Skip to main content

Review of Periscapular and Upper Back Pain in the Athlete Current PM&R Reports—Sports Section

Abstract

Purpose of Review

Periscapular and upper back pain (PSUBP) is frequently seen in the sports medicine clinic. This review aims to summarize specific conditions that cause PSUBP along with their current diagnostic and treatment interventions.

Recent Findings

PSUBP has a broad differential, and management varies based on its etiology, two of which are scapulothoracic bursitis and myofascial pain syndrome. Novel treatment options have been described recently for scapulothoracic bursitis and myofascial pain syndrome. Scapulothoracic bursitis may be treated with ultrasound-guided steroid injection, while more recently, extracorporeal shockwave therapy (ESWT) has been suggested as another treatment option. Ultrasound-guided erector spinae block and extracorporeal shockwave therapy have recently been studied and may be beneficial as a treatment option for myofascial pain syndrome.

Summary

The clinician must consider a broad differential in athletes presenting with PSUBP. Physical therapy remains the initial treatment option for most conditions causing PSUBP. However, it is important to rule out systemic conditions if PSUBP is not improving with conservative measures. More research is needed to define the epidemiology of patients presenting with PSUBP.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Singer K, Boyle J. Thoracic and chest pain. In: Brukner P, Clarsen B, Cook J, Cools A, Crossley K, Hutchinson M, McCrory P, Bahr R, Khan K, editors. Brukner & Khan’s Clinical Sports Medicine: Injuries. 5th ed. Australia: McGraw-Hill Education; 2017. p. 507–20.

    Google Scholar 

  2. Gottschalk A, Ochroch EA. Thoracic pain. In: McMahon SB, Koltzenburg M, Tracey I, Turk DC, editors. Wall & Melzack’s Textbook of Pain. 6th ed. Philadelphia, PA: Elsevier; 2013. p. 718–33.

    Google Scholar 

  3. Niemeläinen R, Videman T, Battié MC. Prevalence and characteristics of upper or mid-back pain in Finnish men. Spine. 2006;31:1846–9.

    PubMed  Article  Google Scholar 

  4. Trompeter K, Fett D, Platen P. Prevalence of back pain in sports: a systematic review of the literature. Sports Med. 2017;47:1183–207.

    PubMed  Article  Google Scholar 

  5. Gimigliano F, Resmini G, Moretti A, Aulicino M, Gargiulo F, Gimigliano A, Liguori S, Paoletta M, Iolascon G. Epidemiology of musculoskeletal injuries in adult athletes: a scoping review. Medicina (B Aires). 2021;57:1118.

    Article  Google Scholar 

  6. Feleus A, Bierma-Zeinstra SMA, Miedema HS, Bernsen RMD, Verhaar JAN, Koes BW. Incidence of non-traumatic complaints of arm, neck and shoulder in general practice. Man Ther. 2008;13:426–33.

    CAS  PubMed  Article  Google Scholar 

  7. Se Won L. Musculoskeletal injuries and conditions: assessment and management. 1st ed. New York: Springer Publishing Company; 2017.

    Google Scholar 

  8. Warth RJ, Spiegl UJ, Millett PJ. Scapulothoracic Bursitis and Snapping Scapula Syndrome: A Critical Review of Current Evidence. The American Journal of Sports Medicine. 2015;43(1):236–45. https://doi.org/10.1177/0363546514526373.

    Article  PubMed  Google Scholar 

  9. Lebus GF, Hussain ZB, Pogorzelski J, Millett PJ. Snapping scapula syndrome. In: Kibler WB, Sciascia AD, editors. Disorders of the Scapula and Their Role in Shoulder Injury. Cham: Springer International Publishing; 2017. p. 145–56.

    Chapter  Google Scholar 

  10. Conduah AH, Baker CL, Baker CL. Clinical management of scapulothoracic bursitis and the snapping scapula. Sports Health A Multidiscip Approach. 2010;2:147–55.

    Article  Google Scholar 

  11. Gaskill T, Millett PJ. Snapping scapula syndrome: diagnosis and management. J Am Acad Orthop Surg. 2013;21:214–24.

    PubMed  Article  Google Scholar 

  12. Seol SJ, Han SH. Scapulothoracic bursitis in a patient with quadriparesis. Medicine. 2015;94:1–4.

    Article  Google Scholar 

  13. Osias W, Matcuk GR, Skalski MR, Patel DB, Schein AJ, Hatch GFR, White EA. Scapulothoracic pathology: review of anatomy, pathophysiology, imaging findings, and an approach to management. Skelet Radiol. 2018;47:161–71.

