Back pain comes in many forms and varieties. Localization and nature of pain, duration, presence or absence of radiation to other parts of the body, provoking factors - all this can be combined in various combinations.Back pain in the area of the shoulder blades- a common type of pain in various diseases.
The main causes of pain in the shoulder blades and back
Why does my back hurt in the area of the shoulder blades?Such symptoms can be observed in diseases of the spine, neurological disorders, pathologies of muscles and other organs. This includes referred pain from lung and heart diseases, and diseases of the gastrointestinal tract, as well as pain from radicular syndromes, trauma and osteochondrosis. Let's take a closer look at the common causes of back and shoulder pain.
Injuries
Injuries to the scapula occur in two ways - by direct impact (impact, fall) and indirectly, with a load along the axis of the upper limb (fall on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, a simultaneous injury to the spine and rib fractures is possible. Such injuries occur in 50% of serious traffic accidents. Severe pain, limited mobility, and severe swelling of the tissues surrounding the scapula may also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causeback painIspineany localization, as well as inshoulder blade area. Degenerative-dystrophic processes in the intervertebral joints and discs, which occur as a result of malnutrition and cartilage regeneration, lead to the formation of protrusions and hernias, spasms of the back muscles and a decrease in the height of the intervertebral discs. Spinal nerves may be pinched; the pain may be caused by radicular syndrome.
Pain is caused by bending or turning the body, lifting weights. Due to the simultaneous inflammation of the back muscles, the pain may increase when lifting and abducting the arms. Possible stiffness of the spine, stooping, forced position of the patient with a slight forward tilt. The pain can be aching, shooting, surrounding the chest. Some patients describe it as feeling like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which a pathological curvature of the spine in the shape of the letter S occurs, predominantly in the coronary plane. As a result, the normal distribution of load and biomechanics is disturbed. Predisposing factors for scoliosis are improper posture, weak back muscles, childhood and improper organization of the workplace. Back pain due to scoliosis is usually caused by spasm, inflammation and tension in the muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by aching pain that disappears when lying down and increases when standing for a long time.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, which most often occurs in the thoracic part. As a result of kyphosis, the spinal column begins to resemble a question mark "? ", and the formation of a hump may begin. Predisposing factors for kyphosis are vitamin D deficiency, osteoporosis and poor posture. Kyphosis can be caused by trauma or tuberculosis of the spine. Ankylosing spondylitis causes extreme kyphosis of the thoracic region.
Pain in kyphosis, as well as in scoliosis, is caused by muscle tension and spasm, as they are subject to excessive stress. At the same time it is feltpain in the back musclesand in the regionspatulas
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change in the intervertebral joints, caused by malnutrition of the articular cartilage, which leads to the gradual destruction of the spine joints. Spondyloarthritis is an inflammation of the intervertebral joints that occurs as a response to an autoimmune or reactive process (rheumatoid arthritis, ankylosing spondylitis, reactive arthritis). The outcome of both processes is ankylosis or fusion of the intervertebral joints, which leads to reduced mobility of the spine. The difference is that in the first case the inflammation is of a secondary nature and arises as a response to the destruction of the joints, and in the second case the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondylarthrosis and spondyloarthrosis is painful and intensifies at night. A characteristic symptom is stiffness and stiffness of the spine in the morning, which disappears after gymnastics or physical activity. The course of the disease is chronic, wavy, with periods of worsening and improvement. The pain can be localized not only between the shoulder blades, but also throughout the spine.
Protrusions and hernias
Protrusions and herniations of intervertebral discs are the result of advanced osteochondrosis of the spine. The intervertebral disc, which has lost its elasticity and elasticity, that is, its peripheral part, which is called the fibrous ring, protrudes under the influence of the load and creates a bulge. If the annulus fibrosus ruptures, the inner contents of the disc fall out, forming a herniated disc. Both protrusions and herniated intervertebral discs can cause entrapment of the spinal cord exiting through the intervertebral foramina. Acute pain, protective tension and muscle spasm occur. The pain can radiate to the shoulder, elbow, forearm, and is often localized in the area of the shoulder blades (with a hernia or protrusion in the thoracic spine).
