Sickness in My Back

Question

Dear TAI Experts:

I’m a 39 yr old female suffering from chronic thoracic spine pain flare ups, with stiff neck muscles and golf ball size knots both on the sides of my neck, and in the area between neck & shoulders & between my shoulder blades. I have to apply direct heavy pressure on the painful knots in order for them to even slightly soften. These flare ups come anywhere from twice a yr to seven times per yr. They have been occurring since I was a teen, but the symptoms have become more intense. It lasts anywhere from 4 days to 2 wks. During the flare up, I also feel fevery but usually don’t actually have a fever. I get weak & tired & often develop a fever blister in conjunction with the flare up. My back makes crackling noises (thoracic region) with the slightest movement. I was diagnosed with scoliosis as a child. I’ve always described this as a “sickness in my back.” I’m bed bound when these occur. I get a tingling feeling along the spine too. Please tell me what you think. I no longer have insurance & cannot afford all the diagnostic tests, which are more than nine thousand to pay out of pocket. Fibromyalgia? Arthritis? Lupus? I’m otherwise healthy. Height/weight proportionate. No meds, allergies, injuries. I’m a vegetarian, though I get protein from soy products. I don’t drink milk. Could this be a problem? Maybe if I had a starting point as to which tests to eliminate at least. I’m desperate for help. Any advise would be greatly appreciated!

Answer

Without doing an examination of your neck and back I cannot comment specifically on your condition. There are a number of reasons that people develop “knots” in their back. Generally speaking, “knots” develop within muscles and may be associated with increased demand for that muscle to work. Some knots, referred to as trigger points, may be very painful and even refer pain distant from where they are located. Trigger point release, such as deep pressure, is an acceptable form of treatment for muscular knots, but may only assist temporarily. A full examination by a physical therapist may reveal underlying causes for the development of muscular knots, such as range of motion limitations, muscle imbalances, postural dysfunction, and even psychological contributions. There are also other structures in the neck region, such as lymph nodes, that may resemble muscular knots.

Regarding the crackling noises in your upper back, popping in the back is not uncommon and not typically a concern unless associated with pain and limited function. Generally, popping can occur in joints that have fluid within the capsule (synovial joints). This popping is usually a result of a dramatic reduction in pressure within the joint causing gas bubbles within the joint fluid to release. Popping can also be associated with tendons and/or ligaments moving across each other. A physical therapist would be able assess the structures in your neck that are contributing to your symptoms and guide treatment, which may include manual therapy and therapeutic exercise.

The associated symptoms you describe – fever, fatigue, blistering, being bed bound – as well as worsening of symptoms requires proper medical work up. I know medical costs are an issue, however, I suggest you consult with a doctor regarding your symptoms.

Leslie Girard, PT, DPT