    Article  Google Scholar 

  14. Frank RM, Ramirez J, Chalmers PN, McCormick FM, Romeo AA. Scapulothoracic anatomy and snapping scapula syndrome. Anat Res Int. 2013;2013:1–9.

    Google Scholar 

  15. Kuhn JE, Plancher KD, Hawkins RJ. Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg. 1998;6:267–73.

    CAS  PubMed  Article  Google Scholar 

  16. Zeng GJ, Puah KL, Hao Y, Lie DTT. Arthroscopic management of scapulothoracic bursitis: clinical outcomes and assessment of novel bony parameters on magnetic resonance imaging. Orthop J Sports Med. 2021;9:1–8.

    CAS  Google Scholar 

  17. Walter WR, Burke CJ, Adler RS. Ultrasound-guided therapeutic scapulothoracic interval injections. J Ultrasound Med. 2019;38:1899–906.

    PubMed  Article  Google Scholar 

  18. Acar N, Karaarslan AA, Karakasli A. The effectiveness of extracorporeal shock wave therapy in snapping scapula. J Orthop Surg. 2017;25:1–6.

    Google Scholar 

  19. Acar N. Low-energy versus middle-energy extracorporeal shockwave therapy for the treatment of snapping scapula bursitis. Pak J Med Sci. 2017;33:335.

    PubMed  PubMed Central  Article  Google Scholar 

  20. Baldawi H, Gouveia K, Gohal C, et al. Diagnosis and treatment of snapping scapula syndrome: a scoping review. Sports Health. 2022;14(3):389–96. https://doi.org/10.1177/19417381211029211.

    Article  PubMed  Google Scholar 

  21. Keith Gill G, Treme G, Richter D. Scapulothoracic disorders. In: Miller MD, Thompson SR, editors. Delee, Drez and Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020. p. 609–20.

    Google Scholar 

  22. Hagert E, Lalonde D. Nerve entrapment syndromes. In: Chang J, Neligan PC, Liu DZ, editors. Plastic Surgery: Volume 6: Hand and Upper Extremity. 4th ed. London, New York, Oxford, Philadelphia, St Louis, Sydney: Elsevier; 2018. p. 525–48.

    Google Scholar 

  23. Sultan HE, Younis El-Tantawi GA. Role of dorsal scapular nerve entrapment in unilateral interscapular pain. Arch Phys Med Rehabil. 2013;94:1118–25.

    PubMed  Article  Google Scholar 

  24. Muir B. Dorsal scapular nerve neuropathy: a narrative review of the literature. J Can Chiropr Assoc. 2017;61:128–44.

    PubMed  PubMed Central  Google Scholar 

  25. Farrell T, Kennedy M, O’Brien C. A case of dorsal scapular neuropathy in a young amateur boxer. J Rehabil Med Clin Commun. 2018;1:1–3.

    Google Scholar 

  26. Argyriou AA, Karanasios P, Makridou A, Makris N. Dorsal scapular neuropathy causing rhomboids palsy and scapular winging. J Back Musculoskelet Rehabil. 2015;28:883–5.

    PubMed  Article  Google Scholar 

  27. McIntosh PM. Scapular winging. In: Frontera WR, Silver JK, Rizzo TD Jr, editors. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019. p. 99–105.

    Google Scholar 

  28. Silkjær Bak S, Johnsen B, Fuglsang-Frederiksen A, Døssing K, Qerama E. Neuromuscular ultrasound of the scapular stabilisers in healthy subjects. Clin Neurophysiol Pract. 2021;6:72–80.

    PubMed  PubMed Central  Article  Google Scholar 

  29. Haim K, Urban BJ. Dorsal scapular nerve block. Anesthesiology. 1993;78:361–2.

    CAS  PubMed  Article  Google Scholar 

  30. Cho H, Kang S, Won H-S, Yang M, Kim Y-D. New insights into pathways of the dorsal scapular nerve and artery for selective dorsal scapular nerve blockade. Korean J Pain. 2019;32:307–12.

    PubMed  PubMed Central  Article  Google Scholar 

  31. Wu Y-T, Wu C-H, Lin J-A, Su D, Hung C-Y, Lam SKH. Efficacy of 5% dextrose water injection for peripheral entrapment neuropathy: a narrative review. Int J Mol Sci. 2021;22:1–13.

