Patients rarely pay due attention to recurrent pain in the shoulder blade area. However, this symptom is a "wake-up call" serious changes not only in the musculoskeletal system, but also in the internal organo-complex. Such conditions can threaten patients with disability and death. How not to miss the disease and cure back pain in the shoulder blade area, read on.
Etiology
The spine is a major component of the human musculoskeletal system. So, the largest part of the static or dynamic current stress falls on the spinal column. It is therefore not surprising that a common reason for consulting a doctor is pain in the shoulder blade area.
However, pain syndromes are quite variable: often the pain is provoked not by the spinal space itself, but by a violation of the function of internal organs. This fact makes it difficult to diagnose the cause of pain syndrome and leads to errors in treatment.
Among the main causes of pain, pathology of the musculoskeletal and internal systems are distinguished.
The first group includes:
- osteochondrosis;
- spinal deformities;
- trauma and spondylolisthesis;
- spondylosis;
- osteoporosis;
- ankylosing spondylitis.
Among the non-vertebral causes, diseases of internal organs are the most common (pneumonia, heart attack, intercostal neuralgia, stomach ulcers, cholecystitis). Also, tumor processes or mental lability (fibromyalgia, psychogenic pain) can trigger pain.
Variation of pain
Why does the back hurt in the shoulder blade area? In general, pain syndromes can be localized directly in the shoulder blade area, and between them. The pain is bilateral (with scoliosis) or located mainly on one side (gastric ulcer, cholecystitis).
With the nature of the pain in the back between the shoulder blades, it can be acute (occurring suddenly with a rapid increase in strength) or chronic (weak and prolonged). The main difference in practice is that patients can accurately name the onset of acute pain syndrome. Even remembering the initial state of chronic pain will be difficult.
Pathological choice
A number of diseases can trigger back pain in the shoulder blade area, but we will focus on the most common.
- Osteochondrosis.Osteochondrosis is a disease during which "aging" of the intervertebral disc occurs. In further cases, such pathological changes lead to the protrusion of a disc herniation. When the thoracic spine is affected by osteochondrosis, patients worry about sharp back pain between the shoulder blades, which occurs when bending or being in an uncomfortable position for long periods of time. It is possible to add significant weakness of the back muscles, disturbances in the perception of temperature and pain.
- Spinal deformities.One of the causes of pain between and in the shoulder blade area is curvature of the spine. As a rule, pain gives rise to kyphosis (hump, hump) or scoliosis (C, S, or Z -shaped spine). With a marked deformity of the spinal column, aching pain appears, exacerbated by physical activity. There are frequent episodes of respiratory failure (shortness of breath, inability to "breathe deeply"). The clinic is also accompanied by increased fatigue and headaches. In rare cases, the chest is bent.
- injuries.Acute pain often appears with direct trauma to the spine or the shoulder blade itself. The same injuries occur when falling from a height, being hit with a blunt object, transportation or an industrial accident. Spinal cord injuries are associated with significant pain, reflex contraction of the back muscles, and bruising. In some cases, neurological pathological attachment is possible. When the scapula is traumatized, the pain is acute, exacerbated by swinging the arm. Sometimes it is combined with bleeding in the cavity of the shoulder joint - hemarthrosis.
- Spondylosis.Spondylosis is called the process of senile destruction in the spine. Typically, in the area of the intervertebral joint, bone tissue grows - osteophytes are formed, which can be complicated by the rise of the vertebrae with each other. In such cases, severe pain, neurological and vascular disorders appear.
- Osteoporosis.Osteoporosis is a disease associated with a decrease in the density of the bone system. Typically, back pain in the shoulder blade area occurs when a thinning thoracic fracture occurs. Postural curvature appears - the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (loss of motor activity and sensitivity).
- Ankylosing spondylitis. . . Ankylosing spondylitis is a disease that affects the intervertebral joints. Usually, the clinic begins with pain between the shoulder blades or in the lower back. The pain is accompanied by stiffness of movement, which increases after a night's rest. With the development of pathology, the spinal column is deformed, curved, leading to chest curvature and respiratory failure. In such a pathological position, ankylosis (immobilization) of the intervertebral joint occurs, in which case the patient can no longer bend. In this case, the disease can also affect the cardiovascular and urinary systems.
