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 chest organs: the stomach, heart, respiratory system and mediastinal organs.
Such pain can be acute, which increases rapidly and passes quickly or increases significantly 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 may appear 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 ointments for back pain or injections, the real cause of its occurrence should be established.When contacting a doctor, it is very important to describe all the mildest symptoms accompanying the pain, the time of its appearance, the factors provoking its intensification, since the doctor needs to help determine the direction of the examination, and sometimes it is 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 many expensive and lengthy examinations, to use various treatment options, which are sometimes prescribed inappropriately and therefore do not provide the desired result.Therefore, it is very important that the patient himself knows the possible list of diseases that characterize this pain syndrome.
Pain caused by pathologies of the spine.
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but we will consider other possible causes of this type of back pain.
intervertebral hernia
You should know that a vertebral hernia in the thoracic spine is very rare, since this part of the spine does not support as high a load as the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath refers the patient for 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 cushion in the center of the disc) begins to protrude into it.
If such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, physiotherapy, reflexology, and in severe cases, surgery is indicated.The difference between pain in intervertebral hernia of the thoracic spine and other pathologies is that it is localized in one place and the pain can also radiate to the chest, which can resemble the symptoms of pulmonary or cardiac dysfunction.If the intervertebral hernia is not treated 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 in combination with hypothermia of the back muscles.
Excessive tension of the back muscles can also cause pain in the shoulder blade area;This is not considered a disease, but with frequent excessive loads, heavy lifting, prolonged sitting or a monotonous position, the risk of developing osteochondrosis, scoliosis and intervertebral hernias increases.Most often, this pain affects people whose work requires them to be in the same position for several hours a day: seamstresses, drivers, office workers and surgeons.
Sometimes, when such a profession and air conditioning are combined, 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 heat-distracting ointments, massages, etc.
To prevent such complications, you should try to avoid drafts, lead as active a lifestyle as possible, practice yoga, Bodyflex, therapeutic exercises and undergo a professional massage course every six months.
Spinal tuberculosis
Nowadays, many doctors seem to “forget” about this disease and anti-tuberculosis services in the country for some reason are declining, but almost 90% of the population is infected with Mycobacterium tuberculosis since childhood.If a person has suffered an injury, especially to the back or joints, or is simply very cold and has a very weakened immune system, a tuberculous focus often appears at the site of the injury, which even by 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 experience very intense, burning pain between the shoulder blades;Patients describe it as a twist or perforation at a point in the spine, and also when the focus is located in the thoracic spine, the pain radiates to the chest, where a sensation of burning, heat and pain is felt.
Tuberculosis of the spine is a very insidious disease and, when it occurs in parts of the spine, the patient does not always have lesions in the lungs;It may be an independent focus of tuberculous 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 that, as a rule, it is located only in the lungs.This is a big mistake!
When the body's defenses are weakened, the Koch bacillus, present in almost all people, is activated in the most weakened organs and begins a slow inflammatory process;These may be the kidneys, lymph nodes, fallopian tubes in women, the prostate or testicles in men, or individual vertebrae in the spine or joints in the extremities.
scoliosis
According to statistics, almost 50% of the population has various 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 since the ribs are connected to the thoracic regions, the shape of the chest also changes.There are quite a few reasons for its development: these are congenital pathologies of ligaments, bones, and acquired: intense physical overload, sedentary office work or, for schoolchildren, sitting at a desk.
With a direct, lateral chest x-ray, a surgeon, neurologist, orthopedist, or osteopath can make a similar diagnosis.Therapy for such a pathology must be very intensive and long-term;This includes massages, use of 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 usually located on one side.
- Pain between the shoulder blades may be intermittent due to intense 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 considered the scourge of a modern city dweller.More recently, this disease was considered a disease of older people, but modern life, a sedentary and unhealthy 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 due to pinching of the nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant and painful back pain, aggravated by sneezing, coughing, sudden changes in body position and physical activity.
- When straightening your shoulders, a crunch can be heard between your shoulder blades.
- Chest pain can be described as a feeling that something is at stake.
- Reduced mobility of the ribs causes difficulty breathing and the person begins to breathe with the stomach.
- Movement in the hands is limited, weakness, tingling or numbness is 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 appear in the shoulder blade area.This occurs in situations where compression of the nerve roots in the thoracic region occurs due to excessive stress, hypothermia, injuries, infectious diseases or osteochondrosis of the thoracic region.
In intercostal neuralgia, the symptoms and pain intensify with pressure on the chest, 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 the pain, the factors that intensify it with loading 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 with the help of X-ray, MRI or CT scan.In this disease, cartilage is destroyed and replaced by bone tissue, which is why bony protrusions can be found on the vertebrae.
Myositis of the back muscles
After any hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation can occur in the muscle tissue - myositis.Like any disease, it can be acute or chronic.The pain can be anywhere in 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 warm ointments and pain relievers for back pain is often helpful.
Diseases of internal organs.
As we have already said, pain in the shoulder blade area in the back is not always a sign of spinal diseases;Almost all diseases of the mediastinal organs, heart, stomach, pancreas and gallbladder can contribute to the occurrence of back pain.In our era 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 blade area.
Diseases of the cardiovascular system.
Coronary heart disease, myocardial infarction and angina are diseases that can also cause this pain.For angina pectoris.For example, the pain never lasts more than 5 minutes and when nitroglycerin is taken, most of the time it goes away immediately.However, in case of an acute attack, if severe pain lasts more than 5 minutes, blood pressure decreases, cold sweat or pale skin appears, an ambulance should be called immediately.
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 in front and behind.Also, the development of stomach and pancreatic cancer can provoke such sensations.
Diseases of the respiratory system.
If the patient, in addition to back pain, is bothered by cough, an increase in body temperature, even if slight, the cause may be lung pathologies.Typically, 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 frequent, 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, on the left, when inhaling, especially intensifying with deep breathing.The main criterion for distinguishing lung pathology from other causes is the presence of fever, although not high, 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 drop in estrogen in postmenopausal women.
- Metastases to the vertebrae from stomach cancer, for example, can also cause pain.
- Spontaneous fractures due to irrational loads.
- Ankylochial spondylitis (Bechterew's disease) is a systemic disease.It most 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 radiologically described as a bamboo stick.