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 thoracic organs - the stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which increases rapidly and quickly disappears or significantly increases over time, or chronic, which bothers the patient for a long time and requires an accurate diagnosis, since it can be a symptom of serious pathology of any organ of the chest.Sometimes pain between the shoulder blades can occur only after sudden physical exertion or after being in a certain uncomfortable position for a long time.
It should be remembered that pain in the interscapular region is not a disease, but a symptom, and before using back pain ointments or injections, the real cause of their occurrence should be established.When contacting a doctor, it is very important to describe all the slightest symptoms that accompany the pain, the time of its appearance, the factors provoking its intensification, because the doctor must help determine the direction of the examination and it is sometimes very difficult to establish the correct diagnosis without accurate data on the nature of the pain.
Very often, untimely identification of the true cause of pain between the shoulder blades forces a person to undergo numerous lengthy and expensive examinations, to use various treatment options, which are sometimes prescribed inappropriately and therefore do not bring the desired result.Therefore, it is very important for the patient himself to know the possible list of diseases characterized by this pain syndrome.
Pain caused by spinal pathologies
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but will consider other possible causes of such back pain.
Intervertebral hernia
You should know that a spinal hernia in the thoracic spine is a very rare phenomenon, since this part of the spine does not bear 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.Changes in intervertebral hernia are due to the fact that the annulus fibrosus - the outer part of the intervertebral disc begins to protrude from 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, surgical intervention is indicated.The difference between such pain in intervertebral hernia of the thoracic spine from other pathologies is that it is localized in one place, and the pain can also radiate into the chest, which may resemble symptoms of lung or heart 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 may occur.
Overexertion associated with hypothermia of the back muscles
Excessive strain on the back muscles can also cause pain in 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 hernia increases.Very often, these pains affect people whose work requires them to stay in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when combining such a profession and air conditioning, hypothermia, the so-called lumbago, can occur, when the pain becomes more intense and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming, distracting ointments, massage, etc.
To avoid such complications, you should try to avoid drafts, lead as active a lifestyle as possible, practice yoga, Bodyflex, therapeutic exercises, and take a professional massage course every six months.
Spinal tuberculosis
Today, many doctors seem to "forget" about this disease, and for some reason the country's anti-tuberculosis services are in decline, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has suffered an injury, especially to the back or joints, or is simply very cold, with a very weakened immune system, quite often a tuberculous focus appears 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 by terrible pain and has a number of complications.With this disease, a person may feel very sharp, burning pain between the shoulder blades;Patients describe it as a twisting or piercing at a point in the spine, and also when the focus is located in the thoracic spine, the pain radiates to the chest, in which a burning sensation, heat and pain are felt.
Tuberculosis of the spine is a very insidious disease, and when it occurs in certain parts of the spine, the patient does not always have damage to the lungs;it can be an independent focus of tuberculosis infection in any part of the spine.People are accustomed to the idea that tuberculosis is a disease that affects only the lower social strata of the population and is usually localized only in the lungs.This is a huge misconception!
When the body's defenses are weakened, the Koch bacillus, present in the body of almost everyone, is activated in the most weakened organs and a slow inflammatory process begins;these may include the kidneys, lymph nodes, fallopian tubes in women, the prostate or testicles in men, or individual vertebrae of the spine or joints of the limbs.
Scoliosis
According to statistics, almost 50% of the population has varying degrees of development of scoliosis - curvature, twisting of the spine, and most often it is the thoracic spine in combination with the cervical or lumbar spine.And as the ribs are connected to the thoracic regions, the shape of the chest also changes.The reasons for its development are many - these are congenital pathologies of ligaments, bones, as well as acquired - intense physical overload, sedentary office work or, for schoolchildren, sitting at a desk.
With a lateral and direct chest x-ray, a surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis.Treatment of such pathology should be very intensive and long-term - this includes massage, wearing a special corset and therapeutic exercises.In scoliosis, back pain between the shoulder blades is the main symptom and also has the following symptoms:
- At an early stage, the curvature may be visually subtle, but as scoliosis progresses, when examining the patient from behind, the curvature becomes noticeable.
- With scoliosis, there is increased fatigue of the back muscles
- The position of the shoulders and arms 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 due to severe overexertion or prolonged standing or sitting, or it may also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are now found even in ten-year-old children, this pathology can rightly be called the scourge of the modern city dweller.More recently, this disease was considered a disease of the elderly, but modern life, an unhealthy and 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 pinching of nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant, painful back pain, worsened by sneezing, coughing, sudden changes in body position and physical activity
- When you straighten your shoulders, you can hear a crack between the shoulder blades
- Chest pain can be described as a feeling of difficulty
- Reduced rib mobility leads to difficulty breathing and the person begins to breathe from the stomach.
- Hand movements are limited, weakness, tingling or numbness are 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 occur in the shoulder blades.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, symptoms and pain intensify with pressure on the chest, when coughing, and can bother the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, to clarify the diagnosis, you should contact qualified orthopedists, neurologists, osteopaths and 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 exacerbations and remissions.It is possible to distinguish spondyloarthrosis from osteochondrosis only using x-rays, MRI or CT scans.With this disease, cartilage is destroyed and replaced by bone tissue, so bony protrusions may be found on the vertebrae.
Myositis of the back muscles
After hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation of muscle tissue may occur - myositis.Like any illness, it can be acute or chronic.The pain can come from 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 the use of warming and pain relieving ointments for back pain is usually helpful.
Diseases of internal organs
As we have already said, pain in the shoulder blades of the back is not always a sign of spinal diseases;Almost any disease of the mediastinal organs, heart, stomach, pancreas and gallbladder 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 manifest itself as pain in the shoulder blades.
Diseases of the cardiovascular system
Coronary heart disease, myocardial infarction, angina are diseases that can also cause such pain.For angina.for example, the pain never lasts more than 5 minutes and when taking nitroglycerin it usually goes away immediately.However, in case of an acute attack, if severe pain lasts more than 5 minutes, blood pressure decreases, cold sweat appears or the skin turns pale, 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 thoracic region both front and back.Also, the development of stomach and pancreatic cancer can cause such sensations.
Respiratory system diseases
If the patient, in addition to back pain, is bothered by a cough, an increase in body temperature, even a slight one, the cause may be pulmonary pathologies.As a rule, 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 common, 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-grade fever, and back pain can appear on the right, left, when inhaling, especially intensifying with deep breathing.The main criterion for distinguishing pulmonary pathology from other causes is the presence of fever, even mild, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, for example against the background of long-term use of steroid hormones or a decline in estrogen in postmenopausal women.
- Metastases to the vertebrae from stomach cancer, for example, can also cause pain.
- Spontaneous fractures due to irrational loading.
- Ankylochial spondylitis (Bechterew's disease) is a systemic disease.It more often affects men, in whom, against the background of inflammation, the vertebrae are affected and ossification of the ligaments occurs.As a result, the spine becomes inflexible and is described radiographically as being like a bamboo stick.