Back pain comes in many forms and varieties. Localization 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 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, pathologies of muscles 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 closer look at the most 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, 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. In case of severe bruising, intense pain, limited mobility and severe swelling of the tissues surrounding the shoulder blade may also be observed.
Osteochondrosis
Osteochondrosis is a common causebackacheANDvertebral columnany localization, and also inscapula area. Degenerative-dystrophic processes in the 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 may be pinched; the pain may be caused by radicular syndrome.
The pain is caused by bending or turning the body, lifting weights. Due to concomitant inflammation of the back muscles, pain may increase when raising and abducting the arms. Possible stiffness of the spine, curvature, forced position of the patient with a slight bending forward. The pain can be aching, stabbing, circling the chest. Some patients describe it by saying they feel like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which a pathological S-shaped curvature of the spine occurs, mainly in the coronary plane. As a result, the normal distribution of loads and biomechanics is disrupted. Predisposing factors for scoliosis are poor posture, weakening of the 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 intensifies with prolonged standing.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, which occurs most often in the thoracic region. As a result of kyphosis, the spine begins to resemble a question mark "? " and a hump may begin to form. 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 subjected to excessive stress. At the same time it makes itself feltback muscle painand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic alteration of the intervertebral joints, caused by malnutrition of the articular cartilage, which 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 reduced mobility of the spine. The difference is that in the first case the inflammation is secondary in nature and occurs in response to the destruction of the joints, and in the second case the primary inflammation leads to degenerative-dystrophic changes.
The pain in spondyloarthritis and spondyloarthrosis is aching in nature and intensifies at night. A characteristic symptom is stiffness and stiffening of the spine in the morning, which disappears after gymnastics or physical activity. The course of the disease is chronic, wavy, with periods of exacerbations and improvements. The pain can be localized not only between the shoulder blades, but throughout the spine.
Protrusion and hernia
Protrusions and herniations of the 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 internal contents of the disc fall out, forming a herniated disc. Both protrusions and herniations of the intervertebral discs can cause entrapment of the spinal cord roots emerging through the intervertebral foramina. Sharp pain, protective tension and muscle spasm occur. The pain can radiate to the shoulder, elbow, forearm and is often localized in the shoulder blade area (with hernia or protrusion in the thoracic spine).
Radiculitis
Sharp pain that begins in the interscapular region and continues along the intercostal spaces is the most common sign of radiculitis. It is caused by crushing of the spinal nerves by a herniated or protruded intervertebral disc. Less commonly, sciatica can be caused by a tumor, spondylosis, or spinal 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 disease accompanied by pain in the shoulder and scapula, caused by arthrosis 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. Humeral periarthrosis is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain occurs gradually, intensifying with episodic pain during physical activity, with a wide range of movements of the shoulder joint (arm swings, throws, when placing the arm behind the back). Then the pain becomes constant, painful even at rest. For this reason the patient is unable to sleep on the affected side.Acheshoulder andreturns to the scapula. Possible shooting pain during movement. Characterized by a strong limitation of the mobility of the shoulder joint, the patient is unable to raise or abduct the arm.
Neuralgia
Aching pain in the shoulder blade area, 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, stabbing. 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 disease
Heart disease is often accompanied by severe pain in the left shoulder blade area. The cause of pain syndrome can be angina pectoris, coronary heart disease, atherosclerosis of the coronary vessels. A sharp sharp pain under the left shoulder blade that does not go away for a long time is a sign of myocardial ischemia or infarction. The nature of the pain is varied: from aching, constant, to acute, with shooting pain in the left shoulder and forearm, neck on the left. A characteristic symptom is that the pain is relieved by 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 scapula area. Pain is reflected in nature and occurs due to the fact that part of the painful impulses coming from the solar plexus and receptors in the gastrointestinal tract returns to the spinal cord. Pain in the shoulder blade area can occur with hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonesAchethey are localizedin the back between the shoulder blades, Moreoveron the right.
Lung diseases
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.
