When most people experience back pain between the shoulder blades, they associate its occurrence with various disorders of the spine, nerve roots, ligaments, intervertebral discs or the discs themselves.But it should be remembered that such painful sensations can also be associated with other diseases of the chest organs - stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which increases rapidly and either passes quickly or increases significantly over time, or chronic, which worries the patient for a long time and requires an accurate diagnosis, as it can be a symptom of a serious pathology of any chest organ.Sometimes pain between the shoulder blades can occur only after a sudden physical strain or after staying in a certain uncomfortable position for a long time.
It must be remembered that pain in the interscapular region is not a disease, but a symptom, and before using any ointment for back pain or injections, the true cause of their occurrence must be determined.When you contact a doctor, it is very important to describe all the minor accompanying symptoms that accompany the pain, the time of its appearance, the provoking factors of its intensification, since the doctor must help determine the direction of the examination, and sometimes it is very difficult to establish the correct diagnosis without accurate data about the nature of the pain.
Very often, premature identification of the true cause of pain between the shoulder blades forces a person to undergo many expensive and lengthy examinations, to use various treatment options, which are sometimes inappropriately prescribed and therefore do not bring the desired result.Therefore, it is very important that the patient himself knows about the possible list of diseases that are characterized by this pain syndrome.
Pain caused by spine pathologies
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but we will consider other possible causes of such back pain.
Intervertebral hernia
You should know that a vertebral hernia in the thoracic spine is a very rare occurrence, since this part of the spine does not carry such an increased load as the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath refers the patient to an MRI or CT scan.The changes in the intervertebral hernia are due to the fact that the fibrous ring - the outer part of the intervertebral disc begins to come out of the tear, while the distance between the vertebrae decreases and the nerve roots are pinched.That is, the annulus fibrosus cracks and the nucleus pulposus (the shock absorber in the center of the disc) begins to protrude into it.
If such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in severe cases, surgery is indicated.The difference between such pain in the intervertebral hernia of the thoracic spine from other pathologies is that it is localized only in one place and the pain can also radiate to the chest, which can resemble symptoms of pulmonary or cardiac dysfunction.If the intervertebral hernia is left untreated for a long time, curvature of the spine, paraparesis of the lower extremities, dysfunction of the pelvic organs and chronic pain syndrome can occur.
Overstrain in combination with hypothermia of the back muscles
Back muscle overload can also cause pain in the area of the shoulder blades;this is not considered a disease, but with frequent excessive loads, heavy lifting, prolonged sitting or monotonous position, the risk of developing osteochondrosis, scoliosis and intervertebral hernias increases.Very often, such pain affects people whose work requires them to be in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when such an occupation and air conditioning are combined, hypothermia, the so-called lumbago, can appear, when the pain becomes stronger and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming ointments, distraction, massage, etc.
To prevent such complications, you should try to avoid drafts, lead a maximum active lifestyle, practice yoga, Bodyflex, therapeutic exercises and undergo a professional massage course every six months.
Spinal tuberculosis
Today, many doctors seem to "forget" about this disease and anti-tuberculosis services in the country are declining for some reason, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has received an injury, especially to the back or wrist, or is simply very cold, with a very weakened immune system, a tubercular focus appears quite often at the site of injury, which even on an X-ray cannot always be recognized in time by specific signs.
Often in such cases, the diagnosis is made only when the person is already exhausted from terrible pain and has a number of complications.With this disease, a person can experience very strong and burning pain between the shoulder blades;patients describe it as twisting or piercing at one point of the spine and also when the focus is localized in the thoracic spine, the pain radiates to the chest, in which a burning sensation, heat and pain are felt.
Spinal tuberculosis is a very insidious disease, and when it appears in parts of the spine, the patient does not always have lung lesions;it can be an independent focus of tuberculosis infection in any part of the spine.People are used to the idea that tuberculosis is a disease that affects only the lower social strata of the population and is localized, as a rule, only in the lungs.This is a big misunderstanding!
When the body's defense forces are weakened, Koch's bacillus, which is present in almost every person's body, is activated in the most weakened organs and a slow inflammatory process begins;these may be the kidneys, lymph nodes, female fallopian tubes, prostate or testicles in men, or individual vertebrae in the spine or joints in the limbs.
Scoliosis
According to statistics, almost 50% of the population has various degrees of scoliosis development - curvature, twisting of the spine, and most often it is the thoracic spine in combination with the cervical or lumbar spine.And since the ribs are connected to the chest regions, the shape of the chest also changes.There are many reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired - intense physical overload, sedentary work in the office or, for schoolchildren, sitting at a desk.
