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

Patients rarely give due attention to recurrent shoulder blade pain. However, this symptom is an "awakening" of serious changes not only in the musculoskeletal system, but also in the organo-internal complex. Such conditions can threaten the disabled and fatal patient. How not to miss the disease and cure back pain in the shoulder blades, read on.

Etiology

The spine is the main component of the human musculoskeletal system. Thus, the lion's share of the pressure during static or dynamic falls on the spine. Therefore, it is not surprising that a common reason for seeing a doctor is pain in the shoulder blades.

However, the pain syndrome is quite changeable: often the pain is not caused 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 treatment errors.

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

The first group includes:

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

Among the non-vertebral causes, diseases of internal organs are the most common (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 the back hurt at 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 is localized mainly on one side (gastric ulcer, cholecystitis).

By the nature of the pain in the back between the shoulder blades, it can be acute (occurring suddenly 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 the onset of the acute pain syndrome. Just remembering the circumstances of the onset of chronic pain will be difficult.

Pathology options

There are a number of conditions that can cause back pain in the shoulder blades, but we will focus on the most common of them.

• Osteochondrosis.Osteochondrosis is a disease in which the "aging" of the intervertebral discs occurs. In advanced cases, such pathological changes lead to hernial protrusion of the disc. When the thoracic spine is affected by osteochondrosis, patients worry about a sharp back pain between the shoulder blades, which occurs when bending over or staying in awkward positions for long periods of time. It is possible to add a tangible weakness of the back muscles, disturbances in the perception of temperature and pain.
• Deformities of the spine.One of the causes of pain between and in the shoulder blade area is curvature of the spine. Usually the pain causes kyphosis (arch, bump) or scoliosis (spine in C, S or Z). With significant deformities of the spine, aching 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.
• Injuries.Acute pain often appears with direct trauma to the spine or the shoulder blades themselves. Similar injuries occur in a fall from a height, impact with a blunt object, transport or industrial accidents. Injuries to the spine are associated with palpable pain, reflex contraction of the back muscles, and bruising. In some cases, the attachment of a neurological pathology is possible. When the scapula is traumatized, the pain is sharp, made worse by the swinging of the arms. Sometimes it is associated with hemorrhages in the shoulder joint cavity - hemarthrosis.
• Spondylosis.Spondylosis is called the senile destructive process in the spine. Usually in the area of the intervertebral joints, bone tissue grows - osteophytes are formed, which can be complicated by the increase in the vertebrae relative to each other. In such cases, severe pain, neurological and vascular disorders appear.
• Osteoporosis.Osteoporosis is a disease associated with a decrease in the density of the bone system. Usually, back pain in the shoulder blades occurs when a fracture of the thinned thoracic vertebrae occurs. A 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 spondylitis. . . Ankylosing spondylitis is a disease 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 movement, which intensifies after a night's rest. With the development of pathology, the spine is deformed, arched, 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 disease can further affect the cardiovascular and urinary systems.
• Diseases of internal organs.With pneumonia (inflammation of the lungs), a detailed clinical picture is characterized by fever, sputum production, and one-sided chest or back pain in 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. Pain syndrome with intercostal neuralgia is acute and piercing, manifests 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, collarbone and lower back. With a stomach ulcer, the pain is dull, localized in the upper abdomen, often accompanied by "hunger" pains (with long breaks between meals). In this case, the disease is characterized by digestive disturbances, nausea, vomiting and acid belching. Sometimes there is bleeding from the ulcer: patients feel pain in the dagger, which disappears at the height of the bleeding. Vomiting and stools turn dark (almost black) due to impurities in the blood. Cholecystitis (inflammation of the gallbladder) is characterized by the occurrence of a characteristic paroxysmal pain syndrome in the right hypochondrium, 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 appears with impurities from the bile.
• Tumors.Pain in the shoulder blades may appear with neoplastic diseases of the vertebrae or nerve sheath (neuroma). Metastases (daughter tumors) from the affected prostate or mammary glands can spread to the spinal 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 by "watchdog symptoms": pain, weight loss, fever, and constant weakness for no apparent reason.
• Mental lability.Instability of the psyche to stress and emotional outbursts can manifest as psychogenic pain. It occurs against the background of complete health: patients may experience sensations of different strengths that cannot be treated even with pain relievers. Stressful situations also cause another idiopathic pain (without a cause) - fibromyalgia. The disease progresses against the background of prolonged painful sensations, intensifying at certain points (triggers).

Diagnostic

X-rays are the gold standard for examining the spine. In order 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 required.

Processing

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

• Osteochondrosis.As a drug treatment for pain relief, nonsteroidal anti-inflammatory drugs and pain relievers are used. Physiotherapy, remedial gymnastics and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernial sac.
• Deformities of the spine.Conservative treatment of the curvature of the spine consists in the use of supportive devices (corsets, bandages). You also need sufficient activity, massages and physiotherapy (paraffin applications, electrical stimulation). In case of significant deformity, surgical methods of treatment are indicated in order to fix the spine in the anatomically correct position.
• Injuries.Minor injuries are treated with rest, heat and massage; more serious injuries may require traction. If conservative methods are ineffective, the spine is reconstructed with an operative method.
• Spondylosis.The treatment of this pathology is aimed at slowing the progression of the disease. So, injections of hyaluronic acid, chondroprotectors, physiotherapy (shock wave therapy), as well as physiotherapy exercises are prescribed. With severe pain syndrome, the blockage is carried out with pain relievers.
• 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 spondylitis.Inflammation and pain are controlled with anti-inflammatory treatment. To modify the immune response, an antimetabolite from the group of structural analogues of folic acid is prescribed. During remission, physiotherapy, breathing exercises and therapeutic massages are performed.
• Diseases of internal organs.Treatment of pneumonia includes antibacterial agents, as well as drugs that relieve bronchospasm. During the rehabilitation period, vibration massages and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warming and anti-inflammatory ointments. Distraction therapy with topical remedies containing red pepper extract or bee venom is often used. Treatment of stomach ulcers consists of combined antibiotic therapy, as well as drugs that reduce the acidity of gastric contents. Help with cholecystitis includes the use of antispasmodics and drugs that affect the bile. In some cases, antibiotic therapy may be necessary. In the presence of large stones in the gallbladder, it is recommended to remove the latter - cholecystectomy.
• Tumors.Treatment of tumor processes consists of chemotherapy with antineoplastic agents and surgical removal (if possible) of the neoplasm.
• Mental lability.Mental 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 shoulder blades, lifestyle changes are needed: increasing the nutritional value of food, playing sports, quitting smoking and drinking. It is important to detect and treat chronic diseases in a timely manner, in order to avoid stress overload.

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