A Pain In The Back

Published on: 4/17/2014

Self-Treatment Ideas For Desk Jockeys

As a therapist, one of the most common symptoms I hear my clients mention is pain or tension in the upper back and neck. They describe it as a knot, pain or tension between the shoulder blades or from the shoulder running up to the base of the skull. In all of these cases, though, one of the first places I evaluate for treatment is actually the front of the body – the abdomen, upper chest, and front of the neck. I know what you are going to ask, “Why would you look at the front when my pain is in the back?”

Many of these clients have a forward posture, whether it’s the whole upper body leaning forward, the shoulders rolling inwards, or the head pulling in front of the rest of the body. These signs are especially common with people who spend a lot of time in a forward posture, often in the form of long hours at a desk or leaning over a keyboard. This produces shortened and taut muscles in the front of the body. Secondarily, the upper back and neck muscles strain to support the weight of the head, which weighs 10-12 pounds. The problem is that those muscles in the back are not very effective at doing so, and over time, the overworked muscles in the back begin to fatigue and go into spasm. This is why you develop those tight and painful trigger points and knots. No matter how much treatment we provide to the back, we will not have lasting results, because we’re treating a secondary issue. The moment you stand up the tight musculature in the front pulls you into the same repetitive pattern (shortening in the front, overworking in the back leading to knots and trigger points).

By helping the front of the body to open up, reversing that forward pull, we ease the strain on the back muscles, allowing them to return to a neutral position and significantly reducing pain and other symptoms. Once the front of the body has opened we can directly treat the back itself, assessing the movement of the shoulder blades and the soft tissue around the spine. Sometimes, I may spend an entire session without directly working on the back, although the whole session is focused on easing the back pain symptoms. There’s no line in our bodies dividing front from back – releasing the pull of the fascia from the front will ease the symptoms in the back.

Fortunately, there are also easy self-treatments you can do to help open the front of the body and ease that strain pattern in the upper back. These two simple techniques use just a pillow or a bath towel as a prop.

To use the pillow, lie down on your back on the floor with the pillow under the torso. You can either align it vertically, running the length of the spine, or horizontally, across the body. Try both, and see which one feels like it helps your ribcage to open and your back to settle. If your pillow is very thin and soft, you may need to use two, or fold one over on itself in order to feel like you’re getting enough lift through the body. Once you’ve found a position that works for you, let your body sink down, molding over the pillow, for at least five minutes.

A very similar technique, and one of my personal favorites, uses a bath towel. Just roll up the towel to create a long roll, about two to three inches in diameter, and lie down with the towel roll under your spine, running the whole length of the spine from the hips to the head. This provides a very direct lift to the spine, while providing space for the shoulder blades and hips to drop back, reversing that forward pull. (You can also use a pool noodle for this one – it’s about the right diameter to lift the spine while letting the shoulder blades float freely, and it has a little bit of squish to it for comfort.) Again, lie on the towel roll for at least five minutes in order to let the body really begin to settle and to adjust to the new position.

Although we can manually pull our shoulders back in an effort to correct our posture on a temporary basis, as soon as we release the effort, our bodies will be drawn forward once more by the taut muscles. Using one or both of these simple stretches is a great way to help the front of your upper body to open up, relieving the pain in the back. We have to remember to treat the front of the back.