Back pain comes in many forms and types. Localization and nature of pain, duration, presence or absence of radiation 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 cause 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. This includes referred pain in lung and heart disease, and gastrointestinal tract disease, as well as pain in radicular syndrome, trauma, and osteochondrosis. Let's take a closer look at the common causes of pain in the back and shoulder blades.
injury
Injury to the scapula occurs in two ways - with direct impact (impact, fall) and indirectly, with load 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 injuries and rib fractures are possible. Such injuries occur in 50% of serious traffic accidents. Severe pain, limited movement, and severe swelling of the tissue around the shoulder blade can also be observed with severe bruising.
Osteochondrosis
Osteochondrosis is a common causebackacheAndbackboneany localization, and also inshoulder blade area. Degenerative-dystrophic processes in the joints and intervertebral 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 may be pinched; the pain may be caused by radicular syndrome.
Pain is provoked by bending or twisting the body, lifting weights. Due to the accompanying inflammation of the back muscles, the pain may increase when lifting and abducting the arm. Possible stiffness of the spine, stooping, forced position of the patient with a slight forward bend. The pain can be aching, shooting, around the chest. Some patients describe it by saying that they feel as if something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which pathological S-shaped curvature of the spine occurs, especially in the coronary plane. As a result, the normal distribution of load and biomechanics is disturbed. Predisposing factors for scoliosis are incorrect posture, weak back muscles, childhood, and incorrect workplace organization. Back pain due to scoliosis is usually caused by spasms, inflammation and tension in the muscles that cannot support and stabilize the weak spine.
Scoliosis is characterized by pain that disappears when lying down and worsens with prolonged standing.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, most often occurring in the thoracic region. As a result of kyphosis, the spinal column begins to resemble a question mark "? ", and the formation of a hump may 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 in the thoracic region.
Pain with kyphosis, like scoliosis, is caused by tension and muscle spasms, because they are subjected to excessive pressure. At the same time it is feltback muscle painand in this regionshoulder blade
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change in the intervertebral joints, caused by malnutrition of the articular cartilage, which leads to the gradual destruction of the spinal joints. 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 impaired movement of the spine. The difference is that in the first case, the inflammation is secondary and occurs in response to joint destruction, and in the second case, the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondyloarthritis and spondyloarthrosis is painful and worsens 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 exacerbation and improvement. Pain can be localized not only between the shoulder blades, but throughout the spine.
Protrusions and hernias
Protrusion and herniation of the intervertebral disc is a consequence of advanced spinal osteochondrosis. The intervertebral disc, which has lost its elasticity and elasticity, or rather its peripheral part, called the fibrous ring, protrudes under the influence of the load and forms a protrusion. If the annulus fibrosus ruptures, the internal contents of the disc will come out, forming a herniated disc. Both protrusions and herniated intervertebral discs can cause entrapment of spinal cord 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 shoulder blade area (with a hernia or protrusion in the thoracic spine).
Radiculitis
Acute pain starting in the interscapular region and continuing along the intercostal space is the most common sign of radiculitis. It is caused by the pinching of a spinal nerve by a herniated or protruding intervertebral disc. Less commonly, sciatica may be caused by a tumor, spondylosis, or vertebral displacement. A characteristic sign of this disease is pain caused by movement in the thoracic spine and lifting heavy objects.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a disease accompanied by pain in the shoulder and scapula, which is caused by arthrosis of the shoulder joint and inflammation of the soft tissue around it. Predisposing factors include injury and microtrauma to 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 blade and shoulder joint.
The pain occurs gradually, intensifies from episodic pain during physical activity, with various movements in the shoulder joint (arm swing, throw, when putting 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.Deep painshoulder andgiving back to the scapula. Possible shooting pains when moving. Characterized by a sharp limitation of movement in the shoulder joint, the patient cannot raise or abduct his arm.
Neuralgia
Pain in the shoulder blade area, radiating along the intercostal nerve, is a sign of neuralgia, a chronic neurological disease. The characteristic symptom is pain that increases when coughing, sneezing, or movement-the pain becomes sharp, shooting. The cause of this disease is irritation of the spinal cord due to spinal disease, spondyloarthritis and spondyloarthrosis, muscle inflammation. Exacerbation can be provoked by drafts, hypothermia, and physical activity.
Heart disease
Heart pathology is often accompanied by severe pain in the area of the left shoulder blade. The cause of the pain syndrome can be angina pectoris, coronary heart disease, atherosclerosis of the coronary vessels. Acute severe pain under the left shoulder blade that does not go away for a long time is a sign of ischemia or myocardial infarction. The nature of the pain is varied - from pain, constant, to acute, with shooting pain in the left shoulder and forearm, neck on the left side. A characteristic symptom is that the pain is relieved with 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 blade area. Pain is reflected in nature, and occurs due to the fact that part of the pain impulse 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 gallstonesillis localbehind between the shoulder blades, againon the right.
Lung disease
Pain in the shoulder blade can occur with some lung and bronchial diseases. Often this is pneumonia, acute bronchitis, asthma and other pathologies. Lung cancer patients oftenback pain in the shoulder blade area.
