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Rhomboid muscle pain - 10 years with little relief

I have had chronic rhomboid muscle pain on the right side for 10 years, and have seen numerous MD's(MRI with no significant problem found), Chiropractors (Adjustments & pressure point message), Physical Therapists (waste of money) and a Neurologist that is currently performing acupuncture.  I self medicate with Ibuprofen, and sleep on an ice pack every night.  In addition, I lay on a baseball and roll over the rhomboid muscle while stretching to break up the spasms for some relief, the ball hits an area that feels like a rope that is in a horizontal position across the rhomboid. Pain radiates from the rhomboid up the right side of my neck, and down my right arm which includes the right shoulder.  Headaches are almost constant.
I will try anything at this point to resolve this issue; any help with this issue would be very much appreciated.
171 Responses
Avatar universal

sorry about ur pain.  have you tried any muscle relaxer meds.  thats the onlyy thing i can think of since u said u get the spasms.  and has your neurologist done a test called emg.  it can at times tell problems in the muscle or nerves.  ibufrofen does not take spasms away.  i have been suffering from spasms of whole body and use to pop advil all day thinking it should heelp.  aske your doc for muscle relaxant at this point.  accupuncture is good.
Avatar universal
Thank you for your response.  I have a medicine cabinet full of muscle relaxers; any effective dose (which has been negligible) is not worth the loopy effect of the medication. Ibuprofen has helped curb the pain intensity; this along with ice gets me from day to day.  If there were an effective surgery procedure available to fix my problem, I would do it in a heart beat.
Avatar universal
I'm sorta' familiar w/ your problem.  Use to play ALOT of
tennis & eventually damaged rotator-cuff but have an idea of
your muscle pain that extends from 'middle trapezius'? I'm
surprised you get relief w/ Ibu. Guess it wks for some for the
inflamm. Never did a thing for me. Only ice-paks & 1/2 lortab-7
(narcotic) & at bed a whole. They sell a clay-filled type flat
cool-pack that lasts 3xlonger than ice by KAZ. It's great at the
scapula area. Works better w/ a very thin towel around it & not
the thick cover. It can be pretty disabling just doing a simple
reach to comb hair. My racket went but I finally found a DR that
sent me to a Sports Medicine Specialist. They appear to know
more abt this than others. PT/chiro's were a waste. You need
time to heal muscles & adjust. My racket went! Cuff was really
bad but just putting on a shirt almost broke a crown. It's been
along time. Don't think any surgery is out there for this + the
scar tissue could create problems. I'll try to find old info &
get back. Meanwhile, what state are you in? There are some
Universities that have sports-division medicine that specialize
in this & some even need people w/ conditions for the professor
to work with. (Not a student)! Do/Can you get your records of
tests done? Also, some chiro ofc's or net sell Biofreeze-gel
that goes deeper than OTC cool gels & numbs for awhile. Later.
Avatar universal
I appreciate your insight, thank you.  I had shoulder cuff injury about six years ago, and had arthroscopic surgery to repair it.  The right rhomboid injury happened prior to the shoulder cuff injury.  I had my second acupuncture procedure today, and it did seem to have a temporary effect.  When the Neurologist was placing the needles, he place one needle right in the middle of the problem.  I asked what muscle it was, and he said it was the trapezius...but didn't say which one. It's interesting that you brought this muscle up, it sounds like you do have a similar injury.

I did go to a physical therapist where their specialty was sports related injuries...it was a joke.  My current chiropractor is an actual MD, and he was the first in a long line of doctors to target the actual location of the injury.  Locating a source of pain can be more difficult than it sounds, but he took the time with me unlike other MD's.  

To answer your question "what state are you in"...This could sound like a pity party, but you did ask.  I use to be very athletic and in very good shape.  In addition, I could take on any physical or mental challenge and would almost always be successful.  My energy has been sapped, pain is constant, and I can't be the person that I want to be for my family and career.  I am not a lazy person by nature, but I feel lazy because I can't get past the pain to participate in life.  As a result, I'm overweight (I look like an NFL Linebacker - 6' 3" 300 Lbs), for my frame...I'm about 50 Lbs too heavy.

