Back pain comes in many forms and variations. Localization and nature of pain, duration, presence or absence of irradiation of other parts of the body, provoking factors - all this can be combined in various combinations.Back pain in the shoulder blade area- 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 shoulder blade area?Such symptoms can be observed in diseases of the spine, neurological disorders, diseases of muscles and other organs. These include referred pain in pulmonary and cardiac diseases and diseases of the gastrointestinal tract, as well as pain in radicular syndromes, trauma and osteochondrosis. Let's take a closer look at the most common causes of back and shoulder blade pain.
Injuries
Injuries to the scapula occur in two ways - through direct impact (impact, fall) and indirectly through loads along the axis of the upper extremity (fall on the elbow, strong contraction of the shoulder girdle muscles). In the first case, simultaneous spinal injuries and rib fractures are possible. Such injuries occur in 50% of serious traffic accidents. If there is severe bruising, severe pain, limited mobility and severe swelling of the tissue surrounding the scapula may also be observed.
Osteochondrosis
Osteochondrosis is a common causeBack painAndSpineany localization, and also inScapular area. Degenerative-dystrophic processes in the intervertebral joints and intervertebral discs, resulting from 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 can become pinched; Pain can be caused by radicular syndrome.
The pain is caused by bending or twisting the body and lifting weights. Due to accompanying inflammation of the back muscles, pain can increase when lifting and spreading the arms. Possible stiffness of the spine, stooping, forced position of the patient with slight forward bending. The pain may be aching, stabbing, and may surround the chest. Some patients describe it as feeling like something is caught between their shoulder blades.
Scoliosis
Scoliosis is a disease in which a pathological S-shaped curvature of the spine occurs primarily in the coronal plane. This disrupts normal load distribution and biomechanics. Predisposing factors for scoliosis include incorrect posture, weak back muscles, childhood and improper organization of the workplace. Back pain due to scoliosis is usually caused by spasms, 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 with prolonged standing.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, most commonly occurring in the thoracic region. As a result of kyphosis, the spine begins to resemble a question mark "? ", and a hump may form. Predisposing factors for kyphosis include vitamin D deficiency, osteoporosis, and poor posture. Kyphosis can be caused by trauma or tuberculosis of the spine. Ankylosing spondylitis causes extreme kyphosis of thechest region.
Like scoliosis, pain in kyphosis is caused by tension and muscle spasms due to excessive stress. At the same time it is noticeableBack muscle painand in the regionShoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change in the intervertebral joints that is caused by malnutrition of the articular cartilage and leads to the gradual destruction of the joints of the spine. Spondyloarthritis is an inflammation of the intervertebral joints that occurs in response to an autoimmune or reactive process (rheumatoid arthritis, ankylosing spondylitis, reactive arthritis). The result of both processes is ankylosis or fusion of the intervertebral joints, which leads to limited mobility of the spine. The difference is that in the first case the inflammation is of a secondary nature and occurs in response to the destruction of joints, and in the second case the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondyloarthritis and spondyloarthrosis is painful in nature and increases at night. A characteristic symptom is stiffness and rigidity of the spine in the morning, which disappears after gymnastics or physical activity. The course of the disease is chronic, wave-like, with phases of exacerbations and improvements. The pain can be localized not only between the shoulder blades, but throughout the entire spine.
protrusion and hernia
Bulging and herniated discs are a consequence of advanced osteochondrosis of the spine. The intervertebral disc, which has lost its elasticity and elasticity, or rather its peripheral part, called the fibrous ring, protrudes under the influence of loads and forms a protrusion. When the annulus fibrosus ruptures, the internal contents of the disc fall out and a herniated disc occurs. Both bulges and herniated discs can cause the roots of the spinal cord that exit through the intervertebral foramina to become pinched. Acute pain, protective tension and muscle cramps occur. The pain can radiate to the shoulder, elbow, forearm and is often localized in the area of the shoulder blades (in the case of a hernia or a bulge 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 occurs when the spinal nerves are pinched by a herniated or herniated disc. More rarely, sciatica can be caused by a tumor, spondylosis, or vertebral displacement. A characteristic sign of the disease is pain caused by movements of the thoracic spine and lifting heavy objects.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a condition associated with pain in the shoulder and scapula, caused by osteoarthritis of the shoulder joint and inflammation of the surrounding soft tissues. The predisposing factors include injuries and microtraumas of the shoulder joint, intense physical activity in athletes and workers, and osteochondrosis of the cervical spine. Humeral periarthrosis is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain occurs gradually and increases with episodic pain during physical activity with a large range of motion in the shoulder joint (swinging the arm, throwing, when placing the arm behind the back). Then the pain becomes constant and hurts even at rest. For this reason, the patient cannot sleep on the affected side.pain inshoulder andgives something back to the shoulder blade. Possible stabbing pain when moving. A severe limitation of mobility in the shoulder joint is characteristic; the patient is unable to lift or move his arm.
