Back pain in the area of ​​the shoulder blades: causes of the disease, treatment.

Patients rarely pay due attention to recurring pain in the area of the shoulder blades. However, this symptom is a "wake-up call" for serious changes not only in the musculoskeletal system, but also in the internal organ complex. Such conditions can threaten the patient with disability and death. How not to miss the disease and cure back pain in the shoulder blades area, read on.

Etiology

The spine is the main component of the human musculoskeletal system. So most of the pressure during static or dynamics falls on the spine. Therefore, it is not surprising that a common reason for consulting a doctor is pain in the area of the shoulder blades.

However, the pain syndrome is quite changeable: often the pain is provoked not by the spine itself, but by a violation of the functions of internal organs. This fact makes it difficult to diagnose the root cause of the pain syndrome and leads to errors in treatment.

Among the main causes of pain, pathologies of the musculoskeletal and internal systems are distinguished.

The first group includes:

1. osteochondrosis;
2. spinal deformities;
3. trauma and spondylolisthesis;
4. spondylosis;
5. osteoporosis;
6. ankylosing spondyloarthritis.

Among the non-vertebral causes, diseases of the internal organs are the most frequent (pneumonia, heart attack, intercostal neuralgia, stomach ulcer, cholecystitis). In addition, tumor processes or mental lability (fibromyalgia, psychogenic pain) can cause pain.

Pain variations

Why does my back hurt in the area of the shoulder blades? In general, the pain syndrome can be localized both directly in the area of the shoulder blades and between them. The pain is bilateral (with scoliosis) or localized mainly on one side (gastric ulcer, cholecystitis).

By the nature of back pain between the shoulder blades, it can be acute (occur abruptly with a rapid increase in strength) or chronic (weak and prolonged). The main difference in practice is that the patient can accurately name the time of onset of the acute pain syndrome. Although remembering the circumstances of the onset of chronic pain will be difficult.

Pathology options

Several diseases can cause back pain in the area of the shoulder blades, but we will focus on the most common.

• Osteochondrosis.Osteochondrosis is a condition during which "aging" of the intervertebral disc occurs. In advanced cases, such pathological changes lead to a herniated bulging of the disc. When the thoracic spine is affected by osteochondrosis, patients are concerned about acute back pain between the shoulder blades, which occurs when bending over or staying in awkward positions for prolonged periods. It is possible to add tangible weakness of the back muscles, disturbances in the perception of temperature and pain.
• Spinal deformities.One of the causes of pain between and in the area of the shoulder blades is the curvature of the spine. As a general rule, pain causes kyphosis (stooping, humping) or scoliosis (spine shaped like a C, S, or Z). With significant deformities of the spine, painful pain appears, aggravated by physical activity. There are frequent episodes of respiratory failure (shortness of breath, inability to "breathe deeply"). The clinic is also accompanied by increased fatigue and headaches. In rare cases, the chest is bent.
• InjuriesAcute pain often occurs with direct trauma to the spine or the shoulder blades themselves. Similar injuries occur from falling from a height, hit with a blunt object, transportation or industrial accidents. Spinal injuries are associated with palpable pain, reflex contraction of the back muscles, and bruising. In some cases, the linkage of neurological pathology is possible. When the scapula is traumatized, the pain is sharp, aggravated by swinging the arms. Sometimes it is combined with hemorrhages in the cavity of the shoulder joint - hemarthrosis.
• SpondylosisSpondylosis is called senile destructive processes in the spine. Usually, in the area of the intervertebral joints, the bone tissue grows: osteophytes are formed, which can be complicated by the increase of the vertebrae relative to each other. In such cases, severe pain, neurological and vascular disorders appear.
• Osteoporosis.Osteoporosis is a condition associated with a decrease in the density of the bone system. Usually, pain in the back in the area of the shoulder blades occurs when a fracture of the thoracic thinned vertebrae occurs. The curvature of the posture appears: the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (disappearance of motor activity and sensitivity).
• Ankylosing spondyloarthritis. . . Ankylosing spondylitis is a condition that affects the intervertebral joints. Usually the clinic begins with pain between the shoulder blades or in the lower back. The pain is accompanied by stiffness of movements, which intensifies after a night's rest. With the development of pathology, the spine is deformed, arches, which leads to curvature of the chest and respiratory failure. In such a pathological position, ankylosis (immobilization) of the intervertebral joints occurs, due to which the patient can no longer bend. In this case, the ailment can additionally affect the cardiovascular and urinary systems.
• Diseases of the internal organs.With pneumonia (inflammation of the lungs), a detailed clinical picture is characterized by fever, sputum production, and one-sided pain in the chest or back in the area of the shoulder blades. During a heart attack, the pain is sharp (stabbing, burning), is determined in the chest and radiates to the left scapula and upper limb. The pain syndrome with intercostal neuralgia is acute and penetrating, manifesting itself in the form of attacks that interfere with the patient's breathing. The pain occurs along the ribs, is distributed under the shoulder blades, clavicle and lower back. With a stomach ulcer, the pain is dull, localized in the upper abdomen, often accompanied by "hungry" pains (with long breaks between meals). In this case, the ailment is characterized by digestive disorders, nausea, vomiting and sour belching. Sometimes there is bleeding from the ulcer: patients feel a stabbing pain, which disappears at the peak of the bleeding. Vomiting and stool turn dark (almost black) due to impurities in the blood. Cholecystitis (inflammation of the gallbladder) is characterized by the appearance of a characteristic paroxysmal pain syndrome in the right upper quadrant, extending to the right side and the scapula. The clinic of the disease includes digestive disorders, the provoking factor of which is the consumption of fatty and fried foods. Sometimes vomiting with impurities of bile appears.
• TumorsPain in the area of the shoulder blades can appear with neoplastic diseases of the vertebrae or nerve sheath (neuroma). Metastases (daughter tumors) from the prostate or affected mammary glands can spread to the vertebral region. In this case, the tumor process is characterized by an asymptomatic course and the appearance of pain is associated with an increase in the neoplasm and its pressure on the neurovascular bundle. Cancer can be suspected from "watchdog symptoms": pain, weight loss, fever, and constant weakness for no apparent reason.
• Mental labilityThe instability of the psyche in the face of stress and emotional outbursts can manifest as psychogenic pain. It arises in the context of complete health: patients can experience sensations of various strengths that cannot be treated even with painkillers. Stressful situations also cause another idiopathic pain (without cause): fibromyalgia. The disease progresses against the background of prolonged pain sensations, which intensify at certain points (triggers).

