Expert: Dr. J. Shawn Leatherman - 1/15/2007

Question
Hello, just after a bit of advice. I'm 22 and am recently experiencing aches between the shoulder blades and when I push my shoulders back to stretch I can feel it crunch. Do you suggest I see a Chiropractor or simply get a massage from a spa? Thank you

Answer
Dear Jenny,

Chiropractic care and massage will definitely be able to help your problem.  Pain between the shoulder blades is a common complaint in chiropractic offices and is usually the result of a few small problems rather than one specific issue.

Common causes are vertebral fixation of the spinal column in that area of the upper back. In women, this is often complicated by the use of a bra that is too tight, or has a small clasp rather than a larger one.  Postural issues are also a factor...lots of desk or computer work, reading, studying etc...allow the shoulders to roll forward and the head to move forward which increases the stress on the upper back musculature.  When these positions are prolonged the fascial system which is a small covering that surround all the muscles, can become tighter and form adhesions to the muscle which further limit motion and creates inflammation and pain.  Sounds like your problem huh?

Jenny, both massage and chiropractic will help the initial alleviation of pain and fascial restriction, but a combination of both along with exercises to combat any postural stress and strengthen the upper back will be the most effective solution for the problem. In addition the massage therapist is not licensed to diagnose a problem or to treat anything outside of a myofascial problem.  Therefore a chiropractic evaluation will be more comprehensive and will be able to address any spinal component.

The bottom line is that it is really up to you, as I have not had the opportunity to examine you to determine the full extent of the problem.  If money is tight, or your insurance coverage is not real good, an initial massage will be the best place to start.  

However, most chiropractic physicians give free consultations and will be able to address money issues in advance and whether or not they think they can help with your specific problem.  Not to mention that many chiropractic physicians have massage therapists on staff at their clinics, and if prescribed, it may be covered under your insurance...again depending on your particular plan.

Regardless of your decision, if you choose massage, make sure that you tell the therapist that you would like deep tissue.  This will make you sore and may be uncomfortable, but it will provide the most therapeutic value concerning the myofacial system.

Good Luck Jenny.  Let me know how everything turns out.  Feel free to write back with any further comments or questions if needed.

Respectfully,
Dr. J. Shawn Leatherman
Director of Clinical Rehabilitation
www.suncoasthealthcare.net