When most people experience back pain between the shoulder blades, they associate its occurrence with various disorders of the spine, nerve roots, ligaments, intervertebral discs, or the discs themselves.But it must be remembered that these painful sensations can also be associated with other diseases of the thoracic organs - stomach, heart, respiratory system, mediastinal organs.
This pain can be acute, which increases rapidly and quickly passes or increases significantly over time, or chronic, which bothers the patient for a long time and requires an accurate diagnosis, as it can be a symptom of a serious pathology of any organ in the chest.Sometimes pain between the shoulder blades may occur only after sudden physical exertion or after being in a certain uncomfortable position for a long time.
It must 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 real cause of its occurrence must be established.When contacting a doctor, it is very important to describe all the minor symptoms accompanying the pain, the moment of their occurrence, the factors provoking its intensification, since 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 about the nature of the pain.
Often, untimely identification of the true cause of pain between the shoulder blades forces a person to undergo many expensive and time-consuming examinations, to 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 the possible list of diseases that are characterized by this pain syndrome.
Pain caused by spinal pathologies
We will not dwell on obvious causes such as bruises, injuries, dislocations and fractures of vertebrae, but we will consider other possible causes of this back pain.
Intervertebral hernia
You should know that a spinal hernia in the thoracic spine is a very rare occurrence, as this part of the spine cannot support as high a load as the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath refers the patient for 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 rupture, while the distance between the vertebrae decreases and the nerve roots are compressed.In other words, 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, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in severe cases, surgery is indicated.The difference between this pain in intervertebral hernia of the thoracic spine and other pathologies is that it is localized in just one location, and the pain can also radiate to the chest, and may resemble symptoms of pulmonary or cardiac dysfunction.If intervertebral hernia is not treated for a long time, curvature of the spine, paraparesis of the lower extremities, dysfunction of the pelvic organs and chronic pain syndrome may occur.
Excessive exertion in combination with hypothermia of the back muscles
Excessive tension in the back muscles can also cause pain in the shoulder blade area;this is not considered a disease, but with frequent excessive loads, heavy lifting, prolonged sitting or monotonous position, the risk of developing osteochondrosis, scoliosis and intervertebral hernias increases.Often, these pains affect 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 this profession and air conditioning, hypothermia, the so-called low back pain, can occur, when the pain becomes more intense and requires prescription of NSAIDs (non-steroidal anti-inflammatory drugs), use of heating, distracting ointments, massage, etc.
To avoid such complications, you should try to avoid drafts, lead an active lifestyle as much as possible, practice yoga, Bodyflex, therapeutic exercises and take a professional massage course 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 in decline, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has suffered an injury, especially to the back or joints, or is simply very cold, with a very weakened immune system, a tuberculous 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 these cases, the diagnosis is made only when the person is already exhausted from terrible pain and has a series of complications.With this disease, a person may feel very strong, burning pain between the shoulder blades;Patients describe it as twisting or perforation at a point in the spine, and also when the focus is located in the thoracic spine, the pain radiates to the chest, where a burning sensation, heat and pain are felt.
Tuberculosis of the spine is a very insidious disease and, when it occurs in parts of the spine, the patient does not always have lesions in the lungs;may be an independent focus of tuberculous infection in any part of the spine.People are used to the idea that tuberculosis is a disease that affects only the lowest social strata of the population and is, as a rule, located only in the lungs.This is a big mistake!
When the body's defenses are weakened, Koch's bacillus, present in almost everyone's body, is activated in the most weakened organs and a slow inflammatory process begins;these may be kidneys, lymph nodes, female fallopian tubes, prostate or testicles in men, or individual vertebrae in the spine or limb joints.
Scoliosis
According to statistics, almost 50% of the population has varying degrees of scoliosis development - curvature, torsion 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 thoracic regions, 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 overload, sedentary office work or, for schoolchildren, sitting at a desk.
