Back pain comes in many forms and variations. The localization and nature of the pain, its duration, the presence or absence of irradiation of 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 disorders, pathologies of muscles and other organs. These include diseases of the lungs and heart, as well as diseases of the gastrointestinal tract, as well as pain caused by 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 - by direct impact (blow, fall) and indirectly by loads along the axis of the upper limb (falling on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, simultaneous spinal injury and rib fracture are possible. Such injuries occur in 50% of serious road accidents. Severe pain, limited movement and severe swelling of the tissues surrounding the scapula can also be observed with severe bruising.
Osteochondrosis
It is a common cause of osteochondrosisbackacheAndspineany localization, and also inscapula area. Degenerative-dystrophic processes resulting from malnutrition and cartilage regeneration in the intervertebral joints and discs lead to the formation of protrusions and hernias, spasms of the back muscles, and a decrease in the height of the intervertebral discs. The spinal nerves can be pinched, and the pain can be caused by radicular syndrome.
The pain is triggered by bending or turning the body, lifting weights. Due to simultaneous inflammation of the back muscles, the pain may increase when lifting and abducting the arms. Possible spinal stiffness, bending, forced position of the patient with a slight forward bend The pain can be aching, shooting, surrounding the chest. Some patients describe it as feeling like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which an abnormal S-shaped curvature of the spine occurs, mainly in the plane of the coronary arteries. As a result, the normal distribution of loads and biomechanics are disrupted. Predisposing factors to scoliosis are incorrect posture, weak back muscles, childhood and improper organization of the workplace. Back pain from scoliosis is usually caused by spasm, inflammation and tension in the muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by aching pain that goes away when lying down and gets worse when standing for a long time.
Kyphosis
Kyphosis is an abnormal curvature of the spine in the sagittal plane, most often occurring in the chest region. As a result of kyphosis, the spinal column is "? " begins to resemble 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 spinal trauma or tuberculosis. Ankylosing spondylitis causes extreme kyphosis of the thoracic region.
Pain from kyphosis, like scoliosis, is caused by tension and muscle spasms as they are subjected to excessive stress. At the same time, it is feltback painand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is a degenerative-dystrophic change of the intervertebral joints, which is caused by malnutrition of the articular cartilage and leads to the gradual destruction of the joints of the spine. Spondyloarthritis is an inflammation of the intervertebral joints that responds to an autoimmune or reactive process (rheumatoid arthritis, ankylosing spondylitis, reactive arthritis). Both processes result in ankylosis or fusion of the intervertebral joints, which leads to impaired spinal mobility. The difference is that in the first case, the inflammation is secondary in nature and responds to the destruction of the joints, and in the second case, the primary inflammation leads to degenerative-dystrophic changes.
The pain of spondyloarthrosis 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, wavy, with exacerbations and improvements. The pain can be localized not only between the shoulder blades, but also in the entire spine.
Protrusion and hernia
Protrusions and herniations of the intervertebral discs are the consequences of advanced osteochondrosis of the spine. The intervertebral disc, which has lost its flexibility and elasticity, or rather its peripheral part, which is called the annulus fibrosus, stretches under load and forms a protrusion. If the annulus fibrosus ruptures, the inner contents of the disc fall out, forming a herniated disc. Both protrusions and intervertebral disc herniation can cause entrapment of the spinal cord roots exiting through the intervertebral foramina. Acute 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 protrusion in the thoracic spine).
Radiculitis
Acute pain starting in the interscapular region and continuing in the intercostal spaces is the most common symptom of radiculitis. It is caused by pinching of the spinal nerves due to a herniated intervertebral disc or a protruding disc. Less commonly, sciatica can be caused by a tumor, spondylosis, or vertebral displacement. The characteristic symptom of the disease is pain caused by movement of the thoracic spine and lifting of heavy objects.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a disease with pain in the shoulder and scapula, which is 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 of athletes and workers, and osteochondrosis of the cervical thoracic spine. Humeral periarthrosis is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain appears gradually, intensifies due to episodic pain occurring during physical activity, with a large range of motion of the shoulder joint (swinging, throwing, placing the arm behind the back). After that, the pain becomes constant, even at rest. Because of this, the patient cannot sleep on the affected side.Pain in itshoulder andreturns it to the scapula. Possible shooting pains when moving. It is characterized by a sharp limitation of mobility in the shoulder joint, the patient cannot raise or abduct the arm.
Neuralgia
Aching pain radiating along the intercostal nerves in the area of the shoulder blades 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, spondyloarthritis and spondyloarthrosis, myositis. Aggravation can be provoked by drafts, hypothermia and physical activity.
Heart diseases
Heart 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 artery disease, atherosclerosis of the coronary arteries. Acute severe pain under the left shoulder blade that does not go away for a long time is a sign of myocardial ischemia or infarction. The nature of the pain is varied - it ranges from aching, constant, to acute, shooting pain in the left shoulder and forearm, in the left neck. A characteristic symptom is that the pain is alleviated by nitrates (medicines used to treat heart failure) - nitroglycerin, isoket, nitrosorbide.
Problems in the gastrointestinal tract
Diseases of the gastrointestinal tract are common causes of back pain in the shoulder blade area. Pain is reflected in nature and is due to the fact that some of the pain impulses from the solar plexus and receptors in the gastrointestinal tract return to the spinal cord. Pain in the area of the shoulder blades may occur with hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. In case of cholecystitis and gallstonespainthey are localizedat the back between the shoulder blades, moreon the right side.
Lung diseases
Pain in the shoulder blades can occur in the case of many 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 during inhalation or exhalation in the area of the shoulder blades is a characteristic sign of intercostal neuralgia, osteochondrosis of the spine, protrusion or herniation of the intervertebral disc, inflammation of the back muscles, and radiculitis. The reason for the pain is that breathing is ensured by the coordinated contraction of a large number of muscles, and movements even in such a large volume can cause increased pain in the above diseases.