neuralgia
Aching pain in the shoulder blade area that radiates 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 stabbing and shooting. The cause of the disease is irritation of the roots of the spinal cord due to diseases of the spine, spondyloarthritis and spondyloarthrosis, and muscle inflammation. Exacerbation can be caused by drafts, hypothermia and physical activity.
Heart disease
Heart disease is often accompanied by severe pain in the left shoulder blade area. The cause of the pain syndrome can be angina pectoris, coronary artery disease, atherosclerosis of the coronary arteries. Acute severe pain under the left shoulder blade that does not go away for a long time is a sign of myocardial ischemia or a heart attack. The nature of the pain is diverse - from aching, constant to acute, with stabbing pain in the left shoulder and forearm, in the left neck. A characteristic symptom is that the pain is relieved by nitrates (drugs used to treat heart failure) - nitroglycerin, isoket, nitrosorbide.
Problems with the gastrointestinal tract
Diseases of the gastrointestinal tract are a common cause of back pain in the shoulder blade area. Pain is reflected in nature and arises because part of the pain impulses from the solar plexus and the receptors in the gastrointestinal tract return to the spinal cord. Pain in the shoulder blade area can occur with a hiatal hernia, chronic or acute pancreatitis, stomach ulcer, and duodenal ulcer. For cholecystitis and gallstonespainare localizedin the back between the shoulder blades, moreright.
Lung disease
Pain in the shoulder blades can occur with a number of diseases of the lungs and bronchi. Most often these are pneumonia, acute bronchitis, asthma and other pathologies. Patients with lung cancer oftenBack pain in the shoulder blade area.
Back pain areas around the shoulder blades
Pain in the shoulder blade area when inhaling or exhaling is a characteristic sign of intercostal neuralgia, spinal osteochondrosis with bulging or herniation of the intervertebral disc, inflammation of the back muscles and radiculitis. The reason for the pain is that breathing is ensured by the coordinated contraction of a large number of muscles, and movements even of such a volume can provoke increased pain in the above-mentioned diseases.
Pain in the sternum and shoulder blades
With glenohumeral periarthrosis, pain often occurs in the area of the sternum and shoulder blades. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of load, which is why pathological changes begin at the attachment point of the collarbone and ribs to the sternum (Tietze syndrome).
Pain in the sternum and shoulder blades also occurs with diseases of the lungs and heart.
Pain in the shoulder blade on the right or left
Pain in the scapula on the left side can reflect heart disease, as mentioned above. Pain in the right shoulder blade is characteristic of acute or chronic cholecystitis, gallstones.
Pain in the shoulder blades and neck
Back pain,in the area of the shoulder blades and neckpossible with osteochondrosis of the cervical and thoracic spine. This symptom is also characteristic of a hernia or protrusion. In some diseases of the heart and lungs (angina, lung cancer, pneumonia), referred pain is observed in the neck and shoulder blade area.
Types of pain in the shoulder blades
Pain in the shoulder blade
Aching pain in the scapula on the left is observed in heart disease, on the right - in diseases of the biliary tract, cholelithiasis. Aching pain is associated with glenohumeral periarthrosis, neuralgia and radicular radiculitis. Aching pain in the back and in the shoulder blade area is also possible with spondyloarthritis and spondyloarthrosis.
Pressing pain in the shoulder blade
Pressing pain in the scapula is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by a number of muscles, the inflammation of which 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 cause pain.
Dull pain when inhaling
Dull pain in the back and shoulder blades, aggravated by inhalation, can be seen in pneumonia, lung cancer, neuromuscular diseases and myositis. This symptom is also a sign of injuries, back bruises and soft tissue hematomas. Dull pain in the back and shoulder blades is associated with some spinal cord diseases, such as multiple sclerosis.
Throbbing pain in the shoulder blade
Throbbing pain in the scapula that increases with movement, sneezing and coughing is a sign of a back injury, fractures and tears of 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 in a fall on the elbow.
Pain in the shoulder blades when moving (walking).
