A young man–about 29–walked into my office this week with acute mid-back pain.  The pain was localzed to his left shoulder blade, just beneath it, and just next to the spine.  He was feeling it more diffusely though, and it felt as if it was his entire left mid and low back that was “on fire”.

I ask all incoming new patients what their goals are regarding their care at my office.  Essentially, I want to know what they are looking for.  This young man with mid-back pain wanted to know why he was having pain–what was the cause and what could he do to fix it.  Fair enough; it was apparent to me that the young man had two major problems going on: he had poor posture and he was very tight muscularly.  The first–postural problems–are directly related to the second.

So that at least answered his question as to what was the cause of pain, but why?  Well, his particular postural problem was an over-hunching upper and mid-back.  His shoulder are so rolled forward as to make him appear in a perpetual slouch.  This happens as a result of tight pectorals or chest muscles.  The concommitant weakness is in the back, at the lower trapezius muscles.  The trapezius is a large diamond-shaped muscle of the back.  Although it is one muscle, we classify it into three regions based on the actions of each part.  The upper traps shrug the shoulders, the middle traps pull the shoulders back, and the lower traps are what we call scapular stabilizers–that is, they hold the shoulder blades down during overhead arm movements.

When the lower trapezius muscles get weak they lead to shrugging shoulders.  And if the pecs are also tight…hunched forward look.  What makes this scenario even worse is that both the pec tightness and lower trap weakness can create stress on the spinal bones of the mid-back, which can lock-up or subluxate.

So the answer for this young man and anybody else in this same situation is the following: Chiropractic adjustment to correct subluxations, myofascial release (massage) to relax the tight muscles along the spine, stretch the tight pectorals and upper traps, and exercises to strengthen the weakened lower traps.  Simple.