    Google Scholar 

  32. Dwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns i, a study in normal volunteers. Spine. 1990;15:453–7.

    CAS  PubMed  Article  Google Scholar 

  33. van Zundert J, Huntoon M, Patijn J, Lataster A, Mekhail N, van Kleef M. Cervical radicular pain. Pain Pract. 2010;10:1–17.

    PubMed  Article  Google Scholar 

  34. Jull G, Falla D. Neck pain. In: Brukner P, Clarsen B, Cook J, Cools A, Crossley K, Hutchinson M, McCrory P, Bahr R, Khan K, editors. Brukner & Khan’s Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education; 2017. p. 347–75.

    Google Scholar 

  35. Lee SW. Neck. In: Lee SW, editor. Musculoskeletal injuries and conditions: assessment and management. 1st ed. New York: Springer Publishing Company; 2016. p. 83–117.

    Google Scholar 

  36. Lance Snyder R. Neck injuries. In: Madden CC, Putukian M, McCarty EC, Young CC, editors. Netter’s Sports Medicine. 2nd ed. Philadelphia, PA: Elsevier; 2018. p. 346–51.

    Google Scholar 

  37. Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J. Mechanism of whiplash injury. Clin Biomech. 1998;13:239–49.

    Article  Google Scholar 

  38. Davies JE. The spine in sport—injuries, prevention and treatment. Br J Sports Med. 1980;14:18–21.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  39. Yang AJ, Welch SA, Frontera WR. Cervical facet arthropathy. In: Frontera WR, Silver JK Jr, Rizzo TD, editors. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019. p. 8–11.

    Google Scholar 

  40. Fiani B, Runnels J, Taylor A, Sekhon M, Chacon D, McLarnon M, Houston R, Vereecken S. Prevalence of sports-related spinal injury stratified by competition level and return to play guidelines. Rev Neurosci. 2021;32:169–79.

    PubMed  Article  Google Scholar 

  41. Rosenthal BD, Boody BS, Hsu WK. Return to play for athletes. Neurosurg Clin N Am. 2017;28:163–71.

    PubMed  Article  Google Scholar 

  42. Perez-Roman RJ, Brusko GD, Burks SS, Serafini AN, Wang MY. Use of single-photon emission computed tomography imaging for hypermetabolic facet identification in diagnosis of cervical and axial back pain. World Neurosurg. 2020;137:e487–92.

    PubMed  Article  Google Scholar 

  43. Depalma MJ, Ishigami S, Gasper JJ, Slipman CW. Common neck problems. In: Cifu DX, Eapen BC, Johns JS, Kowalske K, Lew HL, Miller MA, Worsowicz G, editors. Braddom’s Physical Medicine and Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021. p. 627–50.

    Chapter  Google Scholar 

  44. Manchikanti L, Kaye AD, Soin A, et al. Comprehensive evidence-based guidelines for facet joint interventions in the management of chronic spinal pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Facet Joint Interventions 2020 Guidelines. Pain Physician. 2020;23:S1–127.

    PubMed  Article  Google Scholar 

  45. Chang MC, Boudier-Revéret M. Usefulness of gadolinium-enhanced magnetic resonance imaging in detecting exact site of cervical facet joint pain. Pain Pract. 2021. https://doi.org/10.1111/papr.13080.

    Article  PubMed  Google Scholar 

  46. Boswell MV, Manchikanti L, Kaye AD, Bakshi S, Gharibo CG, Gupta S, Jha SS, Nampiaparampil DE, Simopoulos TT, Hirsch JA. A best-evidence systematic appraisal of the diagnostic accuracy and utility of facet (zygapophysial) joint injections in chronic spinal pain. Pain Physician. 2015;18:E497-533.

    PubMed  Article  Google Scholar 

  47. Usunier K, Hynes M, Schuster JM, Cornelio-Jin Suen A, Sadi J, Walton D. Clinical diagnostic tests versus medial branch blocks for adults with persisting cervical zygapophyseal joint pain: a systematic review and meta-analysis. Physiother Can. 2018;70:179–87.

    PubMed  PubMed Central  Article  Google Scholar 

  48. Falco FJE, Datta S, Manchikanti L, Sehgal N, Geffert S, Singh V, Smith HS, Boswell MV. An updated review of the diagnostic utility of cervical facet joint injections. Pain Physician. 2012;15:E807–38.

