Most people associate back pain between the shoulder blades with various disorders of the spine, nerve roots, ligaments, discs, or the discs themselves. However, it should be remembered that such painful sensations can also accompany other diseases of the chest organs - the stomach, heart, respiratory system and mediastinal organs.
Such pain can be either acute, which increases rapidly and either passes quickly, or increases significantly over time, or chronic, which worries the patient for a long time and requires accurate diagnosis, since it can be a symptom of a serious pathology of any breast organs. Sometimes pain between the shoulder blades can appear only after sudden physical exertion or after a long stay 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 ointments for back pain or injections, the true cause of their occurrence should be established. When contacting a doctor, it is very important to describe all the minor concomitant symptoms that accompany pain, the timing of their occurrence and provoking factors for their intensification, because the doctor needs help in determining the direction of the examination, and sometimes it is very difficult to do itto make 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 many expensive and lengthy examinations, use various treatment options, which are sometimes prescribed inappropriately and therefore do not bring the desired result. Therefore, it is very important for the patient himself to know 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 will consider other possible causes of such back pain.
intervertebral hernia
You should know that a vertebral fracture in the thoracic spine is very rare, since this spine is not as heavily loaded as the cervical and lumbar spine. To diagnose or exclude this pathology, the neurologist, the osteopath directs the patient to MRI, CT. Changes in intervertebral hernias are due to the fact that the fibrous ring - the outer part of the disc - begins to protrude from the tear, while the distance between the vertebrae decreases and the nerve roots become pinched. This means that the fibrous ring breaks and the nucleus pulposus (shock absorber in the middle of the disc) begins to protrude.
When such a hernia is found, doctors prescribe NSAIDs (anti-inflammatory drugs), physical therapy, physical therapy, reflexology, and in severe cases, surgery is indicated. The difference between such pain with an intervertebral hernia of the thoracic spine and 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 impaired lung or heart function. Long-term untreated intervertebral hernia may result in curvature of the spine, paraparesis of the lower extremities, dysfunction of the pelvic organs, and chronic pain syndrome.
Overload in combination with hypothermia of the back muscles
Overload of the back muscles can also cause pain in the shoulder blades, this is not considered a disease, but with frequent excessive loads, weight lifting, prolonged sitting in a monotonous position, the risk of developing osteochondrosis, scoliosis, herniated disc increases. Very often, such pains are experienced by people whose work forces them to stay in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when such an occupation is combined with air conditioning, hypothermia, so-called back pain, can occur when the pain becomes more intense and the appointment of NSAIDs (nonsteroidal anti-inflammatory drugs), the use of warming, distracting ointments, massage, etc.
To prevent such complications, you should try to avoid drafts, lead the most active lifestyle, practice yoga, bodyflex, therapeutic exercises, and undergo a professional massage every six months.
tuberculosis of the spine
Nowadays, many doctors seem to "forget" about this disease, and anti-tuberculosis services in the country for some reason are declining, and in fact almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood. When a person is injured, especially theBack or a joint, or just gets very cold, with a very weakened immune system, a tuberculous focus often appears at the site of the injury, which is not detectable by specific signs even on x-rays, always detectable in time.
In such cases, the diagnosis is often made only after the person is already exhausted from terrible pain and has a number of complications. With this disease, a person can be disturbed by very strong, burning pain between the shoulder blades, patients describe it as twisting or drilling at one point of the spine, and even if the focus is localized in the thoracic spine, the pain radiates to the chest, inwhich there is a burning sensation, heat, pain.
Tuberculosis of the spine is a very insidious disease, and when it occurs in the spine, the patient does not always have foci in the lungs, it can be an independent foci of tuberculosis infection in any part of the spine. People are used to the fact that tuberculosis is a disease that affects only the lower social classes of the population and is usually localized only in the lungs. This is a big mistake!
When the body's defenses are weakened, the Koch bacillus, which is in the body of almost everyone, is activated in the most weakened organs and a slow inflammatory process begins, such as the kidneys, lymph nodes, female fallopian tubes, prostate or testicles in men, i. e. individual vertebrae in the spine or joints in the limbs.
scoliosis
According to statistics, almost 50% of the population has various degrees of scoliosis development - curvature, twisting of the spine, and most often it is the thoracic spine in combination with the cervical or lumbar spine. And since the ribs are connected to the chest regions, the shape of the chest also changes. There are many reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired - intense physical overload, sedentary office work or schoolchildren sitting at a desk.
