Upper Back Muscle Strain or Spasm

What is an upper back muscle strain or spasm?

There are muscles are in your upper back called rhomboid muscles. These muscles connect the inner edges of your shoulder blades to your spine. A strain is a stretch or tear of these muscles. A muscle spasm is an involuntary contraction of the muscles.

How does it occur?

A rhomboid muscle strain or spasm is usually caused by overuse of your shoulder and arm. This happens during overhead activities like serving a tennis ball or reaching to put objects on a high shelf.

It can also occur from activities such as:

• rowing
• carrying a heavy backpack, especially over one shoulder
• poor posture, especially from using a computer for a long period

What are the symptoms?

A strain causes pain in your upper back between your shoulder blades and your spine. A spasm feels like a knot or tightness in the muscle. You may have pain when you move your shoulders or when you breathe.

How is it diagnosed?

Your healthcare provider will examine your back and shoulder to check if the muscles are tender or tight.

How is it treated?

To treat this condition:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time. You can lie down with your rhomboid muscles against the ice.
• Moist heat can help muscle spasms that are constant or that happen again and again. Use moist heat for up to 20 minutes at a time to help relax tight muscles or muscle spasms. Do not use heat if you have swelling.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Massage is also very helpful. You can do a form of self-massage by putting a tennis ball on the floor, lying down with your rhomboid muscles against the ball, and gently rolling the ball against your muscles. You can also buy a foam roller or a self-massage tool, such as a Thera-Cane or Body Back Buddy.
• Your provider may recommend physical therapy. You will be given a set of rehabilitation exercises.

While you recover from your injury you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to run or bicycle instead of playing tennis or rowing.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. A mild rhomboid strain may recover within a few weeks, but a severe injury may take 6 weeks or longer to recover. You need to stop doing the activities that cause pain until your muscle has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your back recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible.

You may safely return to your activities when the muscles are no longer in spasm and you can move your shoulders and arms without pain.

How can I prevent a upper back muscle strain or spasm?

Warm up properly and stretch before activities such as tennis, rowing, or overhead movements. If you work on a computer, take frequent breaks to stretch your neck and back.