When most people experience back pain between the shoulder blades, they attribute it to various disorders of the spine, nerve roots, ligaments, intervertebral discs, or the disc itself.But it should be remembered that such painful sensations can also be associated with other diseases of the chest organs - stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which increases quickly and either passes quickly or increases significantly over time, or chronic, which disturbs the patient for a long time and requires an accurate diagnosis, because it can be a symptom of a serious pathology of any chest organ.Sometimes pain between the shoulder blades can occur only after sudden physical exertion or after being in an uncomfortable position for a long time.
It should be remembered that pain in the interscapular region is not a disease, but a symptom, and before using any ointment for back pain or injections, the true cause of their occurrence should be established.When contacting the doctor, it is very important to describe all the symptoms that accompany the pain, the time of its occurrence, the factors that provoke its intensification, because the doctor needs to help determine the direction of the examination and sometimes it is very difficult to establish the correct diagnosis without accurate data on the nature of the pain.
Often, timely identification of the true cause of pain between the shoulder blades forces a person to undergo many expensive and lengthy examinations, using various treatment options, which are sometimes prescribed improperly and therefore do not bring the desired results.Therefore, it is very important that the patient himself knows about the list of possible diseases characterized by this pain syndrome.
Pain caused by spinal pathology
We will not dwell on the obvious causes such as bruises, injuries, dislocations and fractures of vertebrae, but will consider other possible causes of back pain.
Intervertebral hernia
You should know that vertebral hernia in the thoracic spine is a very rare occurrence, because this part of the spine does not bear the increased load like the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath refers the patient to an MRI or CT scan.Changes in intervertebral hernia are due to the fact that the fibrous ring - 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 pinched.That is, the fibrous ring cracks and the nucleus pulposus (the shock absorber in the center of the disc) begins to protrude into it.
If such a hernia is detected, the doctor prescribes NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in severe cases surgery is indicated.The difference between such pain in intervertebral hernia of the thoracic spine from other pathologies is that it is localized in only one place, and the pain can also radiate to the chest, which may 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 legs, pelvic organ dysfunction, and chronic pain syndrome may occur.
Excess in combination with hypothermia of the back muscles
Overstrain of the back muscles can also cause pain in the shoulder blade area;this is not considered a disease, but with frequent overload, heavy lifting, prolonged sitting, or boring positions, the risk of developing osteochondrosis, scoliosis, and intervertebral hernia increases.Often, such pain affects people whose work requires them to be in the same position for several hours a day - these are tailors, drivers, office workers, surgeons.
Sometimes, when combining such a profession and air conditioning, hypothermia, the so-called lumbago may occur, when the pain becomes more intense and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of heating, disturbing ointments, massage, etc.
To avoid such complications, you should try to avoid drafts, lead a maximally active lifestyle, practice yoga, Bodyflex, therapeutic exercises, and undergo professional massage courses every six months.
Tuberculosis of the spine
Today, many doctors seem to "forget" this disease and anti-tuberculosis services in this country for some reason fell into decline, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has suffered an injury, especially on the back or joints, or is just very cold, with a very weak immune system, a focus of tuberculosis quite often appears at the site of the injury, which even on X-rays cannot always be recognized in time with certain signs.
Often in such cases, the diagnosis is made only when the person is already exhausted due to severe pain and has some complications.With this disease, a person may experience very strong, burning pain between the shoulder blades;the patient describes it as twisting or drilling at one point of the spine, and also when the focus is localized in the thoracic spine, the pain radiates to the chest, where a burning sensation, heat, and pain are felt.
Spinal tuberculosis is a very dangerous disease, and when it occurs in the spine, the patient does not always have lesions in the lungs;it can be an independent focus of tuberculosis infection in any part of the spine.People are accustomed to the idea that tuberculosis is a disease that affects only the lower 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 found in almost every person's body, is activated in the weakest organs and a slow inflammatory process begins;these can be kidneys, lymph nodes, fallopian tubes in women, prostate or testicles in men, or individual vertebrae in the spine or joints in limbs.
Scoliosis
According to statistics, almost 50% of the population has varying degrees of scoliosis development - curvature, twisting of the spine, and often it is the thoracic spine in combination with the cervical or lumbar spine.And because the ribs are connected to the thoracic region, the shape of the chest also changes.There are several reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired - intense physical load, sedentary office work or, for schoolchildren, sitting at a desk.