I will take your advice and look for the clay cold packs, and I will continue to check for any updates to this issue.  Thanks again.
Avatar universal
Yup, sure sounds similar. I too was extremely athletic. Tennis
& snow-skiing were my passion & then things hit. I got the coin
toss that sent me to a Orthopedic Surgeon that sent me to a special radiologist that wk'd w/ a top basket ball team for dx.
Didn't hurt at all, but was a strange 2 hr test watching my
insides on a TV screen. He started a 6" long stylus needle in
upper chest & then continued threading a smaller one thru that &
that 2nd had a camera-tip. Felt like a long thread wiggling
& guided around tissue/cartilage. I had to be awake for breath-
ing purposes (hold-breath) off/on. This was in the 80's & he
relied on the screen to guide it. Way ahead of his time! Said
I was his only patient that never passed out. He said many
walked out when they spotted the stylus & refused. It just felt
creepy inside. That's how I was dx'd. Then referred to Sports
PT. Maybe you need to find who the big buck athletes go to?
Between PT, I had to wear an elastic girdle-type 1/2 shirt to
keep muscles scrunched. I think Dr's need to go back to the
80's & start thinking. I do good w/ water-robics for tone but
I still get this quick stab in scapula area if I stretch to
high. A hand bell keeps arm toned for task-stress away from my
shoulder pull. Let me know later how the Acupunc. goes. A bit
of humor: I did the pity-party thing too, but I meant what U.S.
State you were in. Humor got me thru the pain! Later.
Avatar universal
LOL...did I provide a little too much information?!  I live in Illinois.  The probe & wire procedure sounds gruesome! The acupuncture will discontinue if after 15 sessions there is no improvement according to the doctor...I'm very hopeful.  I will provide an update once I know the results.
Avatar universal
Hi Unemployed,

Have you had a postural examination that also included evaluating your posture during movement?  Abnormal posture during movement can sometimes be hard to detect and may contribute to pain in the rhomboid region.

Hope this helps,

Avatar universal
My daughter is a PT and I also have been having trouble getting a rhomboid strain to heal. She says that thoracic outlet syndrome could be a contributing factor. Have any of you been tested for this or heard of it from any of your doctors?
Avatar universal
Hi Guys

I have the same problem.
In a nutshell , the problem is spine related.
A chiro is not good , you need to see one of them bone setter .
it really works folks!
Also ask somebody to use their elbo and to massage the area by pressing and stretching this muscle.
Avatar universal
I have had the exact same problem (except on the left side) for the past 2 years -- incredibly tight rhomboid muscles that feel like rope with about 50 knots, terrible neck pain, constant headaches and have done the PT, the chriopractor, everything...without relief.  