    PubMed  Google Scholar 

  49. Mourad F, Rossettini G, Galeno E, et al. Use of soft cervical collar among whiplash patients in two italian emergency departments is associated with persistence of symptoms: a propensity score matching analysis. Healthcare. 2021;9:1–16.

    Google Scholar 

  50. Manchikanti L, Kosanovic R, Pampati V, Sanapati MR, Hirsch JA. Outcomes of cervical therapeutic medial branch blocks and radiofrequency neurotomy: clinical outcomes and cost utility are equivalent. Pain Physician. 2022;25:35–47.

    PubMed  Google Scholar 

  51. Moreno B, Barbosa J. Ultrasound-guided procedures in the cervical spine. Cureus. 2021;13:1–10.

    Google Scholar 

  52. Eddy D, Congeni J, Loud K. A review of spine injuries and return to play. Clin J Sport Med. 2005;15:453–8.

    PubMed  Article  Google Scholar 

  53. Deckey DG, Makovicka JL, Chung AS, Hassebrock JD, Patel KA, Tummala SV, Pena A, Asprey W, Chhabra A. Neck and cervical spine injuries in national college athletic association athletes. Spine. 2020;45:55–64.

    PubMed  Article  Google Scholar 

  54. Malanga GA. The diagnosis and treatment of cervical radiculopathy. Med Sci Sports Exerc. 1997;29:236–45.

    Google Scholar 

  55. Aval SM, Durand P, Shankwiler JA. Neurovascular injuries to the athleteʼs shoulder: part I. J Am Acad Orthop Surg. 2007;15:249–56.

    PubMed  Article  Google Scholar 

  56. Joaquim AF, Hsu WK, Patel AA. Cervical spine surgery in professional athletes: a systematic review. Neurosurg Focus. 2016;40:1–8.

    Article  Google Scholar 

  57. Rhee JM, Yoon T, Riew KD. Cervical radiculopathy. J Am Acad Orthop Surg. 2007;15:486–94.

    PubMed  Article  Google Scholar 

  58. Iyer S, Kim HJ. Cervical radiculopathy. Curr Rev Musculoskelet Med. 2016;9:272–80.

    PubMed  PubMed Central  Article  Google Scholar 

  59. Grondin F, Cook C, Hall T, Maillard O, Perdrix Y, Freppel S. Diagnostic accuracy of upper limb neurodynamic tests in the diagnosis of cervical radiculopathy. Musculoskelet Sci Pract. 2021;55:1–7.

    Google Scholar 

  60. Childress MA, Becker BA. Nonoperative management of cervical radiculopathy. Am Fam Physician. 2016;93:746–54.

    PubMed  Google Scholar 

  61. McDonald MA, Kirsch CFE, Amin BY, et al. ACR Appropriateness Criteria® Cervical Neck Pain or Cervical Radiculopathy. J Am Coll Radiol. 2019;16:S57–76.

    PubMed  Article  Google Scholar 

  62. Costello JE, Shah LM, Peckham ME, Hutchins TA, Anzai Y. Imaging appropriateness for neck pain. J Am Coll Radiol. 2020;17:584–9.

    PubMed  Article  Google Scholar 

  63. Hakimi K, Spanier D. Electrodiagnosis of cervical radiculopathy. Phys Med Rehabil Clin N Am. 2013;24:1–12.

    PubMed  Article  Google Scholar 

  64. American Association of Electrodiagnostic Medicine, So YT. Guidelines in electrodiagnostic medicine. Practice parameter for needle electromyographic evaluation of patients with suspected cervical radiculopathy. Muscle Nerve Suppl. 1999;8:S209–21.

    Google Scholar 

  65. Saveland H, Anderberg L, Annertz M, Brandt L. Selective diagnostic cervical nerve root block—correlation with clinical symptoms and MRI-pathology. Acta Neurochir. 2004;146:559–65.

    PubMed  Article  Google Scholar 

  66. Ott FW, Pluhm R, Ozturk K, McKinney AM, Rykken JB. Counterpoint: conventional fluoroscopy-guided selective cervical nerve root block—a safe, effective, and efficient modality in the hands of an experienced proceduralist. Am J Neuroradiol. 2020;41:1112–9.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  67. Li J, Szabova A. Ultrasound-guided nerve blocks in the head and neck for chronic pain management: the anatomy, sonoanatomy, and procedure. Pain Physician. 2021;24:533–48.