Back pain area in the shoulder blade area
Pain in the shoulder blade area when inhaling or exhaling is a characteristic sign of intercostal neuralgia, osteochondrosis of the spine 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 movement even in such a number can provoke an increase in pain in the above diseases.
Pain in the sternum and shoulder blades
Pain in the sternum and shoulder blade is often found 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 site of attachment of the clavicle and ribs to the sternum (Tietze syndrome).
Pain in the sternum and shoulder blades also occurs with lung and heart disease.
Pain in the shoulder blade on the right or left side
Pain in the shoulder blade on the left side 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 shoulder blades and neck
Backache,in the shoulder blade and neck areapossibly with osteochondrosis of the cervical and thoracic spine. These symptoms are also characteristic of a hernia or protrusion. Referred pain in the neck and shoulder blades is observed in several heart and lung diseases (angina pectoris, lung cancer, pneumonia).
Types of pain in the scapula
Pain in the shoulder blade
Painful pain in the shoulder blade on the left side is observed with heart disease, on the right side - with disease of the bile ducts, cholelithiasis. Painful pain accompanied by glenohumeral periarthrosis, neuralgia, and radicular radiculitis. Pain in the back and in the shoulder blade area may also occur with spondyloarthritis and spondyloarthrosis.
Depressed pain in the shoulder
A pressing pain in the shoulder blade is characteristic of myositis or inflammatory muscle disease. The shoulder blade is surrounded by various 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 when breathing
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed with pneumonia, lung cancer, neuromuscular pathology, and myositis. These symptoms are also a sign of injury, back bruising, 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 the shoulder blade
Throbbing pain in the scapula, which increases with movement, sneezing and coughing, is a sign of back injuries, fractures and scapular fractures. The most frequent mechanism of injury is a direct physical impact or an indirect impact delivered along the axis of the upper limb, for example, when falling on the elbow.
When moving (walking) pain in the shoulder blade
Pain in the shoulder blade when walking can occur with hernia and protrusion of the thoracic spine. The axial load on the spinal column that occurs when moving and hitting the ground with the heel is transferred to the diseased intervertebral disc and causes pain.
Burning in the shoulder blade area
A burning sensation in the shoulder blade area is a possible sign of acute myocardial infarction. Ischemia (failure of blood circulation 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 septum of the heart are damaged, the pain can mimic spinal osteochondrosis, poor-quality food poisoning, acute surgical pathology and many other diseases.
Burning and tingling in the skin in the interscapular area may be a symptom of a hernia or protrusion of the intervertebral disc of the thoracic and cervical spine. These symptoms occur in multiple sclerosis and other diseases of the spinal cord.
Shoulder pain and nausea
Pain in the left shoulder blade with nausea and vomiting may also indicate an acute myocardial infarction. The same symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (clogging of the lumen of the bile duct with stones) - more localized pain on the right side, nausea caused by hangover.
How to relieve pain in the shoulder blade
For diseases of the spine and many other diseases, pain relief is facilitated by rest and rest. An effective way to combat pain is to prescribe analgesics, especially non-steroidal anti-inflammatory drugs. In some cases, dry heat, distraction 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 is limited to the application area 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, its use as a medical treatment aims to relieve pain before visiting a doctor. After determining the cause, treatment is adjusted taking into account the diagnosis and the individual characteristics of the patient.
How is shoulder blade pain diagnosed?
To diagnose the cause of pain in the shoulder blade, a clinical examination by a doctor is used, which allows a person to identify mild symptoms and characteristic features of certain diseases. Studies on skin sensitivity, reflex tests, assessment of range of motion in shoulder joints and spine, etc. 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 cause of back pain related to pathologies of the spine, spinal cord, joints and soft tissues. This procedure is safe, highly accurate, and allows you to obtain a detailed image of the area of interest. This method is based on the physical phenomenon of magnetic resonance, which is created using only magnetic fields and radio waves that are safe for human health.
Shoulder pain treatment
The treatment of pain in the back and shoulder blades is aimed at the cause of the disease (etiotropic treatment), the mechanism of its occurrence (pathogenetic treatment), and symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the condition of the patient. For 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 that improve blood microcirculation, therapeutic exercises and physiotherapy are prescribed. To relieve tension in the back muscles, massages are performed and muscle relaxants are prescribed. When the herniated spinal nerve is pinched, physical influence is used - underwater traction, manual therapy. To combat pain, analgesics are prescribed.
Treat shoulder blade pain at home
Treatment at home is only possible if the patient has consulted a doctor, undergone an examination, during which an accurate diagnosis has been established. In most cases, the cause of pain in the shoulder blade and back does not require immediate hospitalization; treatment is carried out at home, according to the doctor's prescription. However, more often the opposite happens - patients try to be treated at home, self-diagnose, and use painkillers uncontrollably. The result of self-diagnosis and self-medication is chronic pain and analgesic side effects. 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 possibility of complete recovery. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I consult for shoulder blade pain?
By explainingcauses and treatment of pain in the shoulder blade and backmanaged by a neurologist, because 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 even in this case, if there are neurological symptoms, a consultation with a neurologist is required. In severe cases, if you have back pain, you should at least contact a therapist so that he can make an early 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-medicate - the consequences of such "treatment" lead to complications, chronic diseases, and in some cases pose a threat to human health and life.