Pain in sternum and shoulder blades
Pain in the sternum and shoulder blades is often found in glenohumeral periarthrosis. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of loads, so pathological changes begin at the point where the clavicle and ribs join the sternum (Tietze syndrome).
Pain in the sternum and shoulder blades also occurs in lung and heart diseases.
Pain on the right or left side of the shoulder blade
Pain in the left scapula can also be reflected in heart disease, as mentioned above. Pain in the right shoulder blade is characteristic of acute or chronic inflammation of the gallbladder or gallstones.
Pain in shoulder blades and neck
Back pain,in the area of the shoulder blades and neckpossible with osteochondrosis of the cervical and thoracic spine. This symptom is also characteristic of hernia or protrusion. The referred pain in the neck and scapula can be observed in certain diseases of the heart and lungs (angina pectoris, lung cancer, pneumonia).
Types of shoulder blade pain
Aching pain in shoulder blade
Painful pain in the shoulder blades on the left side with heart diseases, on the right side - with diseases of the biliary tract, gall bladder. The aching pain is accompanied by glenohumeral periarthrosis, neuralgia and radicular radiculitis. Aching pain in the back and shoulder blades is also possible with spondyloarthritis and spondyloarthrosis.
Pressing pain in shoulder blade
The pressing pain of the scapula is characteristic of myositis or inflammatory muscle diseases. Your shoulder blades are surrounded by a series of muscles, inflammation of which leads not only to pain, but also to limited movement of the shoulder girdle. Severe inflammation of the soft parts and ligaments of the shoulder joint can be accompanied by pain.
Dull pain when inhaling
Dull pain in the back and shoulder blades, aggravated by inhalation, is observed in pneumonia, lung cancer, neuromuscular pathologies, and myositis. This symptom is also a sign of injury, back bruises and soft tissue hematoma. Dull pain in the back and shoulder blades is accompanied by certain diseases of the spinal cord, such as multiple sclerosis.
Throbbing pain in shoulder blade
The throbbing pain of the scapula, which increases with movement, sneezing and coughing, indicates a back injury, fracture or crack of the scapula. The mechanism of injury is most often a direct physical impact, or an indirect impact transmitted along the axis of the upper limbs, for example when falling on the elbow.
Pain in shoulder blades while moving (walking).
Pain in the shoulder blades when walking can be associated with hernias and protrusions of the thoracic spine. Axial loads on the spine, which occur during movement and when the heel hits the ground, are transferred to the diseased intervertebral disc and cause pain.
Burning in the area of the shoulder blades
A burning sensation in the area of the shoulder blades is a possible sign of an acute myocardial infarction. Myocardial ischemia (circulation failure and lack of oxygen in the heart muscle) 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 osteochondrosis of the spine, poor-quality food poisoning, acute surgical pathology, and many other diseases.
A burning sensation and tingling on the skin in the interscapular area can be a symptom of herniated or protruding 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 can also indicate an acute heart attack. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (blockage of the lumen of the bile duct with a stone) - pain is more localized on the right side, nausea is caused by poisoning.
How to relieve pain in the shoulder blades
In the case of spinal diseases and many other diseases, pain relief is facilitated by rest and bed rest. An effective way to combat pain is to prescribe painkillers, primarily non-steroidal anti-inflammatory drugs. In some cases, dry heat, distraction, and anti-inflammatory agents in the form of ointments and gels can help the skin. Patches with anti-inflammatory drugs are widely used, the effect of which is limited to the area of application and does not involve significant side effects.
It is important to note that any pain indicates a consultation with a doctor. This is because long-term use of painkillers increases the risk of serious and dangerous complications. Therefore, their use as medical care is aimed at alleviating pain before consulting a doctor. After determining the cause, the treatment is adjusted taking into account the patient's diagnosis and individual characteristics.
How is pain in the shoulder blades diagnosed?
To diagnose the causes of pain in the shoulder blades, a medical clinical examination should be performed, which allows identifying mild symptoms and signs characteristic of a particular disease. Examination of skin sensitivity, testing of reflexes, assessment of range of motion of the shoulder joint and spine, etc. 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 take 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 scapula pain
The treatment of back and shoulder pain is directed 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 patient's diagnosis and condition. As an example, consider the treatment plan for osteochondrosis of the spine.
In order 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, massage is performed and muscle relaxants are prescribed. When a herniated spinal nerve is pinched, physical influence is used - underwater traction, manual therapy. Painkillers are prescribed to control the pain.
Treatment of shoulder blade pain at home
Treatment at home is only possible if the patient has consulted a doctor and undergone an examination during which an accurate diagnosis was established. In most cases, the causes of shoulder and back pain do not require urgent hospital treatment, the treatment is carried out at home, according to the doctor's instructions. However, more often the opposite happens - patients try to treat it at home, self-diagnose and use painkillers uncontrolled. Self-diagnosis and self-medication results in chronic pain and side effects of painkillers. Patients often consult a doctor late when the disease causes complications. In case of serious diseases, late treatment significantly worsens the prognosis and reduces the probability of complete recovery. Therefore, all back pain requires careful diagnosis and medical consultation.
Which doctor should I see for shoulder pain?
With clarificationcauses and treatment of shoulder and back painit is treated 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 dealt with by a traumatologist, but even in this case, if neurological symptoms appear, a consultation with a neurologist is necessary. In extreme cases, if you have back pain, you should at least contact a therapist to make a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is if the patient does not consult a doctor and does not self-medicate - the consequences of such "treatment" lead to complications, the disease becomes chronic, and in some cases pose a threat to human health and life.