Q. Does my back pain sound like a strain?

Answered by
Dr. Thomas Jefferson
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 19, 2016 and last reviewed on: Oct 09, 2018

Hi doctor,

I am getting recurrent back pain and I believe that the pain is in my rhomboid muscle. Usually, this happens after sitting for a while or while changing the position. Most of the time it occurs from a normal movement. I feel that after some movement the pain starts almost instantly. I cannot tell if I am straining it every time or if it is just knots and trigger points. So, I do not know whether to apply heat or ice. I am just taking Ibuprofen.

A few years ago, I pulled that muscle pretty badly. It took a few weeks to heal. Since then, I have had these flare ups. It is never as bad as that pull and they have lasted now for two to five days. This morning, while getting out of bed, I felt the spasm or a knot or strain. I tried to ice it, but I think it made it worse. Is hot fomentation safe? Does it sound like a strain or pull or a recurring knot?

Dr. Thomas Jefferson



Welcome to icliniq.com.

  • The pain you have in the rhomboid area can be fixed completely if it is purely due to musculoskeletal problems.
  • There is no reason for you to get panicked. I have successfully treated plenty of patients with the same type of pain and they have recovered.
  • Usually, it is because of a strain of the muscle after doing something forceful with an outstretched arm. The recovery duration has varied from just a single day to two weeks.

The Probable causes:

1. Repetitive strain injury of the rhomboids due to continually working with an outstretched arm similar to working with a computer mouse. This especially when the mouse is far off on the table.
2. It may be due to a faulty ergonomic posture adopted by you during some work that resulted in a rhomboid muscle strain.
3. It may be due to referred pain from stomach problem like ulcers.
4. May be a strain in the corresponding thoracic segment of the spine.

Investigations to be done:

Usually not needed in the early stages of treatment.

Differential diagnosis:

Rhomboid muscle strain.
Thoracic segment of spine strain.

Probable diagnosis:

Rhomboid muscle strain.

Treatment plan:

1. Apply heat in the part as ice pack does not make you comfortable.
2. Take the medications regularly.
3. Strengthen the rhomboid muscle group after the pain comes down to rest and medications. A theraband strengthening program for the rhomboids will help especially with the easiest color red.
4. Taping to prevent overstretching of the rhomboid muscles and to provide proprioceptive feedback will help.
5. Rest the part.

Preventive measures:

1. Do not massage the painful part.
2. Ensure that you keep your elbow close to your waist as you position yourself to do any activity. That will safeguard your rhomboids from further injury.
3. Do not try to examine yourself about the pain in the rhomboids. Your attempts may make it worse.

Regarding follow up:

For further information consult a physiotherapist online.---> https://www.icliniq.com/ask-a-doctor-online/physiotherapist

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