Diagnostics

Radiography is the gold standard for examining the spine. To determine the cause of spinal pain, computed tomography can be used. To study other organs and systems, ultrasound or MRI diagnostics are used. To exclude concomitant pathology, laboratory examination methods or other instruments may be needed.

Treatment

These pathological conditions require a specific treatment plan; only a doctor can prescribe medication.

• Osteochondrosis.As drug therapy for pain relief, analgesics and non-steroidal anti-inflammatory drugs are used. Physical therapy, recovery gymnastics, and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernial sac.
• Spinal deformities.Conservative therapy for curvature of the spine consists of the use of support devices (corsets, bandages). You also need sufficient activity, massage, and physical therapy (paraffin applications, electrical stimulation). In the case of significant deformity, surgical treatment methods are indicated to fix the spine in the anatomically correct position.
• InjuriesMinor injuries are treated with rest, heat, and massage; more serious injuries may require traction. If conservative methods are ineffective, the spine is reconstructed with a surgical method.
• SpondylosisThe treatment of this pathology aims to slow down the progression of the disease. Therefore, hyaluronic acid injections, chondroprotectors, physical therapy (shock wave therapy), and physical therapy exercises are prescribed. With severe pain syndrome, the blockage is done with painkillers.
• Osteoporosis.Osteoporosis care includes high doses of calcium and vitamin D supplements. Hormone therapy with female sex hormones, thyroid, and other hormones is also possible.
• Ankylosing spondyloarthritis.Inflammation and pain are controlled by anti-inflammatory therapy. To modify the immune response, an antimetabolite from the group of structural analogues of folic acid is prescribed. During remission, physical therapy, breathing exercises, and therapeutic massages are performed.
• Diseases of the internal organs.Therapy for pneumonia includes antibacterial agents, as well as medications that relieve bronchospasm. During the rehabilitation period, vibratory massages and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warming and anti-inflammatory ointments. Distraction therapy with topical remedies with red pepper extract or bee venom is often used. The treatment of stomach ulcers consists of a combination therapy of antibiotics, as well as drugs that reduce the acidity of the gastric contents. Help with cholecystitis includes the use of antispasmodics and medications that affect the bile. In some cases, antibiotic therapy may be required. In the presence of large stones in the gallbladder, it is recommended to remove the latter - cholecystectomy.
• TumorsTreatment of tumor processes consists of chemotherapy with antineoplastic agents and surgical removal (if possible) of the neoplasm.
• Mental labilityMental lability requires intensive psychotherapy, as well as the use of antidepressants or anxiolytics. Limiting psycho-emotional stress is an important part of treatment.

How to prevent?

To prevent back pain in the area of the shoulder blades, lifestyle modifications are required: increasing the nutritional value of the diet, playing sports, stopping smoking and drinking. It is important to detect and treat chronic diseases early, to avoid stress overload.

Remember, pain is not an independent ailment, but a manifestation of a much more serious pathology that requires proper diagnosis and treatment.