🏥 Assembling the best team for my back

The title is quite literal. I am currently working with three different professionals to undo 6 years of chronic back pain. Upper thoracic, mostly my left side, right around the rhomboid. How do I know it's been 6 years? Because I searched "back pain" in my messages to a friend who was in med school at the time, and there I was, describing the exact same spot and the exact same pain to him 6 years ago.

The DIY years

It was an on and off thing I ignored for years. I blamed it on desk work, even though I made every corrective change I could think of. Standing desk. Ergonomic chairs, and not just any chairs, I tried both the Steelcase Leap V2 and the Herman Miller and eventually stuck with the Steelcase. Every imaginable pillow: memory foam, shredded foam, down, even buckwheat. Three different mattresses. I did the stretches of course. I've been to 5 different physiotherapists, basically one for every year I've had this issue. I had imaging done. I did all the corrective exercises at the gym, which only ever resolved it temporarily. Nothing landed permanently, and I just kept ignoring it because I didn't have the time to sit down and actually take care of the issue.

The turning point

It wasn't until I was let go and my schedule freed up that I took a serious look at this thing nagging at my rhomboid. I started learning about pain management and what actually happens after years of chronic stress on imbalanced muscles. Some muscles can be so knotted that they can't properly heal because fresh oxygenated blood can't get in. The inflammation from constant pain wrecks your deep sleep, and I didn't realize I had been masking terrible sleep with constant coffee for years.

Once I could finally rule out sitting at a desk for 8 hours straight, I could actually invest in my back health and get to the bottom of it. I got my doctor involved and we tried every conservative method first. Even a course of prescribed naproxen and muscle relaxants didn't help. This is where I started being persistent, because why not? I don't have a full-time job right now, so I can dedicate that energy to healing my body. Investing in future me.

Finding the actual source

The persistence paid off with a referral to a physiatrist, a physical medicine and rehabilitation specialist I didn't even know existed. Their assessment: left upper back myofascial pain involving the rhomboid and levator scapulae region, no nerve damage. And here's the part that got me. The rhomboid pain I'd been chasing for 6 years turned out to be referred pain from a trigger point in my lower trapezius. The actual source had been missed the entire time. Everyone, including me, had been treating where it hurt instead of where it came from.

The physiatrist did a trigger point injection, lidocaine straight into the affected spot. It interrupts the pain-spasm cycle and lets fresh blood flow back into tissue that's been chronically contracted. That injection opened a window, and I've been working hard to capitalize on it.

The team

From there I assembled a small but coordinated team:

My physiotherapist at iMove has been essential in mapping the full compensation chain: how the lower trap trigger point referred pain up into the rhomboid, how the serratus anterior stepped in to compensate, and how the thoracic paraspinals tightened up as a secondary consequence. She put me on a targeted eccentric loading program to properly reactivate the lower trap, uses electroacupuncture and dry needling to mechanically break up the trigger point bands, and sequences each intervention to build on the last instead of just chasing symptoms.

My RMT does deep tissue work on the surrounding compensation muscles, the thoracic paraspinals, serratus anterior, and upper trap, between needle sessions. This makes the tissue more receptive when the physio needles it and keeps the compensation pattern from fully re-establishing between appointments.

The physiatrist's trigger point injections, every three months to allow proper tissue recovery, provide the deepest disruption of the pain-spasm loop. It's something neither dry needling nor massage can replicate, and it consolidates what the physio and RMT build up in the weeks between.

The three work in a deliberate sequence: the RMT softens, the physio needles and retrains, and the physiatrist consolidates. Each layer reaches something the others can't, and for the first time in 6 years the treatment is actually moving in the right direction.

What I've learned so far

It took losing my job to finally have the time to fix my back, and honestly, I'll take it. The lessons so far: advocate for yourself until you get proper specialist care, understand the difference between treating where it hurts and treating where it comes from, and build a team instead of betting everything on a single intervention. Still a work in progress, but finally trending the right way.