Patients rarely pay due attention to recurrent pain in the area of the shoulder blades. However, this symptom is a "wake-up call" of serious changes not only in the musculoskeletal system, but also in the internal organo-complex. Such conditions can threaten the patient with disability and death. How not to miss the disease and cure back pain in the area of the shoulder blades, read on.
The spine is the main component of the human musculoskeletal system. So, the lion's share of pressure during statics or dynamics falls on the spinal column. Therefore, it is not surprising that a common reason for consulting a doctor is pain in the area of the shoulder blades.
However, the pain syndrome is quite changeable: often pain is provoked not by the spinal column itself, but by a violation of the functions of internal organs. This fact makes it difficult to diagnose the root cause of the pain syndrome and leads to errors in treatment.
Among the main causes of pain, pathologies of the musculoskeletal and internal systems are distinguished.
The first group includes:
- spinal deformities;
- trauma and spondylolisthesis;
- ankylosing spondylitis.
Among the non-vertebral causes, diseases of the internal organs (pneumonia, heart attack, intercostal neuralgia, gastric ulcer, cholecystitis) are most common. Also, tumor processes or mental lability (fibromyalgia, psychogenic soreness) can provoke soreness.
Why does the back hurt in the area of the shoulder blades? In general, pain syndrome can be localized both directly in the area of the shoulder blades, and between them. Soreness is bilateral (with scoliosis) or is located mainly on one side (gastric ulcer, cholecystitis).
By the nature of the pain in the back between the shoulder blades, it can be acute (occur abruptly with a rapid increase in strength) or chronic (weak and prolonged). The main difference in practice is that the patient can accurately name the time of the onset of acute pain syndrome. While remembering the circumstances of the onset of chronic pain will be difficult.
A number of diseases can provoke back pain in the area of the shoulder blades, but we will focus on the most common of them.
- Osteochondrosis.Osteochondrosis is an ailment during which the intervertebral disc "aging" occurs. In advanced cases, such pathological changes lead to a hernial protrusion of the disc. When the thoracic spine is affected by osteochondrosis, patients are worried about a sharp back pain between the shoulder blades, which occurs when bending or staying in uncomfortable positions for long periods. It is possible to add tangible weakness of the back muscles, disturbances in the perception of temperature and pain.
- Spinal deformities.One of the causes of pain between and in the area of the shoulder blades is the curvature of the spine. As a rule, soreness provokes kyphosis (stoop, hump) or scoliosis (C, S, or Z-shaped spine). With significant deformities of the spinal column, aching pain appears, aggravated by physical activity. There are frequent episodes of respiratory failure (shortness of breath, inability to "breathe deeply"). The clinic is also accompanied by increased fatigue and headaches. In rare cases, the chest is bent.
- Injuries.Sharp pain often appears with direct trauma to the spine or the shoulder blades themselves. Similar injuries occur when falling from a height, hit with a blunt object, transport or industrial accidents. Spinal injuries are associated with palpable pain, reflexive contraction of the back muscles, and bruising. In some cases, the attachment of neurological pathology is possible. When the scapula is traumatized, the pain is acute, aggravated by swinging the arms. Sometimes it is combined with hemorrhages in the shoulder joint cavity - hemarthrosis.
- Spondylosis.Spondylosis is called senile destructive processes in the spine. Usually, in the area of the intervertebral joints, bone tissue grows - osteophytes are formed, which can be complicated by the increment of the vertebrae to each other. In such cases, severe pain, neurological and vascular disorders appear.
- Osteoporosis.Osteoporosis is an ailment associated with a decrease in the density of the bone system. Usually, soreness in the back in the area of the shoulder blades occurs when a fracture of the thinned thoracic vertebrae occurs. Curvature of posture appears - the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (disappearance of motor activity and sensitivity).
- Ankylosing spondylitis. . . Ankylosing spondylitis is an ailment that affects the intervertebral joints. Usually, the clinic begins with pain between the shoulder blades or in the lower back. Soreness is accompanied by stiffness of movements, which intensifies after a night's rest. With the development of pathology, the spinal column is deformed, arched, which leads to curvature of the chest and respiratory failure. In such a pathological position, ankylosis (immobilization) of the intervertebral joints occurs, due to which the patient can no longer bend. In this case, the ailment can additionally affect the cardiovascular and urinary systems.
