Back pain comes in many forms and varieties. Location and nature of pain, duration, presence or absence of irradiation to other parts of the body, provoking factors - all this can be combined in various combinations.Back pain in the shoulder blade region- a common type of pain in various diseases.
The main causes of pain in the shoulder blades and back
Why does my back hurt around my shoulder blades?Such symptoms can be observed in diseases of the spine, neurological disorders, muscle pathologies and other organs. These include referred pain in lung and heart diseases and diseases of the gastrointestinal tract, as well as pain in radicular syndromes, trauma and osteochondrosis. Let's take a look at the common causes of back and shoulder blade pain.
Injuries
Injuries to the scapula occur in two ways - with direct impact (impact, fall) and indirectly, with loads along the axis of the upper limb (fall on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, simultaneous injuries to the spine and rib fractures are possible. These injuries occur in 50% of serious road accidents. Severe pain, limited mobility, and severe swelling of the tissues around the shoulder blade may also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causeback painANDcolumnany location, and also inshoulder blade area. Degenerative-dystrophic processes in the joints and intervertebral discs, resulting from malnutrition and cartilage regeneration, lead to the formation of protrusions and hernias, spasm of the back muscles and a decrease in the height of the intervertebral discs. Spinal nerves can be compressed; the pain may be caused by radicular syndrome.
The pain is caused when bending or turning the body, lifting weights. Due to concomitant inflammation of the back muscles, pain may increase when lifting and abducting the arms. Possible stiffness of the spine, tilt, forced position of the patient with a slight tilt forward. The pain can be aching, sharp, circling the chest. Some patients describe this by saying that they feel as if something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which there is a pathological S-shaped curvature of the spine, mainly in the coronary plane. As a result, normal load distribution and biomechanics are disturbed. Predisposing factors for scoliosis are incorrect posture, weak back muscles, childhood and inadequate organization of the workplace. Back pain due to scoliosis is often caused by spasm, inflammation, and tension in muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by intense pain that disappears when lying down and intensifies with prolonged standing.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, occurring most frequently in the thoracic region. As a result of kyphosis, the spine begins to resemble a question mark "? ", and the formation of a bulge may begin. The 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 in scoliosis, is caused by muscle tension and spasm, as they are subject to excessive stress. At the same time feelback muscle painand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change in the intervertebral joints, caused by malnutrition of the articular cartilage, leading to the gradual destruction of the spinal joints. 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 impaired 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 the joints, and in the second case, the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondyloarthritis and spondyloarthrosis is painful in nature 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, undulating, with periods of exacerbations and improvements. The pain can be localized not just between the shoulder blades, but throughout the spine.
Protrusion and hernia
Protrusions and hernias of intervertebral discs are a consequence of advanced osteochondrosis of the spine. The intervertebral disc, which has lost elasticity and elasticity, or rather its peripheral part, called the fibrous ring, protrudes under the influence of loads and forms a protrusion. If the fibrous ring ruptures, the inner contents of the disc fall out, forming a herniated disc. Both bulges and herniated intervertebral discs can cause entrapment of the spinal cord roots that emerge through the intervertebral foramina. Sharp pain, protective tension and muscle spasm occur. The pain can radiate to the shoulder, elbow, forearm and is usually located in the shoulder blade region (with hernia or protrusion in the thoracic spine).
Radiculitis
Sharp pain that begins in the interscapular region and continues throughout the intercostal spaces is the most common sign of radiculitis. It is caused by compression of the spinal nerves by a herniated or protruded intervertebral disc. Less commonly, sciatica may be caused by a tumor, spondylosis, or vertebral dislocation. 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 disease accompanied by pain in the shoulder and scapula, caused by osteoarthritis of the shoulder joint and inflammation of the surrounding soft tissues. Predisposing factors include injuries and microtraumas of the shoulder joint, intense physical activity in athletes and workers, and osteochondrosis of the cervicothoracic spine. Periarthrosis of the humerus is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain occurs gradually, intensifying from episodic pain during physical activity, with a large range of movement in the shoulder joint (arm swings, throwing, when placing the arm behind the back). Then the pain becomes constant, even at rest. Because of this, the patient is unable to sleep on the affected side.Pain inshoulder andreturns to the shoulder blade. Possible sharp pains when moving. Characterized by a strong limitation of mobility in the shoulder joint, the patient is unable to raise or abduct the arm.
Neuralgia
Pain in the shoulder blade region, radiating 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 and sharp. The cause of the disease is irritation of the roots of the spinal cord due to diseases of the spine, spondyloarthritis and spondyloarthrosis, muscle inflammation. Exacerbation can be provoked by drafts, hypothermia and physical activity.
Heart diseases
Heart pathologies are often accompanied by severe pain in the left shoulder blade region. The cause of the pain syndrome can be angina pectoris, coronary heart disease, atherosclerosis of the coronary vessels. Sharp, intense pain under the left shoulder blade that does not disappear for a long time is a sign of ischemia or myocardial infarction. The nature of the pain is varied - from aching, constant, to sharp, with sharp pain in the left shoulder and forearm, neck on the left. A characteristic symptom is that pain is relieved with nitrates (drugs 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 shoulder blade area. Pain is reflected in nature and occurs due to the fact that part of the painful impulses from the solar plexus and gastrointestinal tract receptors return to the spinal cord. Pain in the shoulder blade region can occur with hiatus hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainThey are locatedon the back between the shoulder blades, moreon the right.