Massage (with tennis ball, someone elses elbow or massage chair) offer some relief but it is often short lived.  While I cannot offer you much help in the way of relief, I may be able to offer you some help in terms of what might be causing it.  While getting and MRI for a completely different reason, it was discvered that I have a herniated disc in my C4-C5 vertebrae.  The dorsal scapular nerve which runs through the rhomboid muscle begins at that location.  My doctor told me that because of the disc herniation the rhomboid muscles on my left side are constantly tightening in an attempt to compensate for the damage.  Have you ever had a cervical spine MRI?
Avatar universal
Hi Steff:
I've had this same issue for 6 years now. I won't recount all the docs and treatments I've had. I've been getting cervical epidural steroid injections which are hit or miss for a c3/c4 herniation. About a year ago I started to have arm tingling so a Ctscan revealed a c-5/6 herniation. Had a series of injections in c5-c6 in late 2006 and most of 2007 it improved my rhomboid problem. I hav been better, not great, but able to work out with weights and enjoy life. Now just last week I woke up after playing golf...and was in immense pain....and it has continued....after reading your comments I now might be able to connect the dots and my c5-6 herniation may be aggravated and causing my underlying problem...teh c3/c4 was more visible but probably not causing the underlying problem....Have you found any web research that shows the dorsal scapular nerve begin at c4-c5? I will look myself as well...as most folks who are in this thread probably are aware, the hardest thing is to convince a doc to spend time discussing and believing your own opinion on the source of pain. I've had some docs tell me that this cannot be related to the spine and others who say it may be....arghh.....Thanks for your perspective.
Avatar universal
I am a 26 year old female pretty much in good health.  About 3 years ago I started experiencing pain in my chest.  I ignored it thinking that it would go away.  Well it never did and instead of getting better it has gotten worst.  The pain now is not only in my chest but also on my upper right shoulder blade, right side of neck, down my right arm to my finger tips, and also under my arm by where the bra strap sits.  At times it feel as if my right breast hurts as well.  I feel helpless because I have gone to several doctors and have gone from pill to pill.  I have noticed that icing it helps and also at times I'll go home and have my husband massage my upper back, which I guess would be called the rhomboid area.  That also helps for a little while.  I am tired of the pain.  At times I feel useless and it is affecting my life.  I have had an MRI done and apparently everything came out normal.  I don't know what to do anymore and I feel as if the doctor that I am seeing now won't hear me out.  She put me on cymbalta, which made me end up in the ER by ambulance.  Now she has me on some seizure med (can't remember the name) I stopped taking it because I recently visited the ER after falling and landing on my back (the right side of course) I was in extreme pain.  Well the ER doc asked me how I slept and she told me that it could have a lot to do with it.  She also said that she felt a lump on my right side (didn't know if it was caused by my fall or not) by my shoulder blade which is where it is very sensitive at times. So she diagnosed me with muscle spasms from the trapezius/rhomboid area and paraspiral muscles T 4-7 area < not sure what that meant.  I have also been diagnosed with costochondritis. This is the first thing that I was diagnosed with, but I have been having all these recent complications for about a year now or so.  If anyone has any advice please share.  I am desperate.  I just want to be normal again.

