Patients rarely pay due attention to recurrent pain in the shoulder blades. However, this symptom is an "awakening" for serious changes not only in the musculoskeletal system, but also in the internal organ complex. Such conditions can endanger the patient with injury and death. How not to miss the disease and cure back pain in the shoulder blades, read on.
Etiology
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 spine. It is therefore not surprising that a common reason for consulting a doctor is pain in the shoulder blades.
However, the pain syndrome is quite variable: often the pain is provoked not by the spine itself, but by a violation of the functions of the internal organs. This fact makes it difficult to diagnose the root cause of the pain syndrome and leads to treatment errors.
Among the main causes of pain are pathologies of the musculoskeletal system and internal systems.
The first group includes:
- osteochondrosis;
- Spinal distortion;
- trauma and spondylolisthesis;
- spondylosis;
- osteoporosis;
- ankylosing spondylitis.
Among the non-vertebral causes, the most common are diseases of the internal organs (pneumonia, heart attack, intercostal neuralgia, gastric ulcer, cholecystitis). Also, tumor processes or mental lability (fibromyalgia, psychogenic pain) can provoke pain.
Variations in pain
Why does the back hurt in the shoulder blades? In general, the pain syndrome can be localized both directly in the area of the shoulder blades and between them. The pain is bilateral (in scoliosis) or is localized mainly on one side (gastric ulcer, cholecystitis).
By the nature of the back pain between the shoulder blades, it can be acute (occurred suddenly with a rapid increase in strength) or chronic (mild and prolonged). The main difference in practice is that the patient can accurately indicate the time of onset of the acute pain syndrome. While remembering the circumstances of the onset of chronic pain will be difficult.
Pathology options
A number of diseases can provoke back pain in the shoulder blades, but we will focus on the most common of them.
- Osteochondrosis.Osteochondrosis is a disease in which there is "aging" of the intervertebral disc. In advanced cases, such pathological changes lead to a herniated disc. When the thoracic spine is affected by osteochondrosis, patients worry about acute back pain between the shoulder blades, which occurs inbending or staying in awkward positions for long periods of time. It is possible to add a noticeable 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, the pain provokes kyphosis (slope, hump) or scoliosis (C, S or Z-shaped spine). With significant deformities of the spine, painful pain aggravated by physical activity occurs. There are frequent episodes of respiratory failure (shortness of breath, inability to "breathe deeply"). The clinic is also accompanied by increased fatigue and headache. In rare cases, the chest is bent.
- Injuries.Acute pain often occurs with direct trauma to the spine or the shoulder blades themselves. Such injuries occur when 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 bruising. In some cases, the attachment of neurological pathology is possible. When the shoulder blade is injured, the pain is sharp, intensifying when waving the arms. Sometimes it is combined with bleeding in the cavity of the shoulder joint - 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 growth of the vertebrae to each other. In such cases, severe pain, neurological and vascular disorders occur.
- Osteoporosis.Osteoporosis is a disease associated with a decrease in the density of the skeletal system. Usually, back pain in the shoulder blade area occurs with a fracture of the thinned thoracic vertebrae. Distortion of the posture appears - 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 a disease that affects the intervertebral joints. The clinic usually begins with pain between the shoulder blades or in the lower back. The soreness is accompanied by stiffness of movements, which intensifies after a night's rest. With the development of the pathology, the spine is deformed, twisted, 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 disease can further affect the cardiovascular and urinary systems.
- Diseases of the internal organs.In pneumonia (inflammation of the lungs), the detailed clinical picture is characterized by fever, sputum production, and unilateral chest or back pain in the scapular region. During a heart attack, the pain is acute (piercing, burning), is determined in the chest and radiates to the left shoulder blade and upper limb. The pain syndrome with intercostal neuralgia is acute and penetrating, manifesting 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. In gastric ulcer, the pain is dull, localized in the upper abdomen, often accompanied by "hungry" pain (with long pauses between meals). In this case, the disease is characterized by digestive disorders, nausea, vomiting and acid belching. Sometimes there is bleeding from the ulcer: patients feel pain with a dagger, which disappears in the midst of bleeding. Vomiting and stools become dark (almost black) in color due to blood impurities. Cholecystitis (inflammation of the gallbladder) is characterized by the appearance of a characteristic syndrome of paroxysmal pain in the right hypochondrium, spreading to the right side and shoulder blade. The clinic of the disease includes digestive disorders, the provoking factor of which is the consumption of fatty and fried foods. Occasionally, vomiting with bile impurities occurs.
- Tumors.Pain in the shoulder blades can occur in neoplastic diseases of the vertebrae or nerve sheath (neuroma). Metastases (daughter tumors) from the affected prostate or mammary glands can spread to the spinal 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 "guard dog symptoms": pain, weight loss, fever and constant weakness for no apparent reason.
- Mental lability.Mental instability to stress and emotional outbursts can manifest as psychogenic pain. It occurs against the background of complete health: patients may experience sensations of varying intensity that cannot be treated even with painkillers. Stressful situations provoke another idiopathic (causeless) pain - fibromyalgia. The disease occurs against the background of prolonged pain, intensifying at certain (trigger) points.
Diagnosis
Radiography is the gold standard for examining the spine. Computed tomography can be used to determine the cause of the back pain. Ultrasound or MRI is used to examine other organs and systems. Laboratory or other instrumental methods of examination may be required to rule out concomitant pathology.
Treatment
These pathological conditions require a specific treatment plan; only a doctor can prescribe medication.
- Osteochondrosis.Non-steroidal anti-inflammatory drugs and analgesics are used as drug therapy to relieve pain. Physical therapy, therapeutic gymnastics and massage are also effective. In the later stages of the disease, surgery to remove the hernia sac is recommended.
- Spinal deformities.Conservative therapy for curvature of the spine consists in 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 to fix the spine in an 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. In severe pain syndrome, the blockade is performed with painkillers.
- Osteoporosis.Osteoporosis care involves high doses of calcium and vitamin D supplements. Hormone therapy with female sex hormones, thyroid hormones and other hormones is also possible.
- Ankylosing spondylitis.Inflammation and pain are controlled by anti-inflammatory therapy. An antimetabolite from the group of structural analogs of folic acid is prescribed to modify the immune response. 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 and anti-inflammatory ointments. Distraction therapy with topical agents with red pepper extract or bee venom is often used. Treatment of gastric ulcers consists of combination 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 the bile. In some cases, antibiotic therapy may be needed. 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. Reducing psycho-emotional stress is an important part of treatment.
How to prevent?
To prevent back pain in the shoulder blades, lifestyle changes are needed: increase the nutritional value of the diet, exercise, quit smoking and drinking. Timely detection and treatment of chronic diseases is important to avoid stress overload.
Remember that pain is not a disease in itself, but a manifestation of a much more serious pathology that requires diagnosis and proper treatment!