I had some pretty unpleasant residual tension in my pyriformis after a pinched nerve, and learned a few ways to deal with it.

1) Epsom salt hot water soaks. Gets the job done.

2) Sit, lie, stand, whatever, with a tennis ball or lacrosse ball under the sore spot. The more it hurts the better it feels. You'll feel the muscle spasm then release when you get it just right. It takes about 5 minutes.

3) The spot that hurts might not be the spot that's hurting. Referred pain is difficult to treat sometimes. With pain in your middle back, it could be caused by anything from your jaw, to your neck, to your shoulder, to your back. Pain tends to move downwards and inwards. Stretch (and strengthen) your neck, make sure you don't slump your head forwards, and triple check the ergonomics of your workstation.

4) I'm not a big believer in the term 'psychosomatic' because it sounds too much like 'all in your head.' Look for times when you're stressed, and run a quick check through your body for tension. If you find it, flex the tight muscles for a few seconds and release.

If you find yourself tense often, and I truly mean this in a respectful way, you have to deal with some important parts of your life. Persistent pain can be your body's way of telling you to address something.

Oh, and, if it's diagnosed as nerve related pain, accept now that it might hurt for a year or more. Don't rush it, don't give into it, and don't ignore it.

Depending on the severity of your injury, you could have significant pain. I couldn't walk for months, and part of the recovery was being able to walk from bedroom to bedroom, because I ignored it. I hope yours isn't that bad, but, definitely get it treated.

ok, last one here.

Check your mattress as well. It's something people overlook sometimes. They wear out, sometimes you don't know until your back starts to hurt.

Obvious question is obvious, but may also be helpful: have you seen a competent psychotherapist?

If the tension is indeed psychosomatic, then treating the psychological cause may be the way to go.

Other things that would be worth investigating: Alexander Technique, Pilates (yes, seriously. What you're describing could be breathing-related in particular, and Pilates is good at that stuff. Go for a teacher accredited by an organisation with a multi-year training program.), Tension Mytosis Syndrome, T'ai Chi (again, seriously. Good t'ai chi can be very useful), trigger point therapy (read http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Tr...), deep tissue massage (painful but effective).

Tried a few of the techniques you mentioned, as well as therapy, but I'll check out the other ones. Thanks.

Visiting a chiropracter for back pain might help. Do not let them crack your neck (increases risk of stroke) and I wouldn't let them crack my spine (it's my freaking spine) and you might want to ignore all the woo. But it's a nice back rub and some stretching.

Good chairs help. There's a thing called backmate (http://www.backmate.co.uk) which is cheap and useful if you don't have control over your choice of chair.

I haven't tried it but lots of people recommend Alexander technique.

I haven't used it myself but I've heard great things and it closely matches your request: "Healing Back Pain: The Mind-Body Connection" by Dr. John E. Sarno (http://www.amazon.com/gp/aw/d/0446557684)

GEt out of the chair! Every half-hour or hour, for several minutes at least. An hour out exercising at lunch. Stay in the chair - spiral down.

Has your dentist recommended a mouth guard, or do you know you a teeth clencher/grinder? Try actually wearing one nightly.

Don't think I am a teeth clencher/grinder.

Probably a deep muscle strain. Source: Myself, same type of injury, same symptoms. I was slammed (think mixed martial arts) while in the Marines and it wrecked the left side of my back. The military wasn't cooperative when I was trying to get it documented as service-related, so I suffered with it for the rest of my time in, ~4.5 more years.

My new job pays for my health-care coverage and so I went to see a physical therapist for a bit; here is what I learned:

1. Find a good one. 2. Do the exercises. They say 2-3 times a day, they mean 2-3 times a day. I really find it easy to do them FIRST-thing in the morning, right after work/before dinner, and then right before bed.

In terms of some very specific exercise types to look into: Lots of thoracic stretching, and also the stretch/strengthening exercise where you pinch your shoulder-blades with your back against the wall, and move your arms up and down slowly. (If you're doing it right, you actually can't move your arms up very much at all, or will need to pinch at the bottom, decrease your pinch, move your arms up some (again, not much), then re-pinch at the top of the exercise.

Stability ball exercises with dumb-bells, seated presses on the stability ball as opposed to seated statically, T and Y's on/off stability balls. (Basically you do a plank off the stability ball, and then with EXTREMELY LIGHT (3lb) dumbbells, raise them out to the side making a T-shape as one exercise, then out to the front making a y-shape as another. (I personally think it's the t's and y's that really helped me the most). I would also do these from the traditional standing position.

Buy a speed bag (as in boxing) if you have space for one as one of the best warm-up exercise machines they had me do before doing the rehab was VERY similar to using a speed-bag. We would warm-up with that rythim of 1 minute in one direction, one minute in reverse, 4 minutes total.

We also did standing rows with exercise bands, rowing back to a pinch in the back, then rowing 'out'.

They also had me moving around just to get some movement into my body; since going to PT I try and move every-day. It hasn't completely gone away but I'd say it's about 98% better, and if you feel like I do, you'd probably say it's a success, I just have a higher-level of ok because of the limits I want to push myself as a martial artist.

Seriously, go to a good Physical Therapist, it has changed my life. It's expensive, but oh so worth it.

I should add that during the 4 years I was in the service I also tried things like regular weight-lifting and exercising programs but I was never applying the amount of work the PT did for my very localized problem. I also will say I did yoga, and even though I love yoga to the point of wanting to become a teacher in the future if the opportunity presents itself, and while I believe yoga is amazing for you mentally, and has amazing physical benefits, it did not help with this specific problem either, again because it is so deep in the back, it just couldn't work out the area as-well as was needed. But if you can afford it, go to yoga too; it gave me a peace of mind that I can only say was matched when I found the first person I 'truly' loved.(Yoga also did wonders for my breathing during jiu-jitsu, so there's that which is nice.)

Oh, and NO LAPTOP IN BED (my extremely bad habit).

I've been dealing with the same symptoms for about 12 years. I saw three different physical therapists while I was in the military, but they couldn't really isolate what was injured. I haven't tried some of the exercises/stretches you mentioned, perhaps I'll give it a shot and try to find a good PT.

try autogenic training

massage therapy and better posture.

Tried. Three different doctors. No one had any clue.