Neck and Mid Back Pain

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Debilitating pain in the neck and mid back is one of the most common issues among patients seeking relief at Dr. Dubin’s office. Here is a typical example of a patient’s problem, and the resulting treatment plan.

Case Study

neck1Nancy came to the office complaining of pain on both sides of her neck and in between her shoulder blades. She could not remember a particular incident that caused her neck and mid-back pain, but stated that the pain came on gradually, became more intense, and was starting to affect her everyday life.

Nancy came to the office complaining Nancy’s job requires spending most of the day typing on a keyboard with her head bent downwards and shoulders slumped forward, while looking at a computer screen (Fig. 1A). Dr. Dubin explained to Nancy that her slumped-forward posture at work was a contributing factor of her current pain symptoms. When the muscles in the back of the neck and mid back (Fig. 2A, 2B, & 2C) contract, or shorten, they cause the head to extend and the shoulders to move backward. Nancy’s posture at work resulted in head flexion and an abnormal shoulder posture that placed a prolonged stretching strain on the muscles in the neck and mid back, leading to fatigue and eventually a repetitive strain injury to those muscles.


Dr. Dubin conducted a thorough exam on Nancy’s neck and mid back, and reassured her that her condition could be effectively treated by utilizing Active Release Technique on the muscles of the neck and mid back to free up soft tissue motion; to free up joint motion; and combotherapy to help to relax the muscles, restore normal muscle tone, and break up scar tissue.

Dr. Dubin also showed Nancy a fifteen-minute stretching and strengthening home rehabilitaion program with the Flexband® and instructed her on how to ergonomically improve her workstation (Fig. 1B).

Nancy’s neck pain and mid back pain resolved after six visits at Dr. Dubin’s office, and she is continuing her home exercise routine. Nancy is now comfortable at work, and reports that her mid back and neck are flexible and pain-free.


Treatment of neck and mid back pain at Dr. Dubin’s office would consist of:

  • Specific deep tissue procedures to the muscles of the neck and mid back to free up joint motion
  • Adjustments of the neck and mid back to free up joint motion
  • Ultrasound and electric muscle stimulation combotherapy to restore normal muscle tone, decrease pain, and absorb scar tissue
  • Recommendations for improved ergonomic environment at work and home (Fig. 1B)
  • Implementation of a personalized home strengthening and flexibility program (Fig. 3)
  • Ice therapy 20 minutes on, 1 hour off (and repeated) to decrease inflammation.