Interscapular Dorsali

The benign interscapular dorsalgia of cervical origin

Introduction

Interscapular dorsal pain is certainly the most common form of dorsalgia and even if is perceived in the mid-dorsal region, the majority of this pain comes from a pathology attributable to the last three segments of the cervical spine. The patient only exceptionally suffers from neck pain, and the pain that is perceived between the shoulders disappears with the appropriate cervical treatment.


Clinical presentation

Pain is perceived between the shoulder blades, both at a precise paravertebral point (usually referred as a “nail sensation”) and wider (sometimes also intrathoracic). The onset of this pain is often insidious and can occur as a result of keeping bad positions during work (typical of secretaries who must keep the neck flexed to write) or, for example, during sleep but also after a trauma.


Risk factors

The only risk factors that can be attributed to the development of this pathology are bad positions during work, bad bed habits (eg sleeping with multiple pillows or watching television for a long time in supine position), and repeated traumas, even minimal, at the level of the lower cervical spine (eg previous whiplashes).


When to contact a physician

Surely when pain becomes disabling and it is resistant to normal anti-inflammatory or painkillers, it negatively affects the normal activities of daily life, work activity and everyday activities or when it adversely affects the quality of sleep. Dorsalgia diagnosisIt is essentially clinical. Thanks to a careful visit by a physician experienced in "orthopedic manual medicine" (according to the French school of Robert Maigne and the Hotel Dieu in Paris) you can easily discover all the signs that are a spasm of an interscapular dorsalgia of cervical originX-rays performed at the cervical spine and dorsal are also necessary to rule out that there may be other major problems that may cause this pain. 


Treatment

Treatment is essentially cervical. Cervical manipulation (performed by a PHYSICIAN), when the situation permits and when it is technically applicable and therefore there are no contraindications and only after proper diagnosis, is the treatment of choice. It can be preceded by progressive ,mobilizations and transversal stretching of the paraspinosis muscles.Handling must be precise, gentle, non-traumatic, and performed in the opposite direction to pain. After three manipulative sessions, each at a distance of one week, you can heal from the symptoms (sometimes even before the 3 canonical sessions). 


Dangers of manipulation

For the treatment of these disorders, such as those of the spine in general, be careful to turn to figures like those of osteopaths and chiropractors. Vertebral manipulation can only be performed by a physician and should be performed only after the formulation of a diagnosis (the doctor's sole act) and after evaluating the risks inherent in the manipulative treatment itself.







Posted By Dr. Roberto Morello, Physiatrist. 

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