When most people experience back pain between the shoulder blades, they attribute its occurrence to various disorders of the spine, nerve roots, ligaments, intervertebral discs or discs.However, it should be remembered that such painful sensations can be associated with other diseases of the chest organs - stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, rapidly increasing or passing quickly or significantly increasing over time, or it can be chronic, which worries the patient for a long time and requires an accurate diagnosis, because it can be a sign of serious pathology of any organ of the chest.Sometimes pain between the shoulder blades can occur only after sudden physical exertion or after being 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 ointment for back pain or injection, the real reason for their occurrence must be determined.When contacting the doctor, it is very important to describe the smallest accompanying symptoms of pain, the time of its occurrence, the provoking factors of its intensification, because the doctor should help determine the direction of the examination, and sometimes it is very difficult to make a correct diagnosis without accurate information about the nature of the pain.
Often, the real cause of pain between the shoulder blades is not determined in time, forcing a person to undergo many expensive and long examinations, to use various treatment options that are sometimes inappropriately prescribed and therefore do not bring the desired results.Therefore, it is very important that the patient himself knows about the possible list of diseases characterized by this pain syndrome.
Pain caused by pathologies of the spine
We will not dwell on the obvious causes such as bruises, injuries, dislocations and fractures of the vertebrae, but we will consider other possible causes of this type of back pain.
Intervertebral hernia
You should know that a vertebral hernia in the thoracic spine is a very rare event, because this part of the spine does not carry an increased load like the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath sends the patient to an MRI or CT scan.The change of the intervertebral hernia is due to the fact that the fibrous ring - the outer part of the intervertebral disk begins to come out of the tear, the distance between the vertebrae decreases and the nerve roots are compressed.That is, the fibrous annulus 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 treatment, and in severe cases, surgical intervention is indicated.The difference of such pain in intervertebral hernias of the thoracic spine from other pathologies is that it is localized only in one place, and the pain can also spread to the inside of the chest, which can 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 limbs, dysfunction of the pelvic organs, and chronic pain syndrome may occur.
Excessive tension with hypothermia of the back muscles
Excessive tension of the back muscles can also cause pain in the area of the shoulder blades;it is not considered a disease, but the risk of developing osteochondrosis, scoliosis and intervertebral hernia increases with frequent overloads, heavy lifting, long sitting or monotonous position.Very often, such pain affects people whose work requires being in the same position for several hours a day - these are tailors, drivers, office workers, surgeons.
Sometimes, when such a profession and conditioning are combined, hypothermia, the so-called lumbago, can occur, when the pain worsens and requires the appointment of NSAIDs (non-steroidal anti-inflammatory drugs), heating, the use of distracting ointments, massage, etc.
To avoid such complications, you should try to avoid drafts, lead a maximally active lifestyle, do 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 are somehow decreasing, but almost 90% of the population has been infected with mycobacterium tuberculosis since childhood.If a person has an injury, especially a back or a joint, or is simply very cold, the immune system is very weakened, the focus of tuberculosis appears at the site of injury quite often, and even on X-ray, it cannot always be recognized in time with certain symptoms.
Often, in such cases, the diagnosis is made only when a person is already exhausted from terrible pain and there are a number of complications.With this disease, a person can feel a very strong, burning pain between the shoulder blades;patients describe it as a twisting or digging in one point of the spine, and when the focus is localized in the thoracic spine, the pain spreads to the chest, where a burning sensation, warmth 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;In any part of the spine, there can be an independent center of tuberculosis infection.People are used to the idea that tuberculosis is a disease that affects only the lower social classes of the population and, as a rule, is localized only in the lungs.This is a huge misconception!
When the body's defenses are weakened, Koch's bacillus, which is present in almost every person's body, is activated in the most weakened organs and a slow inflammatory process begins;these may be the kidneys, lymph nodes, fallopian tubes in women, 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 develops various degrees of scoliosis - curvature, twisting of the spine, and most often it is the thoracic spine along with the cervical or lumbar spine.And since the ribs are attached 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 ones - intense physical exertion, sedentary office work or sitting at a desk for schoolchildren.
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-term - it includes massage, wearing a special corset and therapeutic exercises.In scoliosis, back pain between the shoulder blades is the leading symptom, and it has the following symptoms:
- In the early stages, the curvature may be visually subtle, but as the scoliosis progresses, the curvature becomes noticeable when examining the patient from behind.
- With scoliosis, there is increased fatigue of the back muscles
- Shoulders and arm position 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 or constant during severe overload or prolonged standing or sitting.
Osteochondrosis
Since the initial stages of osteochondrosis are now detected even in ten-year-old children, this pathology can rightly be called the scourge of a modern city dweller.Recently, this disease was considered a disease of the elderly, but modern life, unhealthy, 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 that worsens with sneezing, coughing, sudden changes in body position, and physical activity
- As you straighten your shoulders, you may hear a creak between your shoulder blades
- Chest pain can be described as feeling like a stake
- Decreased mobility of the ribs makes it difficult to breathe, and the person begins to breathe through the stomach.
- Movement in the hands is limited, weakness, tingling or numbness is felt in the hands.
Intercostal neuralgia
Intercostal neuralgia usually bothers a person with pain on one side of the chest, but rarely it can also be in the area of the shoulder blades.This occurs in situations where nerve root compression in the thoracic region occurs due to excessive stress, hypothermia, injury, infectious diseases, or osteochondrosis of the thoracic region.
With intercostal neuralgia, symptoms and pains are intensified by pressure on the chest, during coughing, and may bother the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, you should contact qualified orthopedists, neurologists, osteopaths and surgeons to clarify the diagnosis.
Spondyloarthrosis
This disease is very similar to osteochondrosis in terms of the nature of pain, factors that increase it with load, and changes in body position.It is also chronic in nature, characterized by periods of exacerbation and remission.Distinguishing spondyloarthrosis from osteochondrosis is possible only with X-ray, MRI or CT.With this disease, the cartilage is destroyed and replaced by bone tissue, so bony protrusions can be detected in 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;painful in nature and aggravated by palpation, movement and physical activity.This is not a dangerous condition, and heating and the use of pain-relieving ointments usually help with back pain.
Diseases of internal organs
As we have already said, pain in the area of 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 gall bladder can contribute to the appearance of back pain.During the period of oncological stress, when cancer does not spare children or adults, the development of tumors of the mediastinal organs, stomach and lungs can manifest as pain in the area of the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina pectoris are diseases that can cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes and disappears almost immediately when taking nitroglycerin.However, in case 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
Stomach ulcer, pancreatitis, cholecystitis are three diseases that can cause pain in the thoracic region, both in front and behind.Also, the development of stomach and pancreatic cancer can cause such feelings.
Respiratory system diseases
If the patient, in addition to back pain, coughs, increases body temperature, and is even slightly uncomfortable, the cause may be lung pathologies.Typically, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections and influenza.Recently, cases of development of atypical forms of pneumonia occur more often, when pneumonia is caused by pathogens such as mycoplasma or chlamydia, they are not accompanied by a very high temperature, but may occur against the background of a low-grade fever, and back pain on the right and left may appear when breathing, especially when breathing deeply.The main criterion 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 long-term use of steroid hormones or a decrease in estrogen in postmenopausal women.
- For example, stomach cancer metastases to the vertebrae can also cause pain
- Spontaneous fractures due to irrational loads.
- Ankylosing spondylitis (Bechterev's disease) is a systemic disease.It affects men more often, where against the background of inflammation, the vertebra is affected and ossification of the ligaments occurs.As a result, the spine becomes inflexible and is described radiographically as a bamboo stick.