When most people experience back pain between the shoulder blades, they associate its appearance with various disorders of the spine, nerve roots, ligaments, intervertebral discs, or the discs themselves.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 acute, which increases rapidly and passes quickly or increases significantly over time, or chronic, which bothers the patient for a long time and requires accurate diagnosis, since it can be a symptom of a serious pathology of any organ of the chest.Sometimes pain between the shoulder blades can occur only after sudden physical exertion or after staying in a certain 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 ointments for back pain or injections, it is necessary to establish the true cause of their occurrence.When contacting a doctor, it is very important to describe all the smallest symptoms accompanying the pain, the time when it occurred, the provoking factors of its intensification, since the doctor needs help in determining 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.
Very often, premature identification of the true cause of pain between the shoulder blades forces a person to undergo numerous expensive and lengthy 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 characterized by this painful syndrome.
Pain caused by spinal pathologies
We will not dwell on obvious causes such 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 spinal hernia in the thoracic spine is a very rare occurrence, since this part of the spine does not bear as much load as the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath subjects 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 annulus fibrosus breaks down 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 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 pulmonary or cardiac dysfunction.If intervertebral hernia is left untreated 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 strain combined with hypothermia of the back muscles
Overexertion of 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 a monotonous position increases the risk of developing osteochondrosis, scoliosis and intervertebral hernias.Most 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, the so-called lumbago, may occur, when the pain becomes more intense and requires the prescription 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 as active a lifestyle as possible, 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 decreasing, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has suffered an injury, especially in the back or joints, or is simply very cold, with a very weakened immune system, very often a tuberculosis focus appears at the site of the injury, which even on X-rays 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 the terrible pain and has a series of complications.With this disease, a person may feel a very strong, burning pain between the shoulder blades;patients describe it as a twist or perforation in one point of the spine, and even when the focus is localized in the thoracic spine, the pain radiates to the chest, where a burning sensation, heat and aches 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;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 weaken, Koch's bacillus, present in almost every human organism, activates in the most weakened organs and begins a slow inflammatory process;these may be the kidneys, lymph nodes, female fallopian tubes, the prostate or testicles in men, or individual vertebrae in the spine or joints in the limbs.
Scoliosis
According to statistics, almost 50% of the population has various degrees of development of scoliosis: curvature, twisting of the spine, and most often this 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, and also acquired ones - intense physical overload, sedentary office work or, for schoolchildren, sitting at a desk.
With a lateral and plain chest x-ray, a surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis.Therapy for such a pathology must be very intensive and long-term: this includes massage, the use of a special corset and therapeutic exercises.In scoliosis, back pain between the shoulder blades is the main symptom and also has the following symptoms:
- In an early stage, the curvature may be visually imperceptible, but as scoliosis progresses, when examining the patient from behind, the curvature becomes evident.
- With scoliosis there is increased fatigue in the back muscles
- 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 due to overexertion or standing or sitting for prolonged periods, or it may also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are now found even in ten-year-olds, this pathology can rightfully be called the scourge of a modern city dweller.More recently, this disease was considered a disease of older people, 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
- When you straighten your shoulders, you can feel a crunch between your shoulder blades
- Chest pain can be described as feeling like there is a stake
- Reduced mobility of the ribs leads to difficulty breathing, and the person begins to breathe with his stomach.
- Movement of the hands is limited, weakness, tingling or numbness is felt.
Intercostal neuralgia
Intercostal neuralgia usually bothers a person with pain on one side of the chest, but in rare cases it can also occur 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, the symptoms and pain intensify with pressure on the chest, when coughing, and can bother the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, to clarify the diagnosis it is necessary to contact qualified orthopedists, neurologists, osteopaths and surgeons.
Spondyloarthrosis
This disease is very similar to osteochondrosis in terms of the nature of pain, factors that intensify it with load and changes in body position.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.
Myositis of the back muscles
After any hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation in the muscle tissue may occur: myositis.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 the use of warming ointments and pain relievers for back pain usually helps.
Diseases of the internal organs
As we have already said, pain in the shoulder blade area of the back is not always a sign of spinal diseases;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, in which cancer spares neither children nor adults, the development of tumors of 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, angina pectoris are diseases that can also cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes and with the intake of nitroglycerin it disappears in most cases immediately.However, in 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
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the appearance of pain in the thoracic region both front and back.In addition, such sensations can cause the development of stomach and pancreatic cancer.
Respiratory system diseases
If the patient, in addition to back pain, is bothered by a cough or an increase in body temperature, even a slight one, the cause may be a lung disease.Typically, 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 can appear on the right, left, during inhalation, especially intensifying with deep breathing.The main criterion for distinguishing lung disease 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 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 fractures due to irrational loads.
- Ankylochial spondylitis (Bekhterev's disease) is a systemic disease.It most often affects men in whom, against the background of inflammation, the vertebrae are affected and ossification of the ligaments occurs.As a result, the spine becomes inflexible and is described radiographically as looking like a bamboo stick.