With lateral and direct chest x-rays, surgeons, neurologists, orthopedists or osteopaths can make the same diagnosis.Therapy for such pathologies must be very intensive and long-term - this includes massage, wearing special corsets, and therapeutic exercises.With scoliosis, back pain between the shoulder blades is the main symptom, and it also has the following symptoms:
- In the early stages, the curvature may be visually subtle, but as scoliosis develops, when examining the patient from behind, the curvature becomes noticeable.
- With scoliosis, there is increased back muscle fatigue
- Shoulder and arm positions may be at different heights
- The pain that bothers the patient in the chest is often localized on one side
- Pain between the shoulder blades can be intermittent due to too much exertion or prolonged standing or sitting, or it can also be continuous.
Osteochondrosis
Since the main stage of osteochondrosis is now found even in children as young as ten years old, this pathology can be called a scourge of modern urban residents.Recently, this disease was considered a disease of older people, but modern life, an unhealthy, inactive lifestyle, leads to the early development of dystrophic changes in the joints and spine.The cause of back pain is an inflammatory process that develops in the surrounding tissue around the damaged vertebra, as well as caused by pinched nerve roots.The following symptoms are characteristic of osteochondrosis:
- Persistent, aching back pain that worsens with sneezing, coughing, sudden changes in body position, and physical activity
- When straightening your shoulders, you can hear a grunt between the shoulder blades
- Chest pain can be described as a spike-like feeling
- The reduced mobility of the ribs leads to difficulty breathing, and the person begins to breathe with his stomach.
- Movement in the hand is limited, weakness, tingling or numbness is felt in the hand.
Intercostal neuralgia
Intercostal neuralgia usually bothers a person with pain on the side of the chest, but in rare cases it can also be in the shoulder blade area.This occurs in situations where nerve root compression in the thoracic region occurs due to excessive pressure, hypothermia, injuries, infectious diseases or osteochondrosis of the thoracic region.
With intercostal neuralgia, symptoms and pain intensify with pressure on the chest, when coughing, and can disturb the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, to clarify the diagnosis, you should contact an orthopedist, a neurologist, an osteopath, and a qualified surgeon.
Spondyloarthrosis
This disease is very similar to osteochondrosis, in terms of the nature of pain, factors that strengthen it with loads, and changes in body position.It is also chronic in nature, with periods of exacerbation and remission.It is possible to distinguish spondyloarthrosis from osteochondrosis only with the help of X-ray, MRI or CT.With this disease, cartilage is destroyed and replaced by bone tissue, so bony protrusions can be found on the vertebrae.
Back muscle myositis
After any hypothermia, acute respiratory viral infection, flu, muscle strain, or back injury, inflammation of the muscle tissue can occur - myositis.Like any disease, it can be acute or chronic.Pain can be in any part of the spine;it hurts naturally and also gets worse 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 said, pain in the shoulder blade area in the back is not always a sign of spinal disease;almost all diseases of mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to the appearance of pain in the back.At a time when we are experiencing oncological tension, when cancer does not save children or adults, the development of tumors of the mediastinal organs, stomach, and lungs can also manifest as pain in the shoulder blade area.
Diseases of the cardiovascular system
Coronary 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 most of them disappear immediately.However, in the event of an acute attack, if severe pain lasts more than 5 minutes, blood pressure drops, cold sweat appears, or pale skin, 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 occurrence of pain in the thoracic region in front and behind.Also, the development of stomach and pancreatic cancer can cause such sensations.
Diseases of the respiratory system
If the patient, in addition to back pain, is disturbed by a cough, an increase in body temperature, even if it is slight, 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 can occur against the background of a low-grade fever, and back pain may appear on the right, left, when inhaling, especially intensifying with a deep breath.The main criteria for distinguishing lung pathology from other causes is the presence of fever, even if not high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral body, say, against the background of long-term use of steroid hormones or a decrease in estrogen in postmenopausal women.
- Metastases to the vertebrae of stomach cancer, for example, can also cause pain
- Spontaneous fracture due to irrational load.
- Ankylochial spondylitis (Bechterew's disease) is a systemic disease.It more often affects men, where, against the background of inflammation, vertebrae are affected and ligament hardening occurs.As a result, the spine becomes inflexible and is described radiographically as bamboo-like.