Patients rarely pay attention to recurrent pain in the shoulder blade area. However, this symptom is a "call call" for serious changes not only in the musculoskeletal system but also in the internal organ complex. These conditions can threaten the patient with disability and death. How to not miss the disease and cure the back pain in the shoulder blade region, read on.
The spine is the main component of the human musculoskeletal system. Therefore, most of the pressure during static or dynamics is placed on the spine. So it's not surprising that a common reason for seeing a doctor is pain in the shoulder blade region.
However, the pain syndrome is quite changeable: pain is often caused not by the spine itself, but by a violation of the functions of Organs internal organs. This fact makes it difficult to diagnose the root cause of the painful syndrome and leads to treatment errors.
Among the main causes of pain, pathologies of the musculoskeletal and internal systems stand out.
The first group includes:
- spinal deformities;
- trauma and spondylolisthesis;
- ankylosing spondylitis.
Among the non-vertebral causes, diseases of the internal organs are the most common (pneumonia, infarction, intercostal neuralgia, stomach ulcer, cholecystitis). In addition, tumor processes or mental lability (fibromyalgia, psychogenic pain) can cause pain.
Why does the back hurt in the shoulder blade region? In general, the pain syndrome can be located directly in the region of the shoulder blades and between them. The pain is bilateral (with scoliosis) or is located mainly on one side (gastric ulcer, cholecystitis).
Due to the nature of the back pain between the shoulder blades, it can be acute (occurring 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 onset of the acute pain syndrome. Remembering the circumstances of the onset of chronic pain will be difficult.
A number of ailments can cause back pain in the shoulder blade region, but let's focus on the most common ones.
- Osteochondrosis.Osteochondrosis is a disease during which the "aging" of the intervertebral disc occurs. In advanced cases, these pathological changes lead to a herniated disc protrusion. When the thoracic spine is affected by osteochondrosis, patients are concerned 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, pain causes kyphosis (curvature, hump) or scoliosis (C, S, or Z column). With significant deformities of the spine, there is excruciating pain, 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.Acute pain usually appears with direct trauma to the spine or the shoulder blades themselves. Similar injuries occur from falling from a height, hitting a blunt object, transport or industrial accidents. Spinal injuries are associated with palpable pain, reflex contraction of the back muscles, and bruises. In some cases, the linkage of neurological pathology is possible. When the scapula is traumatized, the pain is sharp, made worse by swinging the arms. It is sometimes combined with hemorrhages in the shoulder joint cavity - hemarthrosis.
- Spondylosis.Spondylosis is called senile destructive processes in the spine. Normally, in the region of the intervertebral joints, bone tissue grows - osteophytes are formed, which can be complicated by the increment of the vertebrae between them. In these cases, severe pain and neurological and vascular disorders appear.
- Osteoporosis.Osteoporosis is a disease associated with decreased density of the bone system. Typically, back pain in the shoulder blade area occurs when a fracture of the narrow thoracic vertebrae occurs. Appears the curvature of posture - the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (disappearance of motor activity and tenderness).
- Ankylosing spondylitis. . . Ankylosing spondylitis is a disease that affects the intervertebral joints. Typically, the clinic starts with pain between the shoulder blades or lower back. The pain is accompanied by stiffness of movement, which intensifies after a night's rest. With the development of the pathology, the spine is deformed, arched, which leads to chest curvature and respiratory failure. In this pathological position, ankylosis (immobilization) of the intervertebral joints occurs, due to which the patient is no longer able to bend. In that case, the disease can additionally affect the cardiovascular and urinary systems.
- Diseases of Organs internal organs.With pneumonia (inflammation of the lungs), a detailed clinical picture is characterized by fever, sputum production, and unilateral pain in the chest or back in the shoulder blade region. During a heart attack, the pain is sharp (stinging, burning), is determined in the chest and radiates to the left scapula and upper limb. The painful syndrome with intercostal neuralgia is acute and penetrating, manifesting itself in the form of crises that interfere with the patient's breathing. The pain occurs along the ribs, spreading under the shoulder blades, collarbone, and lower back. In stomach ulcers, the pain is dull, located in the upper abdomen, usually accompanied by "starvation" pains (with long breaks between meals). In this case, the disease is characterized by digestive disturbances, nausea, vomiting and sour belching. Sometimes there is bleeding from the ulcer: patients experience a sharp pain that disappears at the height of the bleeding. Vomiting and stool become dark (almost black) due to impurities in the blood. Cholecystitis (inflammation of the gallbladder) is characterized by the occurrence of a characteristic paroxysmal pain syndrome in the right hypochondrium, with spread to the right side and scapula. The clinical picture of the disease includes digestive disorders whose provoking factor is the consumption of fatty and fried foods. Sometimes vomiting appears with bile impurities.
- Tumors.Pain in the shoulder blade area may appear with neoplastic diseases of the vertebrae or nerve sheath (neuroma). Metastases (offspring 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 onset of pain is associated with an increase in the neoplasm and its pressure in the neurovascular bundle. Cancer can be suspected by "vigilance 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 as psychogenic pain. It appears in the context of complete health: patients can experience sensations of various potencies that cannot even be treated with painkillers. Stressful situations also trigger another idiopathic (uncaused) pain - fibromyalgia. The illness proceeds against the background of prolonged pain sensations, intensifying at certain points (triggers).
Radiography is the gold standard for examining the spine. To determine the cause of the spinal pain, computed tomography can be used. To study other organs and systems, ultrasound or MRI diagnostics are used. To exclude concurrent pathology, laboratory methods or other instrumental examination methods may be necessary.
These pathological conditions require a specific treatment plan, only a doctor can prescribe medication.
- Osteochondrosis.As drug therapy for pain relief, nonsteroidal anti-inflammatory drugs and analgesics are used. Physiotherapy, corrective gymnastics, and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernia sac.
- Spinal deformities.Conservative therapy for spinal curvature is the use of support devices (corsets, bandages). You also need enough 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, warming and massage; more serious injuries may require traction. If conservative methods are ineffective, the spine is reconstructed with an operative method.
- Spondylosis.The treatment of this pathology aims to slow the progression of the disease. Thus, injections of hyaluronic acid, chondroprotective agents, physical therapy (shock wave therapy) are prescribed, as well as physical therapy exercises. In severe pain syndrome, the block is performed with analgesics.
- Osteoporosis.Osteoporosis care includes high doses 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 from the group of structural analogues of folic acid is prescribed. During remission, physiotherapy, breathing exercises and therapeutic massage are performed.
- Diseases of Organs internal organs.Therapy for pneumonia includes antibacterial agents as well as drugs that alleviate bronchospasm. During the rehabilitation period, vibrating massage and therapeutic exercises are prescribed. Intercostal neuralgia is treated with heat and anti-inflammatory ointments. Distraction therapy with topical remedies such as red pepper extract or bee venom is often used. The treatment of stomach ulcers consists of combined antibiotic therapy, in addition to medications that reduce the acidity of the gastric contents. Helping with cholecystitis includes the use of antispasmodics and drugs that affect bile. In some cases, antibiotic therapy may be needed. In the presence of large gallstones in the gallbladder, removal of the gallbladder is recommended - 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 shoulder blade region, lifestyle changes are needed: increase the nutritional value of the diet, play sports, stop smoking and drinking. It is important to detect and treat chronic illnesses in a timely manner to avoid stress overload.
Remember that pain is not an independent illness, but the manifestation of a much more serious pathology that requires proper diagnosis and treatment!