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Upper back pain, delivered by C-section. Overwieht, pain in arm and shoulder. What to do next?

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General & Family Physician
Practicing since : 2009
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Hi I have upper back pain going on for a bout 1 1/2 years. It all started when I was pregnant with my second baby who was quite a big baby and was delivered by C-Section 9 Months ago. Since the C-Section the pain has gotten worse I am quite health with regards to nutrition and I excercise at least 3 to 4 times a week. I am still about 2 stone overweight since I had her. The pain comes from a specific spot in my back around the shoulder blade area and it feels like a knot. When this is massaged it does make the pain feel better however now the pain moves right around my back and under my arm. It is tender to touch and yesterday was the worst episode yet which lasted for about 3 to 4 hours. I have had a chest Xray done to rule out any heart related issues or broken bones etc. The X-Ray was normal. I was diagnosed with GERD also and I have amended my diet accordingly to try to alleviate this. I cannot take NSAIDs as they make my stomach worse. Heating and Cooling Pads work however I do get a little anxious when this pain comes on as it can feel like chest pain and a little scarey. Can you tell me what to do next, shold I go to a chiropractor or doctor or keep treating it with heat or cold. I don't have any other symptoms Although the pain is worse around my menstrual cycle. I would greatly appreciate your help.
Posted Mon, 24 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Aparna Kohli 4 hours later
Thanks for writing in.
The painful spot in your upper back is a trigger point and that is what is causing the pain. The extra weight also puts a strain on the back. Its extremely unlikely that such pain is caused by GERD/a heart issue.
The following measures will help:
a. Continue with the hot/cold therapy
b. Applying diclofenac gel locally and then using hot fomentation should help tremendously
c. See a physiotherapist who can give appropriate treatment for this. This would be the single best step you can take. Several treatments like diathermy and transcutaneous electrical nerve stimulation are available which can help.
d. You should also be considering alternative therapy like acupressure.
If the pain still persists, I would suggest you see a physician. We may need to inject a relaxant into the pain producing site.

Hope this helps
Let me know if you have any more concerns
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