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 from lung and heart diseases and diseases of the gastrointestinal tract as well as pain from radicular syndromes, trauma and osteochondrosis. Let's take a closer look at the common causes of pain in the back and shoulder blades.
Injuries
Damage to the scapula occurs in two ways - with direct impact (impact, fall) and indirect, 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 spinal cord injury and rib fractures are possible. Such injuries occur in 50% of serious traffic accidents. Severe pain, limited mobility and severe swelling of the tissues around the shoulder blade can also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causeback painAndspineany localization, and also inshoulder blade area. Degenerative-dystrophic processes in the intervertebral joints and discs, as a result of 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 can get pinched, pain can be caused by radicular syndrome.
The pain is induced by bending or turning the body, lifting weights. Due to simultaneous inflammation of the back muscles, pain may increase when the arms are raised and abducted. Possible stiffness of the spine, bent, forced position of the patient with a slight forward bend The pain can be tenderness, shooting, enveloping the chest. Some patients describe it by saying that 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 disturbed. Predisposing factors for scoliosis are incorrect posture, weak back muscles, childhood and incorrect 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 most often occurs in the thoracic region. As a result of kyphosis, the spine begins to look like a question mark "? ", and the formation of a hump can begin. 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 with kyphosis, as with scoliosis, is caused by tension and muscle spasms as they are subjected to excessive stress. At the same time, it is feltpain in back musclesand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is degenerative-dystrophic changes in the intervertebral joints, caused by malnutrition of the articular cartilage, which leads to 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, leading to reduced mobility of the spine. The difference is that in the first case inflammation is secondary in nature and occurs in response to destruction of the joints, and in the second case 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 in 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 only between the shoulder blades, but throughout the spine.
Protrusions and hernias
Protrusions and herniations of intervertebral discs are a consequence of advanced osteochondrosis of the spine. The intervertebral disc, which has lost its elasticity and elasticity, or rather its peripheral part, which is called the fibrous ring, protrudes under the influence of loads and forms a protrusion. If the annulus fibrosus ruptures, the inner contents of the disc fall out and form a herniated disc. Both protrusions and herniated intervertebral discs can cause entrapment of the spinal roots emerging through the intervertebral foramina. Acute pain, protective tension and muscle spasms occur. The pain can radiate to the shoulder, elbow, forearm and is often localized in the area of the shoulder blades (with a hernia or protrusion in the thoracic spine).
Radiculitis
Acute pain that starts in the interscapular region and continues along the intercostal spaces is the most common sign of radiculitis. It is caused by compression of the spinal nerves by a herniated or prolapsed intervertebral disc. Less commonly, sciatica can be caused by a tumor, spondylosis or vertebral displacement. A characteristic sign of the disease is pain caused by movements of the thoracic spine and lifting of 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 tissue. 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 frequent cause of acute pain in the shoulder blades and shoulder joint.
The pain occurs gradually, intensifies from episodic pain during physical activity, with a large range of motion in the shoulder joint (arm swing, throw, when placing the arm behind the back). Then the pain becomes constant, painful even at rest. Because of that, the patient cannot sleep on the affected side.Pain inshoulder andgives back to the shoulder blade. Possible shooting pains with movement. Characterized by a sharp limitation of mobility in the shoulder joint, the patient is unable to raise or abduct his arm.
Neuralgia
Pain in the area of the shoulder blades 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, shooting. The cause of the disease is irritation of the spinal cord roots due to diseases of the spine, spondyloarthritis and spondyloarthrosis, muscle inflammation. Aggravation can be induced by drafts, hypothermia and physical activity.
Heart diseases
Heart pathologies are often accompanied by severe pain in the area of the left shoulder blade. The cause of pain syndrome can be angina pectoris, coronary heart disease, atherosclerosis in the coronary vessels. Acute severe 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 pains in the left shoulder and forearm, neck on the left. A characteristic symptom is that pain is relieved with nitrates (medicines 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. The pain is reflected in nature, and arises because part of the pain impulses from the solar plexus and receptors in the gastrointestinal tract return to the spinal cord. Pain in the area of the shoulder blades can occur with hiatal hernia, chronic or acute pancreatitis, peptic ulcer and duodenal ulcer. For cholecystitis and gallstonespainis localizedin the back between the shoulder blades, moreto 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 area of the shoulder blades.
Areas of back pain in the area of the shoulder blades
Pain in the area of the shoulder blades when inhaling or exhaling 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-mentioned diseases.
