Back Pain & Symptom Guide

The area around the back and shoulder blades may easily become uncomfortable when sitting for long periods, repeatedly using the arms, or when the neck and shoulders are tense. Movement of the spine and rib joints, as well as fatigue in muscles around the scapula, may affect pain.

However, pain should not be assumed to be solely a musculoskeletal problem if it occurs together with chest pain, shortness of breath, cold sweats, severe abdominal pain, or fever.

• Pain on the inner side of the scapula when rotating the torso or extending the arm.
• Pain changes when breathing deeply or coughing.
• The longer you sit, the more your back becomes stiff and sore.
• Pain in the neck and shoulder may extend to the back.
• Pain is reproduced when pressing or assuming a familiar posture.
• Pain worsens when lying down at night.

We do not definitively diagnose lung or rib diseases solely on the basis that pain changes with respiration; however, if there is shortness of breath or systemic symptoms, an initial evaluation is necessary first.

If chest tightness or shortness of breath occurs along with back pain, accompanied by cold sweats, dizziness, or a sensation of fainting, prompt evaluation is required. Examination may also be prioritized if pressing on the ribs or spine causes severe pain after a major injury, or if there is high fever, cough, or unexplained weight loss.

If sudden paralysis or sensory changes in the limbs occur, an emergency neurological evaluation may be necessary.

We check when the symptoms started, how the arm is used in work and exercise, and whether symptoms change with breathing, eating, or sleeping. We examine the movement of the neck and back, shoulder, rib cage tenderness around the ribs, and scapular movement.

We ask about symptoms in the chest and abdomen, as well as fever and trauma; if there are signs that cannot be attributed to musculoskeletal pain, we guide you to necessary examinations.

If there are no warning signs and movement restriction around the spine and ribs, as well as functional issues in the scapula and neck/shoulder muscles appear related to pain, Chuna manual therapy may be considered.

After treatment, we check how discomfort changes in torso rotation, arm extension, breathing, and prolonged sitting. The goal is not to forcefully press on the painful area or forcibly align the spine.

Avoid maintaining the same posture for long periods; incorporate torso rotation and light walking between tasks that involve extending your arms forward. It is better to increase the range of motion that allows comfortable movement rather than continuously maintaining a posture that forcibly pulls the scapula backward.

Acupuncture and pharmacopuncture can be selected based on muscle tension and pain, while exercise is performed according to current function for thoracic rotation, shoulder movement, and breathing patterns.

Depending on whether pain is felt along the center of the spine, tightness in the inner side of one wing bone (scapula), or pain spreading along the flank and ribs, the area to be examined will differ. We also examine how the pain changes when you extend your arm forward or upward, rotate your torso, or take a deep breath.

Back pain can follow restricted movement in the neck and shoulder, and conversely, shoulder joint problems may be perceived as back pain. The reason is that we observe connected movements together rather than pressing on just one area.

Pain when taking a deep breath or coughing does not necessarily indicate a lung disease. Even if the joints and muscles around the ribs are tense, pain may change during breathing.

However, if you experience shortness of breath, chest tightness, or accompanied by cold sweat and dizziness, seek immediate evaluation in the emergency room. If high fever and cough persist, or if a band-like rash appears on one side of the chest and back, we recommend prompt medical evaluation to determine the cause.

We examine the range of motion for bending and straightening the back, and observe how the scapula moves during torso rotation to the left and right and arm lifting. We can also check the range of motion of the neck and shoulders, as well as the movement of the ribs during breathing and the tension in surrounding muscles.

Press the painful area to check if familiar pain appears, but do not determine the cause based on a single tender point. First distinguish between symptoms of the chest and abdomen, and whether there is trauma or fever.

We check whether rotation of the torso and arm extension have become easier after treatment, whether pain during work appears later in time, and whether deep breathing and sleep posture have improved. It is more important whether function is maintained in actual work and exercise than a brief feeling of relief.

In cases of recurring back pain, it is necessary to reduce the duration of maintaining the same posture rather than changing chair shape, move the neck, shoulders, and torso in various ways, and regulate activity levels.

Record whether the pain is in the center of the spine or inside the wing bone (scapula), and which movement—breathing, coughing, extending the arm, or rotating the torso—makes it worse. We also summarize whether chest pain and dyspnea are accompanied by fever, cough, and gastrointestinal symptoms.

For people who sit at a desk for long periods, it is more practical to alternate between leaning back in the chair and getting up to walk around, rather than trying continuously to maintain an upright posture. Using a mouse with one arm for a long time or carrying a bag on the same side only can also advance the onset of pain.

If deep breathing exercises feel comfortable, they can be utilized to gently restore movement in the chest and back. However, if the sharp pain worsens with breathing or is accompanied by chest pain, shortness of breath, or dizziness, do not repeat muscle-relaxing exercises; instead, identify the cause.

Recording when symptoms are severe (morning or evening), how many hours after starting work they appear, and how they differ on weekends or days off can help identify recurring stressors. After treatment, we check not only the intensity of pain but also whether the time until symptoms begin is delayed when performing the same activity, and whether movements such as rotating the torso or extending the arm become easier.

Recording whether back pain appears a few hours after starting work, how it changes with deep breathing and torso rotation, and whether it decreases on weekends makes it easy to identify repetitive strain. If symptoms other than usual accompany chest pain, breath-holding, or cold sweats, do not try to determine the cause with massage or stretching; instead, seek immediate evaluation in the emergency room.

Treatment response is assessed by whether the onset of pain is delayed even when performing the same tasks, and whether torso rotation, arm extension, and deep breathing become easier. Pressing one area hard may provide temporary relief, but it is important not to overlook symptoms of the chest or abdomen and the overall systemic condition.