When most people experience back pain between the shoulder blades, they associate their occurrence with various diseases of the spine, nerve roots, ligaments, intervertebral discs or the discs themselves.But it should be remembered that such painful sensations can be associated with other diseases of the chest organs - stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which quickly increases and either 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 a serious pathology of any organ of the chest.Sometimes the pain between the shoulder blades can occur only after sudden physical exertion or after a long time in a certain uncomfortable position.
It should be remembered that pain in the interscapular region is not a disease, but a symptom, and before using any ointments for back pain or injections, you need to find out the real reason for their occurrence.When you contact a doctor, it is very important to describe all the smallest accompanying symptoms that accompany the pain, the time of its occurrence, the provoking factors for its intensification, because the doctor must help determine the direction of the examination, and sometimes it is very difficult to establish the correct diagnosis without accurate data about the nature of the pain.
Very often, untimely identification of the real cause of pain between the shoulder blades forces a person to undergo very expensive and lengthy examinations, to use various treatment options, which are sometimes incorrectly prescribed and therefore do not bring the desired result.Therefore, it is very important that the patient himself knows about the possible list of diseases that are characterized by 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 such back pain.
Intervertebral hernia
You should know that a vertebral hernia in the thoracic spine is a very rare phenomenon, since this part of the spine does not bear as much increased load as the cervical and lumbar regions.To diagnose or rule out this pathology, a neurologist or osteopath refers the patient to an MRI or CT scan.The changes in the 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 compressed.That is, the annulus fibrosus cracks and the nucleus pulposus (the shock absorber in the center of the disc) begins to protrude into it.
If such a hernia is found, doctors prescribe NSAIDs (anti-inflammatory drugs), physical therapy, exercise therapy, reflexology, and in severe cases, surgery is indicated.The difference between such pain in an intervertebral hernia of the chest from other pathologies is that it is localized only in one place, and the pain can also radiate to the chest, which can resemble symptoms of lung or heart dysfunction.If the intervertebral hernia is not treated for a long time, curvature of the spine, paraparesis of the lower limbs, dysfunction of the pelvic organs and chronic pain syndrome may occur.
Overexertion in combination with hypothermia of the back muscles
Back muscle strain can also cause pain in the shoulder blades;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.Very often such pain affects people whose work requires them to be in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when combining such a profession and air conditioning, hypothermia can occur, the so-called lumbago, when the pain becomes more intense and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming, distracting ointments, massage, etc.
To prevent such complications, you should try to avoid drafts, lead a maximally active lifestyle, practice yoga, Bodyflex, therapeutic exercises and undergo a course of professional massage every six months.
Spinal tuberculosis
Today, many doctors seem to "forget" about this disease, and anti-tuberculosis services in the country for some reason are falling, but almost 90% of the population is infected with Mycobacterium tuberculosis since childhood.If a person has received an injury, especially to the back or joint, or is simply very cold, with a very weakened immune system, a tubercular focus often appears at the site of the injury, which even on an 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 from terrible pain and has a number of complications.With this disease, a person can feel a very strong, burning pain between the shoulder blades;patients describe it as twisting or piercing at one point of the spine, and also when the focus is localized in the chest, the pain radiates to the chest, where burning, heat and pain are felt.
Tuberculosis of the spine is a very insidious disease, and when it appears in separate parts of the spine, the patient does not always have lesions in the lungs;can be an independent focus of tuberculosis infection in any part of the spine.People are used to the idea that tuberculosis is a disease that affects only the low social strata of the population and is localized, as a rule, only in the lungs.This is a huge misconception!
When the body's defenses are weakened, Koch's bacillus, which is present in the body of almost every person, is activated in the most weakened organs and begins a slow inflammatory process;these can be the kidneys, lymph nodes, fallopian tubes in women, prostate or testicles in men, or individual vertebrae of the spine or joints of the limbs.
Scoliosis
According to statistics, almost 50% of the population has varying degrees of scoliosis development - curvature, twisting of the spine, and most often it is the thoracic region in combination with the cervical or lumbar spine.And since the ribs are connected to the chest areas, the shape of the chest also changes.There are quite a few reasons for its development - these are congenital pathologies of the ligaments, bones, as well as acquired - intense physical overload, sedentary work in the office or, for students, sitting at a desk.
With a lateral and direct X-ray of the chest, a surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis.Therapy for such a pathology should be very intensive and long-term - this includes massage, wearing a special corset and therapeutic gymnastics.In scoliosis, the leading symptom is back pain between the shoulder blades, which also has the following symptoms:
- In the early stage, the curvature may be visually barely noticeable, but as the scoliosis progresses, when examining the patient from behind, the curvature becomes noticeable.
- In scoliosis, increased fatigue of the back muscles is observed
- The position of the shoulders and arms can be at different heights
- The pain that bothers the patient in the chest is often localized on one side
- Pain between the shoulder blades may be intermittent from severe strain or prolonged standing or sitting, or it may be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are already found even in ten-year-old children, this pathology can rightly be called a scourge of the modern city dweller.More recently, this disease was considered a disease of the elderly, but modern life, an unhealthy, sedentary 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 pinched nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant, aching back pain made worse by sneezing, coughing, sudden changes in body position, and physical activity
- When you straighten your shoulders, you can hear a crunch between the shoulder blades
- Chest pain can be described as a feeling of having a stake
- The reduced mobility of the ribs leads to difficulty breathing and the person begins to breathe with his stomach.
- The movement of the hands is limited, there is weakness, numbness or tingling 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 be in the area of the shoulder blades.This happens in situations where compression of the nerve roots in the chest area occurs due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the chest area.
With intercostal neuralgia, the symptoms and pain increase with pressure on the chest, with coughing and can bother the patient day and night.Since the pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, in order 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 increase it during loading and changes in the position of the body.It is also chronic in nature, with periods of exacerbations and remissions.Distinguishing spondyloarthrosis from osteochondrosis is possible only with the help of X-rays, MRI or CT.In this disease, the cartilage is destroyed and replaced by bone tissue, so 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 in muscle tissue can occur - myositis.Like any disease, it can be acute or chronic.The pain can be in any part of the spine;it is painful in nature and also increases with palpation, movement and physical activity.This is not a dangerous condition and using warming and pain-relieving ointments for back pain usually helps.
Diseases of internal organs
As we have already said, pain in the area of the shoulder blades on the back is not always a sign of diseases of the spine;almost all diseases of the mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to the appearance of back pain.In our time of oncological stress, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach and lungs can also manifest as pain in the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina pectoris are diseases that can also cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes, and when taking nitroglycerin, in most cases it disappears immediately.However, in the case of an acute attack, if severe pain lasts more than 5 minutes, blood pressure drops, cold sweat or pale skin appears, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Stomach ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the appearance of pain in the chest area both in front and behind.Also, the development of cancer of the stomach and pancreas can cause such sensations.
Diseases of the respiratory system
If the patient, in addition to back pain, is worried about a cough, an increase in body temperature, even slightly, the cause may be lung pathology.Usually, 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 they can appear against the background of low-grade fever, and back pain can appear on the right, left, when breathing, especially intensifying with deep breathing.The main criterion for distinguishing pulmonary pathology from other causes is the presence of fever, even if not high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, say, against the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Vertebral metastases of stomach cancer, for example, can also cause pain
- Spontaneous fractures due to irrational loads.
- Ankylosing spondylitis (Bechterev's disease) is a systemic disease.It affects men more often, in which, against the background of inflammation, the vertebrae are affected and ossification of the ligaments occurs.As a result, the spine becomes inflexible and is radiographically described as a bamboo stick.