Radiculitis
Acute pain that begins in the interscapular region and continues along the intercostal spaces is the most common sign of radiculitis. It is caused by pinching of spinal nerves by a herniated or protruding intervertebral disc. Less commonly, sciatica can be caused by a tumor, spondylosis, or vertebral displacement. A characteristic sign of the disease is pain caused by movements in the thoracic spine and lifting heavy objects.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a disease accompanied by pain in the shoulder and scapula, caused by arthrosis of the shoulder joint and inflammation of the surrounding soft tissues. Predisposing factors are injuries and microtraumas of the shoulder joint, intense physical activity in athletes and workers, osteochondrosis of the cervicothoracic spine. Humeral periarthrosis is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain occurs gradually, increasing from episodic pain during physical activity, with a large range of motion in the shoulder joint (swings, throws, when placing the arm behind the back). Then the pain becomes constant, painful even at rest. Because of this, the patient cannot sleep on the affected side.Pain inshoulder andreturns to the spatula. Possible shooting pains with movement. Characterized by a sharp limitation of mobility in the shoulder joint, the patient is unable to raise or abduct the arm.
Neuralgia
Aching pain in the area of the shoulder blades, which spreads along the intercostal nerves, is a sign of neuralgia, a chronic neurological disease. A characteristic symptom is increased pain when coughing, sneezing or moving - the pain becomes sharp, shooting. The cause of the disease is irritation of the roots of the spinal cord due to diseases of the spine, spondylarthrosis and spondyloarthrosis, muscle inflammation. Aggravation can be caused by drafts, hypothermia and physical activity.
Heart disease
Cardiac pathologies are often accompanied by severe pain in the area of the left shoulder blade. The cause of pain syndrome can be angina pectoris, coronary heart disease, atherosclerosis of coronary vessels. Acute severe pain under the left shoulder blade that does not disappear for a long time is a sign of myocardial ischemia or infarction. The nature of the pain is varied - from painful, constant, to acute, with shooting pain in the left shoulder and forearm, neck on the left. A characteristic symptom is that the pain is relieved by nitrates (medicines for the treatment of heart failure) - nitroglycerin, isoket, nitrosorbide.
Problems with the gastrointestinal tract
Diseases of the gastrointestinal tract are a common cause of back pain in the area of the shoulder blades. Pain is reflected in nature, and it arises due to the fact that part of the pain impulse from the solar plexus and receptors in the gastrointestinal tract returns back to the spinal cord. Pain in the area of the shoulder blades can occur with hiatal hernia, chronic or acute pancreatitis, stomach and duodenal ulcers. For cholecystitis and gallstonespainare localizedin the back between the shoulder blades, moreto the right.
Lung diseases
Pain in the shoulder blades can occur in numerous lung and bronchial diseases. Most often, these are pneumonia, acute bronchitis, asthma and other pathologies. Often suffering from lung cancerback pain in the area of the shoulder blades.
Areas of back pain in the area of the shoulder blades
Pain in the area of the shoulder blades when inhaling or exhaling is a characteristic sign of intercostal neuralgia, osteochondrosis of the spine with protrusion or herniation of the intervertebral disc, inflammation of the back muscles and radiculitis. The reason for the pain is that the act of breathing is ensured by the coordinated contraction of a large number of muscles, and movements even at such a volume can cause increased pain in the aforementioned diseases.
Pain in sternum and shoulder blades
Pain in the sternum and shoulder blades is often found in glenohumeral periarthrosis. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal load distribution, which is why pathological changes begin at the point of attachment of the clavicle and ribs to the sternum (Tietze's syndrome).
Pain in the sternum and shoulder blades also occurs with lung and heart disease.
Pain in the scapula on the right or left side
Pain in the scapula on the left side can be reflected in heart disease, as mentioned above. Pain in the right shoulder blade is characteristic of acute or chronic cholecystitis, gallstones.
Pain in shoulder blades and neck
Back pain,in the area of shoulder blades and neckpossible with osteochondrosis of the cervical and thoracic spine. This symptom is also characteristic of a hernia or protrusion. Reference pain in the neck and scapula occurs in some diseases of the heart and lungs (angina pectoris, lung cancer, pneumonia).
Types of shoulder pain
Aching pain in scapula
Painful pain in the scapula on the left side is observed in heart diseases, on the right side - in diseases of the bile ducts, cholelithiasis. Aching pain is accompanied by glenohumeral periarthrosis, neuralgia and radicular radiculitis. Pain in the back and in the area of the shoulder blades is also possible with spondyloarthrosis and spondyloarthrosis.
Pressure pain in scapula
Pressure pain in the scapula is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by a series of muscles whose inflammation leads not only to pain, but also to limited mobility of the shoulder girdle. Severe inflammation of the soft tissues and ligaments of the shoulder joint can also be accompanied by pain.
Dull pain on inhalation
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed in pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injury, back bruises and soft tissue hematomas. Dull pain in the back and shoulder blades is accompanied by some diseases of the spinal cord, such as multiple sclerosis.
Throbbing pain in scapula
Pulsating pain in the scapula, which increases with movement, sneezing and coughing, is a sign of back injury, fractures and cracks in the scapula. The mechanism of injury is most often a direct physical impact or an indirect impact transmitted along the axis of the upper limbs, for example, when falling on the elbow.