Avatar universal
I have just found this site and see so much of what I am suffering from.  Second really bad issue with rhomboid muscle spasm- my right side this time and numb on the top of my right bicept (nerve entrapment).  Went to Orthopedic who gave me a cortizone shot- helped about 22 hours, and now back to a really good PT who was able to work out the last one.  I am a triathlete, run, swim, bike, just finished a marathon.  50 year old female.  Also weight train.  All is to say, trying to keep fit and healthy and it results in this terrible pain that nothing will help make go away until the PT is able to get the muscle to relase with Miofacial release techniques and other things.  My question is this- I know I need to lay off my training- how bad is swimming for this problem once I get the muscle settled down and am pain free again?  I don't want to stop my triathlon life and I also can't live life with this constant pain- I am becoming a very unpleasent person due to lack of sleep and pain.
Avatar universal
22 year old male.  I work out in the gym 4-5 days per week.  Obviously with my goal being weight gain I push myself generously.  I've been working out for about 2 years and have gained 50 pounds.   August 06 I injured my rhomboid pulling on a pallet jacket at work.  Since it was only a slight pinch with no further pain I didn't let it slow me down in the gym.  The following day I suffered a mild spasm during a chest workout.  2 days later I went to a chiropractor who diagnosed it as a "dislocated rib."  She tried to put it back in and caused a major spasm.  I couldn't turn my head, lift my arm, or get out of bed.  After an MRI, x-rays, and 3 visits to an Orth Surgeon I was diagnosed with a rhomboid muscle strain/ minor tear.  He said, "Let pain be your guide...." I took 8 weeks off from the gym.  I haven't had a major spasm since then, but every time I get the slightest bit stressed out it aches like a toothache.  I've tried those stretches, bengay, heating pads, doc gave me lidoderm patches, and alleve.  I don't feel that my working out is aggravating it further....Is there anything that can be done to fix this problem permanently?
Avatar universal
I strongly suggest anyone with rhomboid area pain, cervical radiopathy / radiculitis, "trigger point" problems, shoulder RSI, chronic rotator cuff tendinitis / tendonopathy, and other similarly diagnosed symptoms to read Jolie Bookspan's online material on stretching and posture correction. Some of it is a bit unconventional, some a bit hokey, but all of it is based in sound science, unlike the advice of most chiropractors and PTs. While many of these pains have different specific medical causes (pinched nerves, bulging discs, actual tendinitis, etc), her approach treats the postural causes of all of them.  Within 4 days of practicing her simple stretches (and avoiding the head forward, arms-across-chest stretches she advises against, which feel great, but are counterproductive, since the rhomboids are already over-stretched) I felt actual natural relief - no more medication, hot / ice packs, menthol pads, etc. It takes constant attention (especially once it does start working, and you have less pain to remind you), but the longer you keep at it, the longer you can sustain the relief. Here's the link:
Good luck!
Avatar universal
Sounds like you have a trigger point (or several).  Please check out a book by Clair Davies: http://www.triggerpointbook.com/.  My husband discovered him while he was studying to become a massage thrapist.  We both had been suffering from chronic pain for many years.  This book showed us how our pain was caused by tigger points.  For example, my husband worked on several trigger points I had in my traps, and stopped my regular migrains (haven't had one in months).  Also, I had several in my shins and couldn't do leg extentions without my eyes watering because I was in so much pain (not from the exercise, but from the leg extention machine pad against my shins).  After working on my trigger points in my shins I can do leg extentions pain free.
Good luck!
Avatar universal
I am so happy to have found this website.  I have felt alone in chronic  pain flare ups that have occurred almost exactly as has been stated in this forum.  I had a fall and herniated discs at C4,5,6 that impinged spinal cord and nerve so I underwent surgery to remove disc and fusion  with bone.  The nuerosurgeon was so intent on releasing the pressure on my spinal cord to avoid paralysis, he didnt even go into the residual pain that would occur.  I am glad that the fusion worked but I have not been pain free in 5 years now.  I used to be very active and now if I so much as walk on treadmill for 30 minutes I end up with a horrific painful inflammation in my upperback that leaves me crying and laying on ice on the bed.  I have regular epidural injections that provide relief for the stiffness and some pain, take vicodin and flexaril, and motrin for pain, spasm relief, and inflammation but dont want to use more than absolutely necessary so I dont tear up my stomach.    I try swimming and while it doesnt have the jolt impact of walking, the very movement of those back muscles can trigger an episode.  I keep telling myself not to feel sorry for myself because there are so many people worse off, but I feel when you live with chronic pain you are in your own torture chamber.  
I have tried pretty much everything others have mentioned here and really for the most part pain management is using a variety of treatment methods to help us cope and be functional... Some days it is okay, some days not.  
good luck to anyone else coping with this type of pain.  
Avatar universal
I hurt my rhomboid popping a 50-pound bag up on my shoulder.  I have been in therapy almost 7 months.  Not much better.  Found that running irritated the rhomboid so I tried running with a sling to minimize the motion.  Is there any brace that would help since I spend hours at a computer?  what about a certain chair?  Interested in answers since it is a continual pain.  Biofreeze hides the pain.  Afraid my non-movement of that shoulder or guarding it will lead to other problems in the shoulder.  Any other suggestions?

Avatar universal
I have had this same issue for about three years now.  At first I thought it was my trapezius muscle but I looked at a diagram yesterday and am thinking now it is my rhomboid muscle as well.  I went through years of treatment for this issue.  Until a few months ago, I was a member of Kaiser and was admitted to the Chronic Pain Management department for 2 years.

I have gone to countless appointments, purchased a new PosturePedic bed, have tried Vicoden and muscle relaxers, accupuncture, accupressure, physical therapy, electro-shock therapy, chiropractor, trigger point injections, cortazone/steroid injections, etc etc etc.  Finally they gave me was a drug called Nortryptelene, which is a very strong antidepressant that also is used for patients with nerve damage.  It made me depressed and suicidal, which is very unlike me.