- Diseases of the internal organs.With pneumonia (inflammation of the lungs), a detailed clinical picture is characterized by fever, sputum production, and one-sided pain in the chest or back in the area of the shoulder blades. During a heart attack, soreness is sharp (stabbing, burning), is determined in the chest and radiates to the left scapula and upper limb. The pain syndrome with intercostal neuralgia is acute and piercing, manifests itself in the form of attacks that interfere with the patient's breathing. The pain occurs along the ribs, is distributed under the shoulder blades, clavicle and lower back. With a stomach ulcer, the soreness is dull, localized in the upper abdomen, often accompanied by "hungry" pains (with long breaks between meals). In this case, the ailment is characterized by digestive disorders, nausea, vomiting and sour belching. Sometimes there is bleeding from the ulcer: patients feel dagger pain, which disappears at the height of the bleeding. Vomiting and stools become dark (almost black) in color due to blood impurities. Cholecystitis (inflammation of the gallbladder) is characterized by the occurrence of a characteristic paroxysmal pain syndrome in the right hypochondrium, spreading to the right side and scapula. The clinic of the disease includes digestive disorders, the provoking factor of which is the consumption of fatty and fried foods. Sometimes vomiting appears with impurities of bile.
- Tumors.Soreness in the area of the shoulder blades can appear with neoplastic diseases of the vertebrae or the nerve sheath (neuroma). Metastases (daughter tumors) from the affected prostate or mammary glands can spread to the vertebral region. In this case, the tumor process is characterized by an asymptomatic course, and the appearance of pain is associated with an increase in the neoplasm and its pressure on the neurovascular bundle. Cancer can be suspected by "watchdog symptoms": pain, weight loss, fever and constant weakness for no apparent reason.
- Mental lability.The instability of the psyche to stress and emotional outbursts can manifest itself as psychogenic pain. It arises against the background of complete health: patients can experience sensations of various strengths that cannot be treated even with painkillers. Stressful situations also provoke another idiopathic (causeless) pain - fibromyalgia. The disease proceeds against the background of prolonged pain sensations, intensifying at certain (trigger) points.
Radiography is the gold standard for examining the spine. In order to determine the cause of vertebral pain, computed tomography can be used. To study other organs and systems, ultrasound diagnostics or MRI are used. To exclude concomitant pathology, laboratory or other instrumental examination methods may be needed.
These pathological conditions require a specific treatment plan; only a doctor can prescribe drugs.
- Osteochondrosis.As a drug therapy to relieve pain, non-steroidal anti-inflammatory drugs and analgesics are used. Physical therapy, remedial gymnastics and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernial sac.
- Spinal deformities.Conservative therapy for curvature of the spinal column consists in the use of supporting devices (corsets, bandages). You also need sufficient activity, massage and physiotherapy (paraffin applications, electrical stimulation). In case of significant deformity, surgical methods of treatment are indicated in order to fix the spine in the anatomically correct position.
- Injuries.Minor injuries are treated with rest, warmth, and massage; more severe injuries may require traction. If conservative methods are ineffective, the spine is reconstructed with an operative method.
- Spondylosis.Treatment of this pathology is aimed at slowing the progression of the disease. So, hyaluronic acid injections, chondroprotectors, physiotherapy (shock wave therapy), as well as physiotherapy exercises are prescribed. With severe pain syndrome, blockade is performed with painkillers.
- Osteoporosis.Osteoporosis care includes high dosage of calcium and vitamin D supplements. Hormone therapy with female sex hormones, thyroid and other hormones is also possible.
- Ankylosing spondylitis.Inflammation and pain are controlled by anti-inflammatory therapy. To modify the immune response, an antimetabolite of the group of structural analogs of folic acid is prescribed. During remission, physiotherapy, breathing exercises, and therapeutic massage are performed.
- Diseases of the internal organs.Therapy for pneumonia includes antibacterial agents, as well as drugs that relieve bronchospasm. During the rehabilitation period, vibration massage and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warming up and anti-inflammatory ointments. Distraction therapy with topical remedies with red pepper extract or bee venom is often used. Treatment of stomach ulcers consists of combined antibiotic therapy, as well as drugs that reduce the acidity of gastric contents. Help with cholecystitis includes the use of antispasmodics and drugs that affect bile. In some cases, antibiotic therapy may be required. In the presence of large stones in the gallbladder, it is recommended to remove the latter - cholecystectomy.
- Tumors.Treatment of tumor processes consists of chemotherapy with antineoplastic agents and surgical removal (if possible) of the neoplasm.
- Mental lability.Mental lability requires intensive psychotherapy, as well as the use of antidepressants or anxiolytics. Limiting psycho-emotional stress is an important part of treatment.
How to prevent?
To prevent back pain in the area of the shoulder blades, lifestyle modifications are required: increasing the nutritional value of the diet, playing sports, quitting smoking and drinking. It is important to timely detect and treat chronic diseases, to avoid stress overload.
Remember, pain is not an independent ailment, but a manifestation of a much more serious pathology that requires diagnosis and proper treatment!