When moving (walking), pain in the shoulder blades
Pain in the shoulder blades when walking can occur with hernias and protrusions of the thoracic spine. Axial loads of the spinal column that occur when moving and hitting the ground with the heel are transferred to the diseased intervertebral disc and cause pain.
Burning in the area of the shoulder blades
A burning sensation in the area of the shoulder blades is a possible sign of an acute myocardial infarction. Ischemia (failure of circulation and lack of oxygen in the heart muscle) of the myocardium is accompanied by intense pain, painful shock and a drop in blood pressure. However, if the posterolateral wall of the left ventricle and the septum of the heart are damaged, the pain can imitate osteochondrosis of the spine, poisoning with poor-quality food, acute surgical pathology and many other diseases.
Stinging and tingling of the skin in the interscapular area can be a symptom of a hernia or protrusion of the intervertebral discs of the thoracic and cervical spine. This symptom occurs in multiple sclerosis and other diseases of the spinal cord.
Shoulder pain and nausea
Pain in the left scapula with nausea and vomiting may also indicate an acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (clogging of the lumen of the bile duct with a stone) - the pain is localized more to the right, nausea is caused by intoxication.
How to relieve shoulder pain
In diseases of the spine and many other diseases, pain relief is facilitated by rest and bed rest. An effective way to suppress pain is to prescribe analgesics, mainly non-steroidal anti-inflammatory drugs. In some cases, dry heat, distraction, and anti-inflammatory agents in the form of ointments and gels on the skin help. Patches with anti-inflammatory drugs are widely used, the effect of which is limited to the area of application and is not accompanied by significant side effects.
It is important to remember that any pain is an indication for consulting a doctor. The reason is that long-term use of analgesics increases the risk of serious and dangerous complications. Therefore, their use as medical care is aimed at relieving pain before visiting a doctor. After determining the cause, the treatment is adjusted taking into account the diagnosis and the individual characteristics of the patient.
How is shoulder blade pain diagnosed?
To diagnose the causes of pain in the shoulder blades, a clinical examination by a doctor is used, which makes it possible to identify mild symptoms and signs characteristic of a particular disease. A study of skin sensitivity, reflex testing, assessment of range of motion in the shoulder joint and spine, etc. is carried out. Instrumental methods such as ECG, ultrasound, CT or MRI are used to confirm the diagnosis.
Magnetic resonance is a universal method for diagnosing the causes of back pain associated with pathologies of the spine, spinal cord, joints and soft tissues. The procedure is safe, very precise and allows you to get detailed images of the area of interest. The method is based on the physical phenomenon of magnetic resonance, which is created using only magnetic fields and radio waves that are safe for human health.
Treatment of pain in the scapula
The treatment of pain in the back and shoulder blades is focused on the cause of the disease (etiotropic treatment), mechanisms of occurrence (pathogenetic treatment) and symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the patient's condition. As an example, consider the treatment plan for osteochondrosis of the spine.
Chondroprotectors, vitamin therapy, drugs that improve blood microcirculation, therapeutic exercises and physiotherapy are prescribed to eliminate degenerative-dystrophic phenomena and improve the nutrition of the soft tissues of the spine. To relieve tension in the back muscles, massage is performed and muscle relaxants are prescribed. In case of entrapment of a spinal nerve hernia, physical influence is used - underwater traction, manual therapy. Analgesics are prescribed to control pain.
Scapular pain treatment at home
Treatment at home is possible only if the patient consulted a doctor, underwent an examination, during which an accurate diagnosis was made. In most cases, the causes of pain in the scapula and back do not require immediate hospitalization, the treatment is carried out at home, according to the doctor's prescriptions. However, the opposite happens more often - patients try to treat themselves at home, diagnose themselves and use painkillers uncontrollably. The result of self-diagnosis and self-treatment is chronic pain and side effects of analgesics. Patients often come to the doctor late when the disease causes complications. In the case of serious diseases, late treatment significantly worsens the prognosis and reduces the probability of a complete cure. That's why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I consult for pain in the shoulder blades?
By clarifyingcauses and treatment of shoulder and back painit is dealt with by a neurologist, because in most cases the pain syndrome is of neurogenic origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are dealt with by a traumatologist, but even in this case, if there are neurological symptoms, a consultation with a neurologist is required. In extreme cases, if you have back pain, you should at least contact a therapist to make a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is if the patient does not consult a doctor and self-medicates - the consequences of such "treatment" lead to complications, chronicity of the disease, and in some cases represent a threat to human health and life.