    CAS  PubMed  Google Scholar 

  68. Wu J, Xu Y, Pu S, Zhou J, Lv Y, Li C, Du D. US-guided transforaminal cervical nerve root block: a novel lateral in-plane approach. Pain Med. 2021;22:1940–5.

    PubMed  Article  Google Scholar 

  69. Kuijper B, Tans JTJ, Beelen A, Nollet F, Visser MD. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ. 2009;339:1–7.

    Article  Google Scholar 

  70. Zhang Y-H, Hu H-Y, Xiong Y-C, et al. Exercise for neuropathic pain: a systematic review and expert consensus. Front Med. 2021;8:1–16.

    Google Scholar 

  71. Alshami AM, Bamhair DA. Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial. Trials. 2021;22:1–12.

    Article  CAS  Google Scholar 

  72. Borrella-Andrés S, Marqués-García I, Lucha-López MO, Fanlo-Mazas P, Hernández-Secorún M, Pérez-Bellmunt A, Tricás-Moreno JM, Hidalgo-García C. Manual therapy as a management of cervical radiculopathy: a systematic review. Biomed Res Int. 2021;2021:1–15.

    Article  Google Scholar 

  73. Santa Barbara MT, Sowa G. Disorders of the cervical spine. In: Frontera WRBJR, Bockenek WL, Chae J, Robinson LR, editors. DeLisa’s Physical Medicine and Rehabilitation - Principles and Practice. 6th ed. Philadelphia, PA: Wolters Kluwer; 2020. p. 555–74.

    Google Scholar 

  74. Savva C, Korakakis V, Efstathiou M, Karagiannis C. Cervical traction combined with neural mobilization for patients with cervical radiculopathy: a randomized controlled trial. J Bodyw Mov Ther. 2021;26:279–89.

    PubMed  Article  Google Scholar 

  75. Ghasemi M, Masaeli A, Rezvani M, Shaygannejad V, Golabchi K, Norouzi R. Oral prednisolone in the treatment of cervical radiculopathy: a randomized placebo controlled trial. J Res Med Sci. 2013;18:S43–6.

    PubMed  PubMed Central  Google Scholar 

  76. Diwan S, Manchikanti L, Benyamin RM, Bryce DA, Geffert S, Hameed H, Sharma ML, Abdi S, Falco FJE. Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain. Pain Physician. 2012;15:E405–34.

    PubMed  Article  Google Scholar 

  77. Manchikanti L, Cash KA, Pampati V, Malla Y. Two-year follow-up results of fluoroscopic cervical epidural injections in chronic axial or discogenic neck pain: a randomized, double-blind, controlled trial. Int J Med Sci. 2014;11:309–20.

    PubMed  PubMed Central  Article  Google Scholar 

  78. Patnaik S, Carr A, Inaparthy P, Kieffer WK. Radicular arm pain. Br J Hosp Med. 2021;82:1–10.

    Article  Google Scholar 

  79. Mosby. Mosby’s Dictionary of Medicine, Nursing & Health Professions - EBook. Vol Tenth edition. Mosby; 2017. https://search-ebscohostcom.offcampus.lib.washington.edu/login.aspxdirect=true&db=nlebk&AN=1239146&site=ehost-live. Accessed 15 July 2022.

  80. Borg-Stein J, Simons DG. Myofascial pain. Arch Phys Med Rehabil. 2002;83:S40–7.

    PubMed  Article  Google Scholar 

  81. Patel AT. Trapezius strain. In: Basford JR, Bockenek WL, Chae J, Robinson LR, editors. DeLisa’s Physical Medicine and Rehabilitation - Principles and Practice. 6th ed. Philadelphia, PA: Wolters Kluwer; 2020. p. 43–5.

    Google Scholar 

  82. Arnold LM, Bennett RM, Crofford LJ, et al. AAPT Diagnostic Criteria for Fibromyalgia. J Pain. 2019;20:611–28.

    PubMed  Article  Google Scholar 

  83. Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology Preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62:600–10.

    Article  Google Scholar 

  84. Gundersen A, Borgstrom H, McInnis KC. Trunk injuries in athletes. Curr Sports Med Rep. 2021;20:150–6.

    PubMed  Article  Google Scholar 

  85. Borg-Stein J, Iaccarino MA. Myofascial pain syndrome treatments. Phys Med Rehabil Clin N Am. 2014;25:357–74.

    PubMed  Article  Google Scholar 

  86. Donnelly JM, Simons DG. Pain Sciences and Myofascial Pain. In: Travell, Simons & Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual. Third edition (Donnelly JM, ed.). Philadelphia, PA. Wolters Kluwer Health; 2019.