With a lateral, direct chest x-ray, a surgeon, neurologist, orthopedist, or osteopath can make a similar diagnosis.Therapy for such pathology should be very intensive and long-term - this includes massage, wearing a special corset and therapeutic exercises.In scoliosis, back pain between the shoulder blades is the main symptom and also has the following symptoms:
- At an early stage, the curvature may be visually subtle, but as scoliosis progresses, when examining the patient from behind, the curvature becomes noticeable.
- With scoliosis, there is increased fatigue in the back muscles.
- The position of the shoulders and arms may be at different heights
- The pain that bothers the patient in the chest is usually located on one side
- Pain between the shoulder blades may be intermittent due to intense overexertion or prolonged standing or sitting, or it may also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are now found even in ten-year-old children, this pathology can be called the scourge of the modern city dweller.More recently, this disease was considered a disease of the elderly, but modern life, an unhealthy and 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 compression of the nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant, aching back pain, aggravated by sneezing, coughing, sudden changes in body position, and physical activity
- As you straighten your shoulders, you may hear a pop between your shoulder blades.
- Chest pain can be described as feeling like there is a stake
- Reduced mobility of the ribs causes difficulty in breathing and the person begins to breathe with the stomach.
- Movement in the hands is limited, weakness, tingling or numbness is felt in the hands.
Intercostal neuralgia
Intercostal neuralgia usually bothers people with pain on one side of the chest, but in rare cases it can also be in the shoulder blade area.This occurs in situations where compression of the nerve roots in the thoracic region occurs due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the thoracic region.
In intercostal neuralgia, symptoms and pain intensify with pressure on the chest, when coughing, and can bother the patient day and night.As pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, 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 intensify it with load and changes in the position of the body.It is also chronic in nature, with periods of exacerbations and remissions.It is possible to distinguish spondyloarthrosis from osteochondrosis only with the help of X-rays, MRI or CT.With this disease, cartilage is destroyed and replaced by bone tissue, so bony protrusions can be found on the vertebrae.
Back muscular myositis
After any hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation in muscle tissue - myositis - may occur.Like any disease, it can be acute or chronic.Pain can occur in any part of the spine;It is painful in nature and also intensifies with palpation, movement and physical activity.This is not a dangerous condition, and using warming and analgesic ointments for back pain often helps.
Diseases of internal organs
As we have already said, pain in the shoulder blade region of the back is not always a sign of spinal disease;Almost all diseases of the mediastinal organs, heart, stomach, pancreas and gallbladder can contribute to the appearance of back pain.In our time of oncological tension, when cancer spares neither children nor adults, the development of tumors in the mediastinal organs, stomach and lungs can also manifest itself as pain in the shoulder blade area.
Diseases of the cardiovascular system
Coronary heart disease, myocardial infarction and angina pectoris are diseases that can also cause this pain.For angina pectoris.for example, the pain never lasts more than 5 minutes and when taking nitroglycerin 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, call an ambulance immediately.
Gastrointestinal tract diseases
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the occurrence of pain in the thoracic region, both in the front and back.Additionally, the development of stomach and pancreatic cancer can cause such sensations.
Respiratory system diseases
If the patient, in addition to back pain, is bothered by coughing, an increase in body temperature, even if it is slight, the cause may be lung pathologies.Typically, illnesses 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 low fever, and back pain may appear on the right, left, when inhaling, intensifying especially with deep breathing.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 bodies, for example, against the background of prolonged use of steroid hormones or a drop in estrogen levels in postmenopausal women.
- Metastasis of stomach cancer in the vertebrae, for example, can also cause pain
- Spontaneous fractures due to unreasonable loads.
- Ankylochial spondylitis (Bechterew disease) is a systemic disease.It most frequently affects men, in whom, in a context of inflammation, the vertebrae are affected and ossification of the ligaments occurs.As a result, the spine becomes inflexible and is radiographically described as being similar to a bamboo pole.