the muscle behind my left shoulder blade for years. Possibly from when I first had PMR.

I spent most of yesterday sitting in a car and it was so painful this morning I took my physio’s advice and rolled a tennis ball against a wall using that part of my back. It’s been so much worse since I did that I began to wonder if I’d done more harm than good. Now reading PMRPro’s advice it all makes complete sense. I’m tempted by the big dose of Ibuprofen but I think I’ll just try the hot water bottle for now. Hoping those cytokines only hang around for 24 hours but maybe I’m being optimistic.

I hope whatever you try works for you.

Thanks PMRpro for answering a question Ihadn’t even asked. Your posts are always so interesting and informative .

[PMRpro Ambassador in reply to scrambledegg]

I've never managed to get the tennis ball thing to work! Just ends up on the floor!!

[scrambledegg in reply to PMRpro]

Try putting it in a sock, put it over your shoulder with the ball in the toe end and hold on to the other end of the sock over the front of your shoulder.

[Viveka in reply to scrambledegg]

Two tennis balls tied together in the end of a stocking, one for each side of the spine but avoiding the middle of the spine? This may be more gentle than directly on the spot with a ball. Also can feel like bliss.

Sounds like you may benefit from some form of expert massage that includes needling. It's finding the right person. A sports background physio who does massage and needles? A Mctimony chiropractor? Acupuncturist?

[Liljeblad]

I have the same too. For me it’s heat that gives temporarily relief. I use bags filled with wheat seeds and rice which I heat up in the microwave. You can fill a large sock with rice and heat it up 2-3 min.

The tennis ball provokes more pain.

[Mamamia21]

My PMR journey started with pain in my shoulder blades, then moved to my shoulders and then my hips. No amount of massage or pain killers helped but steroids did the trick once they decided that this is what it was... In all the years I have had this I think my shoulder blade pain was the worse... I couldn't roll over in bed without being in extreme agony... I do hope the suggestions from people above will do the trick for you.

[Grandmaziggy]

I went for a neck, back and shoulder massage last Monday and it was heaven, felt drained for a few hour's after but then felt great the day after. Ive booked to have another one on Good Friday can't wait 😃

[Mfaepink1973 in reply to Grandmaziggy]

I have one every 2 weeks and it’s quite painful when she works on the knots and I feel bruised and battered for a day or so afterwards, but then so much better and worth the temporary discomfort.

[bBarnabus in reply to Mfaepink1973]

Thanks I will try that