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How to manage back pain and have a good posture?

How to manage back pain and have a good posture?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Atul Prakash

Medically reviewed by

Dr. K. Shobana

Published At August 24, 2017
Reviewed AtApril 22, 2024

Patient's Query

Hi doctor,

I am a 27 year old female. I am a medical student and has been experiencing some thoracic back pain for the last one year or so. I have no history of back, cervical or MSK problems. I have not had any imaging of my spine. Admittedly, I do not have the best posture. During most of the day I am working and standing. I have a stressful lifestyle, but I am experiencing the pain even on vacation. I do not have weight loss, fever, chills, neurologic symptoms, etc. It distracts me from my daily life. The pain is a constant dull ache or tension and is located medially, extending from C7 to the bottom borders of my scapulae. It feels like it is just lateral to my spinous processes, maybe in the laminar groove or maybe even at the zygapophyseal joints. At times I find that I can take a deep breath and even this causes my back to crack, although it is not painful. I regularly receive massages, which helped at first but no longer provide any relief. The only thing that provides relief is extreme extension of my spine, often by lying on a pair of tennis balls, foam roller or upside down from a chair. Even this does not feel like enough to relieve the tension. The maneuver which gives me the most relief is having my back cracked by a friend wrapping my arms around my shoulders and being picked up. Please help with my pain.

Answered by Dr. Atul Prakash


Welcome to icliniq.com.

Thanks for a comprehensive description and your picture marking out the point of pain (attachment removed to protect patient identity). Couple of possibilities are there. First is this could be due to poor posture. From the picture this is subjective. You have slightly rounded posture and shoulders protracted. Further, this can put your neck muscles out of synchronization and they too can fatigue and you can get fatigue pain which get referred to the area between the shoulders. The other possibility is that this could be an inflammatory condition seems less likely. Management will include your CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and vitamin D level check. Visit a qualified manual therapist who could help you with your posture. Get strengthen your interscapular muscles, your neck muscles, set your shoulder that will help with proper upper body posture, do release of any tight muscles and even open up the interspinous spaces in your thoracic spine. You may need a thoracic spine x-ray AP (anteroposterior) and lateral at some stage. Meanwhile, try an anti-inflammatory tablet like Ibuprofen or Diclofenac.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Atul Prakash
Dr. Atul Prakash

Orthopedician and Traumatology

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