A 19 year old student complained of upper back pain on the right side by her shoulder blade. The pain began two weeks ago and was exacerbated with a flight to the east coast. It was felt with sitting and moving boxes. It was always sore and irritating. When she stands the pain subsides. Leaning away is also palliative. After she threw a ball she felt something trigger in her upper right back. The pain returned with greater intensity while she was painting seated on the floor. She had to lie down to relieve the pain. She has had a history of sinus pressure and infections since she was little. She has a mild scoliosis. She also has a two-year history of jaw pain for which she saw a previous chiropractor with whom it improved and stopped the jaw from locking. The patient was seen 3 times in 2 weeks and had complete resolution of her back pain. She has not since had a sinus infection and her jaw pain improved by 90%. She didn’t have any pain for 6 months and now she visits every 2 months for preventative care.