A surgeon, neurologist, orthopedist, or osteopath can make a similar diagnosis with lateral and direct chest X-rays. Therapy for such a pathology should be very intensive and long - this is a massage, wearing a special corset, therapeutic exercises. With scoliosis, back pain between the shoulder blades is the leading symptom, and the following symptoms are also inherent:
- In the early stages, the visual curvature can be subtle, but as the scoliosis progresses, when the patient is examined from behind, the curvature becomes noticeable.
- In scoliosis, there is increased fatigue in the back muscles
- Shoulders and arm position can be at different heights
- Pain that bothers the patient in the chest is more often localized on one side
- Pain between the shoulder blades can occur both periodically due to severe overexertion or prolonged standing or sitting, and can be constant.
osteochondrosis
Since today the primary stages of osteochondrosis can be found even in ten-year-old children, this pathology can rightly be called the scourge of a modern city dweller. More recently, this disease was considered a disease of the elderly, but modern life, an incorrect, sedentary lifestyle leads to the early development of dystrophic changes in the joints and spine. The cause of back pain is favored by the inflammatory process that develops in the surrounding tissues around the damaged vertebrae and pinched nerve roots. The following symptoms are characteristic of osteochondrosis:
- Constant, aching pain in the back, aggravated by sneezing, coughing, a sharp change in posture during physical exertion
- When stretching the shoulders, a crunch is heard between the shoulder blades
- Chest pain can be described as "worth the effort"
- The reduction in mobility of the ribs leads to difficulty breathing, and the person begins to breathe in the stomach, so to speak
- Movement in the hands is restricted, weakness, tingling or numbness in the hands is felt.
intercostal neuralgia
Intercostal neuralgia most often plagues a person with unilateral chest pain, but in rare cases it can also appear in the area of the shoulder blades. This occurs in situations where there is compression of the nerve roots in the thoracic region during excessive stress, hypothermia, trauma, infectious diseases or osteochondrosis of the thoracic region.
With intercostal neuralgia, symptoms, pain with pressure on the chest, with coughing increase and can disturb the patient day and night. Since pain in osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, to clarify the diagnosis one should consult qualified orthopedists, neurologists, osteopaths and surgeons.
spondyloarthritis
This disease is very similar to osteochondrosis, depending on the type of pain, depending on the factors that aggravate it during exercise, change in body position. It is also chronic, with periods of exacerbations and remissions. A distinction between spondylarthrosis and osteochondrosis is only possible with the help of X-ray, MRI or CT. In this disease, cartilage is destroyed and replaced with bone tissue, leaving bony prominences on the vertebrae.
Myositis of the back muscles
After any hypothermia, SARS, influenza, muscle strain, back injury, inflammation in muscle tissue - myositis can occur. Like any disease, it can be acute or chronic. Pain in this case can appear in any part of the spine, it is painful in nature, and also increases with palpation, exercise and physical exertion. This is not a dangerous condition, and using warming and pain-relieving ointments for back pain usually helps.
Diseases of the internal organs
As we have already said, pain in 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 gallbladder can contribute to the occurrence of back pain . In our oncologically tense time, when cancer does not spare either children or adults, the development of tumors of the mediastinal organs, stomach and lungs can also be manifested by pain in the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina are diseases that can also be the cause of such pain. With quinsy. for example, the pain never lasts more than 5 minutes, and with nitroglycerin it usually goes away immediately. However, if during an acute attack severe pain lasts more than 5 minutes, blood pressure drops, cold sweats appear, and the skin turns pale, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the appearance of chest pain, both in front and behind. Also, the development of oncological diseases of the stomach, pancreas can provoke such sensations.
diseases of the respiratory tract
If, in addition to back pain, the patient fears a cough, then an increase in body temperature, even small, may be pulmonary diseases. Usually diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections, influenza. Recently, cases of the development of atypical forms of pneumonia have become more common, when pneumonia is caused by such pathogens as mycoplasma or chlamydia, they are not accompanied by a very high temperature, but can occur against the background of a subfebrile condition, and back when inhalation canPain occurs on the right and left, which is particularly aggravated by deep inspiration. The main criterion for distinguishing pulmonary pathology from other causes is the presence of temperature, not even high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, for example, against the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Metastases in the vertebrae of stomach cancer, for example, can also cause pain.
- Spontaneous fractures with irrational loads.
- Ankylochiasating spondylitis (Bechterew's disease) is a systemic disease. Affected more often than men, in whom against the background of inflammation, the vertebrae are affected and ossification of the ligaments occurs. As a result, the spine becomes immobile and is described radiologically as a bamboo stick.