Areas of back pain in the shoulder blade area
Pain in the shoulder blade area during inhalation or exhalation is a characteristic sign of intercostal neuralgia, spinal osteochondrosis with protrusion or herniation of the intervertebral disc, inflammation of the back muscles and radiculitis. The reason for the pain is that the act of breathing is ensured by the coordinated contraction of a large number of muscles, and movements even at such a 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. Inflammatory and degenerative-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 with diseases of the lungs and heart.
Pain in the right or left shoulder blade
Pain in the left scapula may be reflected in heart disease, as mentioned above. Pain in the right scapula 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 scapula is observed in some heart and lung diseases (angina pectoris, lung cancer, pneumonia).
Types of shoulder blade pain
Aching pain in the shoulder blade
Aching pain in the scapula on the left is observed with heart diseases, on the right - with diseases of the biliary tract, cholelithiasis. Aching pain is accompanied by glenohumeral periarthrosis, neuralgia and radicular radiculitis. Aching pain in the back and in the shoulder blade area is also possible in spondyloarthritis and spondyloarthrosis.
Pressing pain in the scapula
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 may also be accompanied by pain.
Dull pain during inhalation
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed in cases of pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injuries, bruises on the back and soft tissue hematomas. Dull pain in the back and shoulder blades is accompanied by some spinal cord diseases, such as multiple sclerosis.
Pulsating pain in the shoulder blade
Throbbing pain in the scapula, which intensifies with movement, sneezing and coughing, is a sign of back injuries, fractures and cracks 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 the event of a fall 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 area
A burning sensation in the shoulder blade area is a possible sign of acute myocardial infarction. Ischemia (circulatory failure and oxygen deficiency in the heart muscle) of the myocardium is accompanied by severe pain, painful shock and a drop in blood pressure. However, if the posterolateral wall of the left ventricle and the cardiac septum are damaged, the pain can imitate spinal osteochondrosis, 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 a 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
Left scapular pain 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 a stone) - the pain is localized further to the right, nausea is caused by intoxication.
How to relieve shoulder blade pain
In diseases of the spine and many other diseases, rest and bed rest contribute to pain relief. An effective way to combat pain is to prescribe analgesics, mainly 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 to consult a doctor. The reason is that long-term use of painkillers increases the risk of serious and dangerous complications. Therefore, their use as medical assistance is aimed at relieving pain before visiting 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 shoulder blade pain, a clinical examination by a doctor is used, which allows you to identify mild symptoms and signs characteristic of a particular disease. A study of skin sensitivity, reflex testing, assessment of the range of motion of the shoulder joint and spine, etc. is carried out. Instrumental methods such as ECG, ultrasound, CT or MRI are used to confirm the diagnosis.
MRI 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 you to obtain detailed images of the area of interest. The method is based on the physical phenomenon of magnetic resonance imaging, which is created using only magnetic fields and radio waves that are safe for human 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 (pathogenic treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the patient's 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, a massage is performed and muscle relaxants are prescribed. When a herniated spinal nerve is pinched, physical influence is used: underwater traction, manual therapy. Analgesics are prescribed to combat the pain.
Treat shoulder blade pain at home
Home treatment 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 shoulder blade and back pain do not require urgent hospitalization; the treatment is carried out at home, according to the doctor's prescriptions. However, more often the opposite happens: patients try to seek treatment at home, self-diagnose and uncontrollably use painkillers. The result of self-diagnosis and self-medication is chronic pain and side effects of analgesics. Patients often turn to the doctor late when the disease causes complications. In case of serious diseases, late treatment significantly worsens the prognosis and reduces the likelihood of a complete recovery. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I see for shoulder blade pain?
ClarifyingCauses and treatment of shoulder blade and back painis managed by a neurologist, since in most cases the pain syndrome is of neurogenic origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are treated by a traumatologist, but again, if neurological symptoms are present, consultation with a neurologist is necessary. In extreme cases, if you suffer from back pain, you should at least contact a therapist so that he can establish a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is if the patient does not see 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.