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- a type of pain common in various diseases.
The main causes of shoulder blade and back pain
Why does my back hurt around my shoulder blades?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 common causes of back and shoulder blade pain.
Injuries
Injuries to the scapula occur in two ways - by direct impact (impact, fall) and indirectly, by loads along the axis of the upper limb (fall on the elbow, strong contraction of the muscles of the shoulder girdle). In the first case, simultaneous damage to the spine and rib fractures are possible. Such injuries occur in 50% of serious road accidents. Severe pain, limited mobility, and significant swelling of the tissues surrounding the shoulder blade may also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causeBack acheAndspineany location, and also inscapula area. Degenerative-dystrophic processes in the joints and intervertebral discs, resulting from malnutrition and regeneration of cartilage, 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 and pain may be caused by radicular syndrome.
The pain is caused by bending or rotating the body, by lifting weights. Due to concomitant inflammation of the back muscles, pain may increase when raising and abducting the arms. Possible stiffness of the spine, hunched, forced position of the patient with a slight bend forward. The pain may be aching, stabbing, circling in the chest. Some patients describe it as feeling like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease characterized by a pathological S-shaped curvature of the spine, mainly in the coronal plane. As a result, the normal distribution of loads and biomechanics is disrupted. Predisposing factors for scoliosis are poor posture, weak back muscles, childhood and poor workplace organization. Back pain from 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, most often occurring in the thoracic region. Due to kyphosis, the spine begins to resemble a question mark "? "» and the formation of a bump 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.
Kyphosis pain, like scoliosis, is caused by muscle tension and spasm as they are put under excessive stress. At the same time, we feelback muscle painand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change in the intervertebral joints, caused by malnutrition of the articular cartilage, leading to the progressive destruction of the spinal joints. Spondylitis 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 these two processes is ankylosis or fusion of the intervertebral joints, which leads to impaired mobility of the spine. The difference is that in the first case, inflammation is of a secondary nature and occurs in response to the destruction of the joints, and in the second case, primary inflammation leads to degenerative-dystrophic changes.
The pain associated with spondyloarthritis and spondyloarthrosis is aching in nature and intensifies at night. A characteristic symptom is stiffness and stiffness of 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.
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 its elasticity and elasticity, or rather its peripheral part, called the annulus fibrosus, protrudes under the influence of loads and forms a protrusion. If the annulus fibrosus ruptures, the internal contents of the disc fall out, forming a herniated disc. Intervertebral disc protrusions and herniations can cause entrapment of the spinal cord roots emerging from the intervertebral foramina. Sharp pain, protective tension and muscle spasms occur. The pain can radiate towards the shoulder, elbow, forearm and is often localized at the level of the shoulder blades (with herniation or protrusion of the thoracic spine).
Radiculitis
Sharp pain starting in the interscapular region and continuing along the intercostal spaces is the most common sign of radiculitis. It is caused by pinching of the spinal nerves by a herniation or protrusion of the intervertebral disc. More rarely, 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 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 tissues. Predisposing factors include injuries and microtrauma 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 from episodic pain during physical activity, with a large range of movement in the shoulder joint (arm swings, throwing, when placing the arm behind the back). Then the pain becomes constant, painful even at rest. As a result, the patient cannot sleep on the affected side.Pain inshoulder andrestores the shoulder blade. Possible shooting pain during movement. Characterized by a severe limitation of mobility at the shoulder joint, the patient is unable to raise or abduct his arm.
Neuralgia
Aching pain in 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 and throbbing. The cause of the disease is irritation of the roots of the spinal cord due to spinal diseases, spondyloarthritis and spondyloarthrosis, muscle inflammation. Exacerbation can be provoked by drafts, hypothermia and physical activity.
Heart disease
Heart pathologies are often accompanied by severe pain in the left shoulder blade. The cause of the pain syndrome can be angina, coronary heart disease, atherosclerosis of the coronary vessels. Sharp, intense 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 sharp, 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 shoulder blades. Pain is reflected in nature and is due to the fact that part of the pain impulses coming from the solar plexus and receptors of the gastrointestinal tract return to the spinal cord. Pain in the shoulder blades can occur in cases of hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainare locatedin the back between the shoulder blades, moreon the right.