  87. Fernández-de-las-Peñas C, Dommerholt J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study. Pain Med. 2018;19:142–50.

    PubMed  Article  Google Scholar 

  88. Furlan AD, Mittal N, Kumbhare D, Giraldo-Prieto M, Mailis-Gagnon A. Chronic pain. In: Frontera WR, Basford JR, Bockeneck WL, Chae J, Robinson LR, editors. DeLisa’s Physical Medicine and Rehabilitation - Principles and Practice. 6th ed. Philadelphia, PA: Wolters Kluwer; 2020. p. 891–925.

    Google Scholar 

  89. Do TP, Heldarskard GF, Kolding LT, Hvedstrup J, Schytz HW. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018;19:1–17.

    Article  Google Scholar 

  90. American Physical Therapy Association. State Laws and Regulations Governing Dry Needling Performed by PTs. Americal Physical Therapy Association website. March 30, 2022. https://www.apta.org/patient-care/interventions/dry-needling/laws-by-state#.  Accessed 15 July 2022.

  91. Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29:136–46.

    PubMed  Article  Google Scholar 

  92. Qing W, Shi X, Zhang Q, Peng L, He C, Wei Q. Effect of therapeutic ultrasound for neck pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2021;102:2219–30.

    PubMed  Article  Google Scholar 

  93. Liptan G, Mist S, Wright C, Arzt A, Jones KD. A pilot study of myofascial release therapy compared to Swedish massage in Fibromyalgia. J Bodyw Mov Ther. 2013;17:365–70.

    PubMed  PubMed Central  Article  Google Scholar 

  94. Bethers AH, Swanson DC, Sponbeck JK, Mitchell UH, Draper DO, Feland JB, Johnson AW. Positional release therapy and therapeutic massage reduce muscle trigger and tender points. J Bodyw Mov Ther. 2021;28:264–70.

    PubMed  Article  Google Scholar 

  95. Romero-Morales C, Bravo-Aguilar M, Abuín-Porras V, Almazán-Polo J, Calvo-Lobo C, Martínez-Jiménez EM, López-López D, Navarro-Flores E. Current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Dis Mon. 2021;67:1–35.

    Google Scholar 

  96. Li X, Wang R, Xing X, Shi X, Tian J, Zhang J, Ge L, Zhang J, Li L, Yang K. Acupuncture for myofascial pain syndrome: a network meta-analysis of 33 randomized controlled trials. Pain Physician. 2017;20:E883–902.

    PubMed  Google Scholar 

  97. Lopez-Martos R, Gonzalez-Perez L, Ruiz-Canela-Mendez P, Urresti-Lopez F, Gutierrez-Perez J, Infante-Cossio P. Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. Med Oral Patol Oral Cir Bucal. 2018;23:e454–62.

    CAS  PubMed  PubMed Central  Google Scholar 

  98. Liu L, Lu J, Chen Y, Wei J, Zhang X-F, Wang B-B. Evidence for kinesio taping in management of myofascial pain syndrome: a systematic review and meta-analysis. Med Sci Sports Exerc. 2019;51:861–2.

    Article  Google Scholar 

  99. Moore C, Hulsopple C, Boyce B. Utilization of botulinum toxin for musculoskeletal disorders. Curr Sports Med Rep. 2020;19:217–22.

    PubMed  Article  Google Scholar 

  100. Benecke R, Heinze A, Reichel G, Hefter H, Göbel H. Botulinum type A toxin complex for the relief of upper back myofascial pain syndrome: how do fixed-location injections compare with trigger point-focused injections? Pain Med. 2011;12:1607–14.

    PubMed  Article  Google Scholar 

  101. Yürük D, Akkaya ÖT, Polat ÖE, Alptekin HA. Ultrasound-guided erector spinae plane block and trapezius muscle injection for myofascial pain syndrome. J Ultrasound Med. 2022;41:185–91.

    PubMed  Article  Google Scholar 

  102. Rahbar M, Samandarian M, Salekzamani Y, Khamnian Z, Dolatkhah N. Effectiveness of extracorporeal shock wave therapy versus standard care in the treatment of neck and upper back myofascial pain: a single blinded randomised clinical trial. Clin Rehabil. 2021;35:102–13.