- Diseases of internal organs.With pneumonia (pneumonia), the detailed clinical picture is characterized by fever, sputum production, and side pain in the chest or back in the shoulder blade area. During a heart attack, the pain is sharp (stabbing, burning), determined in the chest and radiating to the left scapula and upper limbs. The pain syndrome with intercostal neuralgia is acute and stabbing, manifesting itself in the form of attacks that interfere with the patient’s breathing. Pain occurs along the ribs, distributed under the shoulder blades, clavicle and lower back. With stomach ulcers, the pain is dull, localized in the upper abdomen, often accompanied by "hungry" pain (with long breaks between meals). In this case, the disease is characterized by indigestion, nausea, vomiting and sour belching. Sometimes there is bleeding from the ulcer: the patient feels a dagger pain, which disappears at the height of the bleeding. Vomiting and stools become dark (almost black) due to blood stains. Cholecystitis (inflammation of the gallbladder) is characterized by the occurrence of a characteristic paroxysmal pain syndrome in the right hypochondrium, spreading to the right and scapula. The clinic of this disease includes digestive disorders, the provoking factor is the consumption of fatty and fried foods. Sometimes vomiting appears with bile impurities.
- Tumor.Pain in the shoulder blade area can appear with neoplastic disease of the vertebrae or nerve sheaths (neuromas). Metastases (daughter tumors) of the affected prostate or mammary gland can spread to the vertebral area. In this case, the tumor process is characterized by an asymptomatic course, and the appearance of pain is associated with an increase in the neoplasm and its pressure on the neurovascular bundle. Cancer can be suspected by "watch dog symptoms": pain, weight loss, fever and persistent weakness for no apparent reason.
- Mental liability.Psychological instability to stress and emotional outbursts can manifest itself as psychogenic pain. It arises with a complete health background: patients can experience sensations of various strengths that cannot be treated even with painkillers. Stressful situations also give rise to another idiopathic pain (for no reason) - fibromyalgia. The disease persists against a background of prolonged pain sensations, intensifying at certain points (triggers).
Diagnostics
Radiography is the gold standard for examining the spine. To determine the cause of vertebral pain, computed tomography can be used. To study other organs and systems, diagnostic ultrasound or MRI is used. To exclude concomitant pathology, laboratory or other instrumental examination methods may be required.
Treatment
This pathological condition requires a specific treatment plan; only a doctor can prescribe medication.
- Osteochondrosis.As drug therapy for pain relief, non-steroidal anti-inflammatory drugs and analgesics are used. Physical therapy, rehabilitation gymnastics and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernia sac.
- Spinal deformities.Conservative therapy for curvature of the spinal column consists of the use of supportive devices (corsets, bandages). You also need adequate activity, massage and physiotherapy (paraffin application, electrical stimulation). In cases of significant deformity, surgical treatment methods are indicated to correct the spine in the anatomically correct position.
- injuries.Mild injuries are treated with rest, warmth and massage; more severe injuries may require traction. If conservative methods are not effective, the spine is reconstructed by surgical methods.
- Spondylosis.This pathological treatment aims to slow the progression of the disease. Therefore, hyaluronic acid injections, chondroprotectors, physiotherapy (shock wave therapy), as well as physiotherapy exercises are prescribed. With severe pain syndrome, blockade is done with painkillers.
- Osteoporosis.Osteoporosis care includes high doses of calcium and vitamin D supplements. Hormone therapy with female sex hormones, thyroid and other hormones can also be done.
- Ankylosing spondylitis.Inflammation and pain are controlled by anti-inflammatory therapy. To modify the immune response, antimetabolites of the structural analog group of folic acid are prescribed. During remission, physiotherapy, breathing exercises, and therapeutic massage are performed.
- Diseases of internal organs.Therapies for pneumonia include antibacterial agents, as well as medications that relieve bronchospasm. During the recovery period, vibration sequences and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warming and anti-inflammatory ointment. Disorder therapy with topical medications with red pepper extract or bee venom is often used. Treatment of stomach ulcers consists of combined antibiotic therapy, as well as drugs that reduce the acidity of the gastric contents. Help with cholecystitis includes the use of antispasmodics and medications that affect the bile. In some cases, antibiotic therapy may be needed. With the presence of large stones in the gallbladder, it is recommended to remove the latter - cholecystectomy.
- Tumor.Treatment of the tumor process consists of chemotherapy with antineoplastic agents and surgery (if possible) of the neoplasm.
- Mental liability.Mental liability requires intensive psychotherapy, as well as the use of antidepressants or anxiolytics. Limiting psycho-emotional stress is an important part of treatment.
How to prevent?
To prevent back pain in the shoulder blade area, lifestyle modifications are needed: increase the nutritional value of the diet, play sports, quit smoking and drinking. It is important to detect and treat chronic diseases in a timely manner, to avoid excessive stress.
Remember, pain is not an independent disease, but a more serious pathological manifestation that requires proper diagnosis and treatment!