Pain in the shoulder blades when walking can occur with hernias and protrusions of the thoracic spine. Axial loads on the spine that occur when moving and placing the heel on the ground are transferred to the diseased intervertebral disc and cause pain.
Burning in the shoulder blade area
A burning sensation in the shoulder blade area is a possible sign of an acute heart attack. Ischemia (circulatory failure and lack of oxygen in the heart muscle) of the myocardium is accompanied by severe pain, painful shock and a drop in blood pressure. However, when the posterolateral wall of the left ventricle and the septum of the heart are damaged, pain can imitate osteochondrosis of the spine, poor-quality food poisoning, acute surgical pathology and many other diseases.
Burning and tingling on the skin in the interscapular area can be a symptom of an inguinal hernia or a bulging of the intervertebral discs in the thoracic and cervical spine. This symptom occurs in multiple sclerosis and other spinal cord diseases.
Shoulder pain and nausea
Pain in the left shoulder blade with nausea and vomiting can also indicate an acute heart attack. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (blockage of the lumen of the bile duct by a stone) - the pain is localized more to the right, nausea is caused by intoxication.
How to relieve pain in the shoulder blades
In diseases of the spine and many other diseases, pain relief is facilitated by rest and bed rest. An effective method of controlling pain is to prescribe analgesics, primarily nonsteroidal anti-inflammatory drugs. In some cases, dry heat, distractions and anti-inflammatory agents in the form of ointments and gels on the skin help. Patches containing anti-inflammatory medications are widely used, the effect of which is limited to the area of application and is not associated with any significant side effects.
It is important to remember that any pain is an indication to see a doctor. The reason for this 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 the doctor. After determining the cause, treatment is adjusted taking into account the diagnosis and the individual characteristics of the patient.
How is pain in the shoulder blades diagnosed?
To diagnose the causes of pain in the shoulder blades, a clinical examination is carried out by a doctor, which makes it possible to identify mild symptoms and signs characteristic of a particular disease. An examination of skin sensitivity, an examination of reflexes, an assessment of the range of motion in the shoulder joint and spine, etc. are carried out. Instrumental methods such as ECG, ultrasound, CT or MRI are used to confirm the diagnosis.
Magnetic resonance imaging is a universal method for diagnosing the causes of back pain associated with diseases of the spine, spinal cord, joints and soft tissues. The procedure is safe, highly precise and allows you to obtain detailed images of the area of interest. The method is based on the physical phenomenon of magnetic resonance, which is generated exclusively with magnetic fields and radio waves that are harmless to health.
Treatment of shoulder blade pain
Treatment of pain in the back and shoulder blades is aimed at the cause of the disease (etiotropic treatment), the mechanisms of its occurrence (pathogenetic treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the patient's condition. As an example, consider a treatment plan for spinal osteochondrosis.
To eliminate degenerative-dystrophic phenomena and improve nutrition of the soft tissues of the spine, chondroprotectors, vitamin therapy, drugs to improve blood microcirculation, therapeutic exercises and physiotherapy are prescribed. To relieve tension in the back muscles, massages are performed and muscle relaxants are prescribed. When a spinal nerve is pinched, physical influence is used - underwater traction, manual therapy. Analgesics are prescribed to combat pain.
Treating shoulder blade pain at home
Home treatment is possible only if the patient consulted a doctor and underwent an examination that made an accurate diagnosis. In most cases, the causes of pain in the scapula and back do not require urgent hospitalization; The treatment is carried out at home according to a doctor's prescription. However, the opposite happens more often: patients try to get treatment at home, make a self-diagnosis and take painkillers uncontrollably. The consequences of self-diagnosis and self-medication are chronic pain and side effects of analgesics. Patients often come to the doctor late when the disease causes complications. In serious illnesses, delayed treatment significantly worsens the prognosis and reduces the likelihood of complete recovery. That is why back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I see if I have shoulder blade pain?
Through educationCauses and treatment of pain in the shoulder blades and backTreatment is carried out by a neurologist, since in most cases the pain syndrome is of neurogenic origin. These are almost exclusively diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are treated by a traumatologist, but even in this case, if there are neurological symptoms, consultation with a neurologist is necessary. In extreme cases, if you have back pain, you should at least contact a therapist so that he or she can make a preliminary diagnosis and refer the patient to another specialist consultation. The worst thing is if the patient does not consult a doctor and does not self-medicate - the consequences of such "treatment" lead to complications, chronicity of the disease and, in some cases, pose a threat to human health and life.