Pain in the sternum and shoulder blades
Pain in the sternum and shoulder blades is often seen with 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 place 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 shoulder blade on the right or left
Pain in the shoulder blade on the left 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 the shoulder blades and neck
Back pain,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 has been observed in some diseases of the heart and lungs (angina pectoris, lung cancer, pneumonia).
Types of shoulder blade pain
Pain in the shoulder blade
Pain in the shoulder blade on the left is observed with heart diseases, on the right - with diseases of the biliary tract, cholelithiasis. Pain is accompanied by glenohumeral periarthrosis, neuralgia and radicular radiculitis. Pain in the back and in the area of the shoulder blades is also possible with spondyloarthrosis and spondyloarthrosis.
Pressing pain in shoulder blade
Pressing pain in the shoulder blade 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 can also be accompanied by pain.
Dull pain on inhalation
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed with pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injury, bruising of the back and soft tissue hematoma. Dull pain in the back and shoulder blades is accompanied by some diseases of the spinal cord, such as multiple sclerosis.
Throbbing pain in shoulder blade
Throbbing pain in the scapula, which is aggravated by movement, sneezing and coughing, is a sign of a 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 area of the shoulder blades
A burning sensation in the area of the shoulder blades is a possible sign of acute myocardial infarction. Ischemia (circulatory failure and lack of oxygen in the heart muscle) of the myocardium is accompanied by intense pain, painful shock and a drop in blood pressure. But if the posterolateral wall of the left ventricle and the septum of the heart are damaged, pain can mimic spinal osteochondrosis, poor-quality food poisoning, acute surgical pathology and many other diseases.
Burning and tingling of the skin in the interscapular area can be a symptom of a herniated or protruding intervertebral disc in the thoracic and cervical spine. This symptom occurs in multiple sclerosis and other diseases of the spinal cord.
Shoulder pain and nausea
Pain in the left scapula with nausea and vomiting may also indicate acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (blockage of the lumen of the bile duct with a stone) - pain is localized more to the right, nausea is caused by poisoning.
How to relieve pain in the shoulder blades
In diseases of the spine and many other diseases, pain relief is facilitated by rest and bed rest. 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 analgesics increases the risk of serious and dangerous complications. Therefore, their use as medical treatment is aimed at relieving pain before visiting a doctor. After determining the cause, treatment is adjusted taking into account the patient's diagnosis and individual characteristics.
How is shoulder blade pain diagnosed?
To diagnose the causes of pain in the shoulder blades, a clinical examination by a doctor is used, which makes it possible to identify mild symptoms and signs characteristic of a particular disease. An examination of skin sensitivity, test of reflexes, assessment of range of motion in shoulder joints and spine etc. is carried out. To confirm the diagnosis, instrumental methods such as ECG, ultrasound, CT or MRI 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 you to obtain detailed images of the area of interest. The method is based on the physical phenomenon of magnetic resonance, which is only created using 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 (pathogenetic treatment) and symptoms (symptomatic treatment). The treatment plan depends on the patient's diagnosis and condition. As an 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, massage is performed and muscle relaxants are prescribed. When a herniated spinal nerve is pinched, physical impact is used - underwater traction, manual therapy. To combat pain, painkillers are prescribed.
Treatment of shoulder blade pain at home
Treatment at home is only possible if the patient has consulted a doctor, undergone an examination in which an accurate diagnosis has been established. In most cases, the causes of pain in the shoulder blade and back do not require emergency hospitalization; the treatment is carried out at home in accordance with the doctor's prescriptions. But more often the opposite happens - patients try to be treated at home, self-diagnose and use uncontrolled painkillers. The result of self-diagnosis and self-medication is chronic pain and side effects of analgesics. Patients often come to the doctor late when the disease causes complications. In the case of serious diseases, late treatment significantly worsens the prognosis and reduces the likelihood of a complete recovery. Therefore, any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I contact for shoulder blade pain?
By clarifyingcauses and treatment of pain in shoulder blades and backis handled by a neurologist, as the pain syndrome is in most cases of neurogenic origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spinal cord injuries are treated by a traumatologist, but even in this case, if there are neurological symptoms, a consultation with a neurologist is required. In extreme cases, if you have back pain, you should at least contact a doctor so that he can make 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 self-medicates - the consequences of such "treatment" lead to complications, chronic diseases and in some cases pose a threat to human health and life.