Lung diseases
Pain in the shoulder blades can occur in a number of diseases of the lungs and bronchi. Most often these are pneumonia, acute bronchitis, asthma and other pathologies. Lung cancer patientsback pain in the shoulder blades.
Areas of back pain around the shoulder blades
Pain in 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 provided 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 with glenohumeral periarthrosis. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of loads, therefore 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 shoulder blade can translate into 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 ache,at the level 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 is observed in certain diseases of the heart and lungs (angina, lung cancer, pneumonia).
Types of pain in the shoulder blades
Aching pain in the shoulder blade
Aching pain in the shoulder blade on the left is observed with heart disease, 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 shoulder blades is also possible in cases of spondyloarthritis and spondyloarthrosis.
Pressing pain in the shoulder blade
Pressing pain in the shoulder blade is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by a set of muscles, 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 inspiration
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 injury, back bruising, and soft tissue hematoma. Dull pain in the back and shoulder blades is accompanied by certain spinal cord diseases, such as multiple sclerosis.
Shooting pain in the shoulder blade
Shooting pain in the shoulder blade, which intensifies with movement, sneezing and coughing, is a sign of back injury, fractures and cracks of the shoulder blade. 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 during 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 impacting the heel with the ground are transferred to the diseased intervertebral disc and cause pain.
Burning in the shoulder blades
A burning sensation in 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 severe pain, painful shock and a drop in blood pressure. However, if the posterolateral wall of the left ventricle and the heart septum are damaged, the pain can mimic 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 herniation 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
Pain in the left shoulder blade accompanied by 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 ducts by a stone) - the pain is localized more to the right, nausea is caused by intoxication.
How to relieve pain in the shoulder blades
For spinal diseases and many other illnesses, pain relief is aided by rest and bed rest. An effective way to combat pain is to prescribe painkillers, mainly nonsteroidal 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 containing 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 care is aimed at relieving pain before consulting 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 pain in the shoulder blades, 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 tests, assessment of the range of movements of the shoulder joint and spine, etc. are realized. 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, very precise and provides detailed images of the area of interest. The method is based on the physical phenomenon of magnetic resonance, created using only magnetic fields and radio waves that are safe for human health.
Treatment of shoulder blade pain
The treatment of pain in the back and shoulder blades targets the cause of the disease (etiotropic treatment), the mechanisms of its appearance (pathogenetic treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and condition of the patient. As an example, consider a treatment plan for osteochondrosis of the spine.
To eliminate degenerative-dystrophic phenomena and improve the nutrition of the soft tissues of the spine, chondroprotectors, vitamin therapy, drugs improving blood microcirculation, therapeutic exercises and physiotherapy are prescribed. To relieve tension in the back muscles, a massage is performed and muscle relaxers are prescribed. When a herniated spinal nerve is pinched, physical influence is used - underwater traction, manual therapy. To combat the pain, painkillers are prescribed.
Treating Shoulder Blade Pain at Home
Home treatment is possible only if the patient consulted a doctor, underwent 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, treatment is carried out at home, in accordance with the doctor's prescriptions. However, most often the opposite happens: patients try to be treated at home, self-diagnose and uncontrollably use painkillers. The result of self-diagnosis and self-medication is chronic pain and side effects of painkillers. Patients often come to the doctor late when the disease causes complications. In case of serious illnesses, late treatment significantly worsens the prognosis and reduces the chances of complete recovery. This is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I consult if I have pain in my shoulder blades?
By clarifyingcauses and treatment of pain in the shoulder blades and backis managed by a neurologist, because in most cases the pain syndrome is of neurogenic origin. Almost all of them are diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are taken care of by a traumatologist, but even then, if there are neurological symptoms, a 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 make a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is that if the patient does not consult a doctor and does not self-medicate, the consequences of such "treatment" lead to complications, chronicity of the disease and, in some cases, constitute athreat to human health and life.