Lung diseases
Pain in the shoulder blades can occur in various diseases of the lungs and bronchi. Most often these are pneumonia, acute bronchitis, asthma and other pathologies. Lung cancer patients oftenback pain in the shoulder blade region.
Areas of back pain in the shoulder blade region
Pain in the shoulder blade area when inhaling or exhaling is a characteristic sign of intercostal neuralgia, spinal osteochondrosis with protrusion or hernia of the intervertebral disc, inflammation of the back muscles and radiculitis. The reason for the pain is that the act of breathing is guaranteed by the coordinated contraction of a large number of muscles, and movements even in this volume can cause increased pain in the above diseases.
Pain in the sternum and shoulder blades
Pain in the sternum and shoulder blades is often found in glenohumeral periarthrosis. Degenerative inflammatory and dystrophic changes in the shoulder joint disrupt the normal distribution of loads, which is why pathological changes begin at the site of attachment of the clavicle and ribs to the sternum (Tietze syndrome).
Pain in the sternum and shoulder blades also occurs in diseases of the lungs and heart.
Pain in the shoulder blade on the right or left
Pain in the left shoulder blade 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
Backache,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. Referred pain in the neck and shoulder blade is seen in some diseases of the heart and lungs (angina pectoris, lung cancer, pneumonia).
Types of shoulder blade pain
Aching shoulder blade pain
Pain in the shoulder blade on the left is observed in heart disease, on the right - in diseases of the biliary tract, cholelithiasis. Aching pain is accompanied by glenohumeral periarthrosis, neuralgia and radicular radiculitis. Pain in the back and shoulder blade area is also possible with spondyloarthritis and spondyloarthrosis.
Pressing pain in shoulder blade
Severe pain in the shoulder blade is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by a series 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 may also be accompanied by pain.
Dull pain when inhaling
Dull pain in the back and shoulder blades, aggravated by inhalation, can be seen in pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injury, back bruising, and soft tissue hematoma. Dull pain in the back and shoulder blades is accompanied by some spinal cord diseases, such as multiple sclerosis.
Throbbing pain in shoulder blade
Throbbing pain in the scapula, which intensifies 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 on the spine that occur when moving and hitting the ground with the heel are transferred to the diseased intervertebral disc and cause pain.
Burning in the shoulder blade region
A burning sensation in the shoulder blades is a possible sign of an acute myocardial infarction. Myocardial ischemia (circulatory failure and oxygen deficiency in the heart muscle) is accompanied by severe 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 mimic spinal osteochondrosis, low-grade food poisoning, acute surgical pathology and many other diseases.
Burning and tingling on the skin in the interscapular region may be a symptom of hernia or protrusion of the intervertebral discs of 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 may also indicate an acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (blockage of the lumen of the bile duct with stones) - the pain is localized further to the right, nausea is caused by intoxication.
How to relieve shoulder blade pain
For spinal diseases and many other illnesses, pain relief is facilitated by rest and bed rest. An effective way to combat pain is to prescribe analgesics, especially non-steroidal 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 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 medical consultation. The reason is that prolonged use of painkillers increases the risk of serious and dangerous complications. Therefore, its use as medical care is aimed at relieving pain before consulting a doctor. After determining the cause, treatment is adjusted taking into account the diagnosis and individual characteristics of the patient.
How is shoulder blade pain diagnosed?
To diagnose the causes of pain in the shoulder blades, a clinical examination carried out by a doctor is used, which allows you to identify symptoms and mild 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. are carried out. To confirm the diagnosis, instrumental methods such as ECG, ultrasound, computed tomography or magnetic resonance imaging are used.
Magnetic resonance imaging 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, highly accurate and allows detailed images of the area of interest to be obtained. 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.
Shoulder blade pain treatment
Treatment of pain in the back and shoulder blades is aimed at the cause of the disease (ethiotropic treatment), the mechanisms of its occurrence (pathogenetic treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the patient's diagnosis and condition. For example, consider a treatment plan for spinal osteochondrosis.
To eliminate degenerative-dystrophic phenomena and improve the nutrition of the soft tissues of the spine, chondroprotectors, vitamin therapy, drugs that improve blood microcirculation, therapeutic exercises and physiotherapy are prescribed. To relieve tension in the back muscles, massages are given and muscle relaxants are prescribed. When a herniated spinal nerve is pinched, physical influence is used - underwater traction, manual therapy. To combat the pain, painkillers are prescribed.
Treating shoulder blade pain at home
Treatment at home is possible only if the patient has consulted a doctor, undergone an examination, during which an accurate diagnosis was established. In most cases, the causes of pain in the shoulder blades and back do not require urgent hospitalization, treatment is carried out at home, according to a doctor's prescription. However, more often the opposite happens - patients try to be treated at home, self-diagnose and use painkillers uncontrollably. The result of self-diagnosis and self-medication is chronic pain and side effects of painkillers. Patients often arrive at the doctor late when the disease causes complications. In the case of serious illnesses, late treatment significantly worsens the prognosis and reduces the likelihood of complete cure. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I see for shoulder blade pain?
By clarifyingcauses and treatment of shoulder and back painis seen by a neurologist, as in most cases the pain syndrome is of neurogenic origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spine injuries are treated by a traumatologist, but even in this case, if there are neurological symptoms, a consultation with a neurologist is necessary. In extreme cases, if you have back pain, you should at least contact a therapist so that he can establish a preliminary diagnosis and refer the patient for a consultation with another specialist. The worst thing is that the patient does not go to the doctor and self-medicates - the consequences of this "treatment" lead to complications, the chronicity of the disease and, in some cases, pose a threat to human health and life.