Needless to say, after that, I mostly stopped seeing doctors, unless it was emergency treatment.  I have had my neck lock up so badly that I had to get an injection with a huge needle in my rear, which almost immediately provided relief.  I don't recall what it was but they told me that it is something they cannot give other than in an emergency.  Kaiser refused to do an MRI of my back.  They would only do an MRI of my neck because they claimed the numbness in my right arm HAD to be from my neck.  This doesn't make sense because the center of my pain is in the middle of my back, to the right of my spine, just underneath my shoulderblade.  They found bulging disks in my neck but based on what you guys are saying here, I'm concerned I may have herniated a disk much lower than they were willing to look at.  I have a new provider which is PPO so I will have to make an appointment.

I am only 29 years old and the problem started when I was 26.  It started as a repetitive motion injury, as I do accounting for a living and do lots of 10 key.  I have gained a lot of weight since the injury as well from the steroid treatments, fatigue from pain, and although I don't really feel depressed about it, I feel like it is taking over my life.  I try not to let it get to me but it does affect my mood and I have retreated from my social life because of it.  I am so sorry to hear you guys are suffering as well, but at the same time relieved to hear of other people with the same problem so I don't feel quite so alone.  No one else I have spoken to has even given any suggestions.  I plan on printing this out and confronting my new doctor if they also refuse to do an MRI like I have always felt was needed.
Avatar universal
I've had problems with my rhomboids for years.  It gets worse when I spend alot of time on the computer (which I cannot avoid).  Nothing seems to work.  I have spent a small fortune on chiropractors and weekly massage.

Has anyone considered botox?  If so, please let me know.  I am ready to try anything before an epidural.
Avatar universal
I am amazed that so many others suffer from rhomboid muscle pain/spasm.  I thought I was the only one!  I have always noticed that my upper back became tired when I was involved in prolonged activity involving holding my arms in front of me, for example, washing the dishes or holding an infant in my arms.  Later I injured my upper back when leaning over a bed to hold a patient's hand during a painful procedure.  That got better, but here it is ten years later and the upper back spasms are killing me!  I blamed the spasms on my cholesterol medication, but stopping that didn't help.  I finally went to the doctor and he referred me to a PT, who pointed out that my upper back muscles were severely overstretched ( he said my shoulder blades should be about three finger widths apart and they are twice that).  He also pointed out that I had hump in my upper back from hunching my shoulders forward.  This poor posture I have had all my life, but the past five years my work has been at a computer and that must have been the final straw for my poor rhomboids (and probably my trapezius as well.)  Even when the muscle is not in spasm, the attachment sites on the scapula and spine are exquisitely tender to touch, no doubt from the years of constant strain on them.

I realized that I can't overcome years of poor posture in a jiffy.  However, I am religiously following my exercises to expand my contracted chest muscles and to strengthen my neck and have already reduced the number of spasms I experience.  Rubbing my upper back on the back of my chair or even the wall helps relieve an acute spasm.  Ibuprofen makes me feel better although I know it does nothing to relax muscles.  (Unless lessening the perception of pain helps to relax them.)  Tylenol is worthless for this discomfort.  Likewise ice packs.

An earlier poster mentioned the website http://www.drbookspan.com and so far it seems to be a very commonsense resource.  