With a lateral and direct X-ray of the chest, a surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis.Therapy for such a pathology should be very intensive and long-term - this includes massage, wearing a special corset and therapeutic exercises.With scoliosis, back pain between the shoulders is the main symptom, and it also has the following symptoms:
- At an early stage, the curvature may be visually subtle, but as the scoliosis progresses, when the patient is examined from behind, the curvature becomes visible.
- With scoliosis, there is increased fatigue of the back muscles
- Shoulders and arm position can be at different heights
- The pain that bothers the patient in the chest is often localized on one side
- Pain between the shoulder blades may be intermittent from severe overexertion or prolonged standing or sitting, or it may also be constant.
Osteochondrosis
Since the main stages of osteochondrosis are now found even in ten-year-old children, this pathology can rightly be called the scourge of a modern city dweller.Recently, this disease was considered a disease of the elderly, but modern life, an unhealthy, sedentary lifestyle, leads to the early development of dystrophic changes in the joints and spine.The cause of back pain is the inflammatory process that develops in the surrounding tissues around the damaged vertebrae, as well as due to compressed nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant and painful back pain, worsened by sneezing, coughing, sudden changes in body position and physical activity
- When you straighten your shoulders, you may hear a crack between your shoulder blades
- Chest pain can be described as feeling like there is a pin
- The reduced mobility of the ribs leads to difficulty in breathing and the person begins to breathe with his stomach.
- Movement in the hands is limited, weakness, tingling or numbness is felt in the hands.
Intercostal neuralgia
Intercostal neuralgia usually bothers a person with pain on one side of the chest, but in rare cases it can also be in the shoulder area.This occurs in situations where compression of the nerve roots in the thoracic region occurs due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the thoracic region.
With intercostal neuralgia, the symptoms and pain intensify with pressure on the chest, when coughing and can disturb the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia are very difficult to differentiate, to clarify the diagnosis, you should contact orthopedists, neurologists, osteopaths and qualified surgeons.
Spondyloarthrosis
This disease is very similar to osteochondrosis, in terms of the nature of pain, factors that intensify it with load and changes in body position.It is also chronic in nature, with periods of flare-ups and remissions.It is possible to distinguish spondyloarthrosis from osteochondrosis only with the help of X-rays, MRI or CT.With this disease, the cartilage is destroyed and replaced by bone tissue, so bony protrusions can be found in the vertebrae.
Myositis of the back muscles
After any hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation of the muscle tissue - myositis - can occur.Like any disease, it can be acute or chronic.The pain can be in any part of the spine;it is painful in nature and also intensifies with palpation, movement and physical activity.This is not a dangerous condition, and using warming and soothing ointments for back pain usually helps.
Diseases of internal organs
As we have already said, pain in the shoulder area on the back is not always a sign of diseases of the spine;almost all diseases of the mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to the appearance of back pain.In our time of oncological tension, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach and lungs can also appear as pain in the shoulder area.
Diseases of the cardiovascular system
Coronary heart diseases, myocardial infarction, angina pectoris are diseases that can also cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes and when taking nitroglycerin it mostly goes away immediately.However, in case of an acute attack, if severe pain lasts more than 5 minutes, blood pressure drops, cold sweat or pale skin appears, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the appearance of pain in the chest region both before and after.Also, the development of stomach and pancreatic cancer can cause such sensations.
Diseases of the respiratory system
If, in addition to back pain, the patient is bothered by cough, the increase in body temperature, even if it is slight, the cause may be lung pathologies.Typically, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections and influenza.Recently, cases of the development of atypical forms of pneumonia have become more frequent, when pneumonia is caused by pathogens such as mycoplasma or chlamydia, they are not accompanied by a very high temperature, but can occur against the background of low temperature, and back pain can appear on the right, left, when you inhale, especially with a deep breath.The main criterion to distinguish lung pathology from other causes is the presence of temperature, even if not high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, say, against the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Vertebral metastases of stomach cancer, for example, can also cause pain
- Spontaneous breakage due to irrational loads.
- Ankylosing spondylitis (Bechterew's disease) is a systemic disease.It affects men more often, in which, against the background of inflammation, the vertebrae are affected and the ossification of the ligaments occurs.As a result, the spine becomes rigid and is described radiographically as a bamboo stick.