Back pain comes in many forms and varieties. Localization and nature of pain, duration, presence or absence of radiation in 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 diseases, pathologies of muscles and other organs. These include 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 the common causes of back and shoulder pain.
Injuries
Injuries to the scapula occur in two ways - with a direct impact (impact, fall) and indirectly, with loads on the axis of the upper limb (falling on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, simultaneous injury to the spine 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 scapula can also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causeback painAndspineeach localization and also inthe scapula region. 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, back muscle spasms and a decrease in the height of the intervertebral discs. Spinal nerves can be compressed; the pain may be caused by radicular syndrome.
The pain is provoked by bending or turning the body, lifting weights. Due to concomitant inflammation of the back muscles, pain may increase when lifting and abducting the arms. Possible stiffness of the spine, stooping, forced position of the patient with a slight forward bend. The pain may be a shooting pain, encompassing the chest. Some patients describe it as feeling like something is stuck between the shoulder blades.
Scoliosis
Scoliosis is a disease in which a pathological S-shaped curvature of the spine occurs, mainly in the coronal 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 improper organization of the workplace. Back pain due to scoliosis is usually caused by spasm, inflammation and tension in muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by aching pain that disappears when lying down and worsens with prolonged standing.
kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, which occurs most often in the thoracic region. As a result of kyphosis, the spine begins to look like a question mark "? " and a hump may begin to form. 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 in kyphosis, as in scoliosis, is caused by tension and muscle spasms as they are subjected to excessive stress. At the same time it is feltpain in the 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 the 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, which leads to impaired mobility of the spine. The difference is that in the first case the inflammation is secondary in nature and occurs in response to the destruction of the joints, and in the second case the primary inflammation leads to degenerative-dystrophic changes.
The pain in spondyloarthrosis 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, wave-like, with periods of exacerbations and improvements. The pain can be localized not only between the shoulder blades, but also 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, which is called the fibrous ring, protrudes under the influence of loads and forms a bulge. If the annulus fibrosus tears, the inner contents of the disc fall out, forming a herniated disc. Both protrusions and herniated intervertebral discs can cause entrapment of the spinal cord roots exiting through the intervertebral foramina. Sharp pain, protective tension and muscle spasm 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 bulge in the chest).
Radiculitis
Sharp pain starting in the interscapular region and continuing along the intercostal spaces is the most common sign of sciatica. It is caused by spinal nerves being pinched by a herniated or bulging intervertebral disc. Less commonly, sciatica can be caused by a tumor, spondylosis, or vertebral displacement. A characteristic sign of the disease is pain provoked by movements in the thoracic spine and lifting heavy objects.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a disease accompanied by pain in the shoulder and scapula, caused by arthrosis of the shoulder joint and inflammation of the surrounding soft tissues. Predisposing factors include injuries and microtraumas of the shoulder joint, intense physical activity in athletes and workers, osteochondrosis of the cervico-thoracic spine. Shoulder periarthrosis is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain appears gradually, is intensified by episodic pain during physical activity, with a large range of motion in the shoulder joint (arm swings, throwing, when placing the arm behind the back). Then the pain becomes constant, hurts even at rest. Therefore, the patient cannot sleep on the affected side.Pain inshoulder andreturns to the scapula. Possible shooting pains with movement. It is characterized by a sharp limitation of mobility in the shoulder joint, the patient cannot 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 roots of the spinal cord due to diseases of the spine, spondyloarthrosis and spondyloarthrosis, inflammation of the muscles. Exacerbation can be provoked by draft, hypothermia and physical activity.
Heart diseases
Cardiac pathologies are 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 disappear for a long time is a sign of myocardial ischemia or infarction. The nature of the pain is varied - from pain, 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 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 area of the shoulder blades. Pain is reflected in nature and arises due to the fact that part of the pain impulses from the solar plexus and receptors in the gastrointestinal tract are returned to the spinal cord. Pain in the shoulder blades can occur with hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainare localizedin the back between the shoulder blades, More ▼on 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 provided by the coordinated contraction of a large number of muscles, and movements even with such a volume can provoke increased pain in the above diseases.
Pain in sternum and shoulder blades
Pain in the sternum and shoulder blades is common 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 point of attachment of the clavicle and ribs to the sternum (Tietze's syndrome).
Pain in the sternum and shoulder blades also occurs in diseases of the lungs and heart.
Pain in the scapula on the right or left side
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 shoulder blades and neck
back pains,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. Referral pain in the neck and scapula is observed in some diseases of the heart and lungs (angina pectoris, lung cancer, pneumonia).
Types of shoulder blade pain
Shoulder blade pain
Pain in the scapula on the left is observed in heart diseases, on the right - in diseases of the bile ducts, cholelithiasis. The 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 scapula
Pressing pain in the scapula is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by numerous 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 in pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injury, bruises on 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 that worsens with movement, sneezing and coughing is a sign of 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 extremities, such as 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 chest. Axial loads on the spine, occurring when moving and hitting the heel on the ground, are transferred to the diseased intervertebral disc and provoke pain.
Burning in the region of the shoulder blades
A burning sensation in the area of the shoulder blades is a possible sign of an 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 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 of the skin in the interscapular region may be a symptom of herniated or bulging intervertebral discs of 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 shoulder blade with nausea and vomiting may also indicate an acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (clogging of the lumen of the bile duct with a stone) - the pain is localized more to the right, nausea is caused by intoxication.
How to relieve shoulder pain
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 the prescription of 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 a medical aid is aimed at relieving pain before visiting a doctor. After establishing the cause, the treatment is adjusted, taking into account the diagnosis and the 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 to identify mild symptoms and signs characteristic of a certain disease. Examination of skin sensitivity, examination of reflexes, evaluation of the range of motion in the shoulder joint and spine, etc. , is carried out. Instrumental methods such as ECG, ultrasound, CT or MRI are used to confirm the diagnosis.
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 created using only magnetic fields and radio waves that are safe for human health.
Treatment of shoulder pain
The 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 the symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the patient's 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 gymnastics and physical therapy are prescribed. To relieve tension in the muscles of the back, a massage is performed and muscle relaxants are prescribed. When pinching a spinal nerve hernia, physical impact is used - underwater traction, manual therapy. Analgesics are prescribed to combat pain.
Shoulder pain treatment at home
Treatment at home is possible only if the patient has consulted a doctor, undergone an examination, during which an accurate diagnosis was established. In most cases, the causes of pain in the scapula and back do not require urgent hospitalization, the treatment is carried out at home, in accordance with the doctor's prescriptions. But more often the opposite happens - patients try to treat themselves at home, self-diagnose and uncontrollably use painkillers. The result of self-diagnosis and self-treatment is chronic pain and side effects of analgesics. Often, patients 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 probability of a complete cure. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I see for shoulder blade pain?
By clarifyingcauses and treatment of shoulder and back painis processed by a neurologist, since 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 necessary. In extreme cases, if you have back pain, you should at least contact a therapist so that he can establish a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is if the patient does not go to a doctor and self-medicates - the consequences of such "treatment" lead to complications, chronification of the disease and in some cases pose a threat to human health and life.