    PubMed  Article  Google Scholar 

  103. Lee CH, Lee S-U. Usefulness of extracorporeal shockwave therapy on myofascial pain syndrome. Ann Rehabil Med. 2021;45:261–3.

    PubMed  PubMed Central  Article  Google Scholar 

  104. Tayrose GA, Beutel BG, Cardone DA, Sherman OH. The masters athlete. Sports Health Multidiscip Approach. 2015;7:270–6.

    Article  Google Scholar 

  105. Concannon LG, Grierson MJ, Harrast MA. Exercise in the older adult: from the sedentary elderly to the masters athlete. PM&R. 2012;4:833–9.

    Article  Google Scholar 

  106. Salvarani C, Gabriel SE, Michael O’Fallon W, Hunder GG. Epidemiology of polymyalgia rheumatica in olmsted county, minnesota, 1970–1991. Arthritis Rheum. 1995;38:369–73.

    CAS  PubMed  Article  Google Scholar 

  107. Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955–2007. Arthritis Rheum. 2010;62:1576–82.

    PubMed  PubMed Central  Article  Google Scholar 

  108. González-Gay MA, Matteson EL, Castañeda S. Polymyalgia rheumatica. Lancet. 2017;390:1700–12.

    PubMed  Article  Google Scholar 

  109. Meliconi R, Pulsatelli L, Uguccioni M, Salvarani C, Macchioni P, Melchiorri C, Focherini MC, Frizziero L, Facchini A. Leukocyte infiltration in synovial tissue from the shoulder of patients with polymyalgia rheumatica. Quantitative analysis and influence of corticosteroid treatment. Arthritis Rheum. 1996;39:1199–207.

    CAS  PubMed  Article  Google Scholar 

  110. Salvarani C, Barozzi L, Cantini F, et al. Cervical interspinous bursitis in active polymyalgia rheumatica. Ann Rheum Dis. 2008;67:758–61.

    CAS  PubMed  Article  Google Scholar 

  111. Cantini F, Salvarani C, Olivieri I, et al. Shoulder ultrasonography in the diagnosis of polymyalgia rheumatica: a case-control study. J Rheumatol. 2001;28:1049–55.

    CAS  PubMed  Google Scholar 

  112. Salvarani C. Proximal bursitis in active polymyalgia rheumatica. Ann Intern Med. 1997;127:27.

    CAS  PubMed  Article  Google Scholar 

  113. Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, and Takayasu’s arteritis. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O’Dell JR, editors. Firestein & Kelley’s Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021. p. 1595–616.

    Google Scholar 

  114. Dasgupta B, Cimmino MA, Maradit-Kremers H, et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis. 2012;71:484–92.

    PubMed  Article  Google Scholar 

  115. bin Mahmood S, Nelson E, Padniewski J, Nasr R. Polymyalgia rheumatica: an updated review. Clevel Clin J Med. 2020;87:549–56.

    Article  Google Scholar 

  116. Moya-Alvarado P, Fernandez Leon A, Corica ME, Camacho Marti V, López-Mora DA, Castellví I, Corominas H. The added value of 18f-FDG PET/CT in the assessment of onset and steroid resistant polimyalgia rheumatica. PLoS ONE. 2021;16:1–13.

    Article  CAS  Google Scholar 

  117. Dasgupta B, Dolan AL, Panayi GS, Fernandes L. An initially double-blind controlled 96 week trial of depot methylprednisolone against oral prednisolone in the treatment of polymyalgia rheumatica. Rheumatology. 1998;37:189–95.

    CAS  Article  Google Scholar 

  118. Toussirot E, Michaud M, Wendling D, Devauchelle V. Abatacept as adjunctive therapy in refractory polymyalgia rheumatica. J Rheumatol. 2021;48:1888–9.

    PubMed  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brian Cervoni.

Ethics declarations

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Sports Medicine Rehabilitation

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cervoni, B., Liem, B. Review of Periscapular and Upper Back Pain in the Athlete Current PM&R Reports—Sports Section. Curr Phys Med Rehabil Rep 10, 225–238 (2022). https://doi.org/10.1007/s40141-022-00361-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40141-022-00361-8

Keywords

  • Periscapular pain
  • Upper back pain
  • Posterior shoulder pain
  • Thoracic pain