Good luck to everyone!  And avoid surgery and injections if you can--scar tissue will leave you with more problems than you started with.
Avatar universal
Hi All
I am joining this site from Hawkes Bay, New Zealand.  I have had "mysterious" symptoms for five years since doing a lot of really physical landscaping (which I used to love!) It started with chest pains which lead to ECGs and heart tests which came out normal.  Major migraines, deep burning pain to the left side of my thoracic area in the back and referring in to my chest on the left side, up my neck and into the head.  I have spent a lot of money and seen some really diverse people trying to get on top of this pain.  It has taken over my life.  I used to be very active, happy and sociable.  Due to this constant chronic pain and the frustration of not being able to get an answer I have become withdrawn, always tired and cranky.  My life is great apart from this bloody thing that won't go away even though I have tried everything imaginable.  Recently I had an MRI which turned up bulging discs at T4 T5 and T6 which doesn't seem to be a great deal but maybe there is some nerve damage there?  I have been offered injections for pain relief but I am really dubious about going ahead with them.  What a surprise when I land on this site and suddenly there you all are recounting a lot of my symptoms! My back is always stiff and I can't rotate very far on one side even though I have had countless massages, seen piles of chiropractors, osteos, accupuncturists etc. I have very strong muscles in my back due to all the digging etc that I used to do.  Thay are always very tight and never give in.  You have given me some new hope and another direction to search in - After five years I was contemplating giving in to those doctors that want to give me antidepressants because they have no answers. Some days I go to bed thinking it wouldn't be so bad if I didnt wake up, at least I wouldn't have the pain anymore.  I would never do that to my family but it's so frustrating.  I just want my life back - I have so much I want to do but am stuck in this painful body!  So anyway sorry it's longwinded but it feels good to vent to others that actually do understand cos sometimes as you all know, it feels like you're very alone.  I will investigate the Rhomboid/Trapezius muscle theory - it sounds promising to me.  Thank you so much.  Good luck to you all with finding some relief.  Sherri - New Zealand
Avatar universal
Another painful day - week - month with my LEFTshoulder blade and arm.  Had a massage last week and it did nothing. I am right handed so my computer time is more stressful for my right arm (I think)
So today I have been on the computer looking for answers.  You all sound like me with the medications, PT,
doctors etc.and not much relief to speak of.  
I can not reach my scapula area to put icy hot on it, but have laid on the ice pack and it offers some
help as does the hot tub...but both are short lived relief.
I swim 3x a week, 45 minutes of water "aerobics" then as many laps as I can handle.  I am a 60 year old female who until 4 years ago when working in the garden and shredded my RIGHT rotator cuff, have been in
good physical shape.  Now it seems I am falling apart.  My should hurts so bad that I just want to sit and do nothing.
I love the swimming, but the pain returns within an hour of getting out of the pool.
My question is this...........am I making matters worse by swimming?  I only do the breast stroke one way and swim on my back the return way.  Maximum I can do is 4 laps.  We also use a small foam board and do some push down exercises and some behind our back exercises pushing down the board under water.  Are these making my rhomboid damage any worse?  
My husband was alive when I had the rotator cuff surgery so I had a "caregiver" for the few days of recovery.
He has since passed away and I wonder if I need surgery to repair the rhomboid, is it very involved?  Will I be able to take care of myself alone for a few days?  
Thanks for anyone who can answer my questions.  Doctors being so busy, I like to have my research done before
I go in and talk surgery (if that is what they recommend) or at least know my options.
Thanks everyone
Avatar universal
HI there,
I was doing some online research and came across this group. Sorry to hear about all the pain you've had! I've had pain here and there that I wasn't able to find relief for but after trying a million things a few things have worked for me. I used neuromuscular massage- much different from traditional massage and better then PT, in my opinion, and pilates!

My MD prescribed pilates for a year. I saw my instructor 2x a week- with in a few visits I was amazed! I had been working out before that BUT I wasn't working the muscles that needed stregthening and over working ones that were already to tight!

Based on what you've describe, I wonder if you pec major and minor (chest muscle that attaches to your sternum and the upper inside of your arm) are the real culprits? The way I understand muscle to work is, the muscle on the front of the body usually do one type of movement and the ones on the back do the opposite. EX. when you forward bent at the waist the abs are flexing and the muscle on your back are being stretched. SO if you're pecs are tight (over worked, and constantly "flexed") that will bring you sh. slightly forward and the partner muscle on the back side is being overstretched- rhomboids, erectors, mid-traps. You doing your breaststroke may be tightening that pec more then it needs? I'd try standing in a door way with hands on the frame and arms are in a L step forward gently- do you feel tight, does it feel like a good stretch? Good Luck!
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