Back pain comes in many forms and varieties. Localization and nature of pain, duration, presence or absence of radiation in other parts of the body, provoking factors - all this can be combined in various combinations.Back pain in the shoulder blade area- a common type of pain in various diseases.
The main causes of pain in the shoulders and back
Why does my back hurt in the shoulder blade area?Such symptoms can be observed in diseases of the spine, neurological disorders, pathologies of muscles and other organs. These include referred pain in pulmonary and cardiac and gastrointestinal diseases, as well as pain in radicular syndromes, trauma and osteochondrosis. Let's take a closer look at the common causes of back and shoulder pain.
Injuries
Injuries to the scapula occur in two ways - with direct impact (impact, fall) and indirectly, with loads along the axis of the upper limb (fall on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, the simultaneous injury of the spine and rib fractures is possible. Such injuries occur in 50% of serious traffic accidents. Severe pain, limited mobility and severe swelling of the tissues surrounding the scapula can also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causepain on the backAndspineany tracking, as well as toshoulder blade area. Degenerative-dystrophic processes in the intervertebral joints and discs, resulting from malnutrition and cartilage regeneration, lead to the formation of protrusions and hernias, spasms of the back muscles and a decrease in the height of the intervertebral discs. Spinal nerves can be pinched, pain can be caused by radicular syndrome.
Pain is caused by bending or twisting the body, lifting weights. Due to the simultaneous inflammation of the back muscles, the pain may increase when lifting and abducting the arms. Possible stiffness of the spine, stooping, forced position of the patient with a slight forward bend. The pain can be aching, shooting, circling of the chest. Some patients describe it as feeling like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which a pathological S-shaped curvature of the spine occurs, mainly in the coronal plane. As a result, the normal distribution of loads and biomechanics is disturbed. Predisposing factors for scoliosis are incorrect body posture, weak back muscles, childhood and improper organization of the workplace. Back pain due to scoliosis is usually caused by spasm, inflammation and tension in the muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by pain that subsides when lying down and worsens with prolonged standing.
Kyphosis
Kyphosis is a pathological curvature of the spine in the sagittal plane, which occurs most often in the thoracic region. As a result of kyphosis, the spine begins to look like a question mark "? » and hump formation can begin. Predisposing factors for kyphosis are vitamin D deficiency, osteoporosis and poor posture. Kyphosis can be caused by trauma or tuberculosis of the spine. Ankylosing spondylitis causes extreme kyphosis of the thoracic region.
Pain with kyphosis, as with scoliosis, is caused by tension and muscle spasm, as they are subjected to excessive stress. At the same time it is feltmuscle pain in the backand in the regionshoulder blades
Spondyloarthritis, spondyloarthritis
Spondyloarthritis is degenerative-dystrophic changes in the intervertebral joints, caused by malnutrition of the articular cartilage, leading to the gradual destruction of the spinal joints. Spondyloarthritis is an inflammation of the intervertebral joints that occurs in response to an autoimmune or reactive process (rheumatoid arthritis, ankylosing spondylitis, reactive arthritis). The result of both processes is ankylosis or fusion of the intervertebral joints, leading to impaired mobility of the spine. The difference is that in the first case, the inflammation is of a secondary nature and occurs in response to the destruction of the joints, and in the second case, the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondyloarthritis and spondyloarthritis is aching in nature and intensifies at night. A characteristic symptom is stiffness and stiffness of the spine in the morning, which subsides after gymnastics or physical activity. The course of the disease is chronic, wave-like, with periods of exacerbations and improvements. The pain can be located not only between the shoulder blades, but throughout the spine.
Protrusion and hernia
Intervertebral disc protrusions and herniations are a consequence of advanced osteochondrosis of the spine. The intervertebral disc that has lost its elasticity and elasticity or rather its peripheral part called the annulus fibrosus protrudes under the influence of loads and forms a protrusion. If the annulus fibrosus ruptures, the internal contents of the disc fall out, forming a herniated disc. Both protrusions and herniations of intervertebral discs can cause entrapment of spinal cord roots emerging through the intervertebral foramina. Sharp pain, protective tension and muscle spasm occur. The pain can radiate to the shoulder, elbow, forearm and is often located in the area of the shoulder blades (with a hernia or protrusion in the thoracic spine).
Rhizitis
Sharp pain starting in the interscapular region and continuing along the intercostal spaces is the most common sign of radiculitis. It is caused by pinching of the spinal nerves by a herniated or bulging intervertebral disc. Less commonly, sciatica can be caused by a tumor, spondylosis, or vertebral displacement. A characteristic sign of the disease is pain caused by movements in the thoracic spine and lifting heavy objects.
Humeral periarthritis
Humerus scapula is a disease accompanied by pain in the shoulder and scapula, caused by arthropathy of the shoulder joint and inflammation of the surrounding soft tissues. Predisposing factors include injuries and microtraumas of the shoulder joint, intense physical activity in athletes and workers, and osteochondrosis of the cervical thoracic spine. The humeral joint is the most common cause of acute pain in the shoulder blades and shoulder joint.
The pain appears gradually, is intensified by episodic pain during physical activity, with a large range of motion in the shoulder joint (the arm swings, throws, when you place the arm behind the back). Then the pain becomes constant, it hurts even at rest. Because of this, the patient cannot sleep on the affected side.Pain insideshoulder andreturns to the scapula. Possible pains during movement. Characterized by a sharp limitation of mobility in the shoulder joint, the patient cannot raise or abduct his arm.
Neuralgia
Pain in the area of the shoulder blades, radiating along the intercostal nerves, is a sign of neuralgia, a chronic neurological disease. A characteristic symptom is increased pain when coughing, sneezing or moving - the pain becomes sharp, shooting. The cause of the disease is the irritation of the roots of the spinal cord due to diseases of the spine, spondyloarthritis and spondyloarthritis, muscle inflammation. Exacerbation can be caused by currents, hypothermia and physical activity.
Heart deseases
Cardiac pathologies are often accompanied by severe pain in the area of the left shoulder blade. The cause of the pain syndrome can be angina pectoris, coronary artery disease, atherosclerosis of the coronary vessels. Acute severe pain under the left shoulder blade that does not subside for a long time is a sign of myocardial ischemia or infarction. The nature of the pain varies - from pain, continuous, to sharp, with volute pain in the left shoulder and forearm, neck on the left. A characteristic symptom is that the pain is relieved with nitrates (medicines for the treatment of heart failure) - nitroglycerin, isocet, nitrosorbide.
Problems with the gastrointestinal tract
Diseases of the gastrointestinal tract are a common cause of back pain in the shoulder blade region. Pain is reflective in nature and occurs due to the fact that part of the pain is pushed from the solar plexus and the receptors of the gastrointestinal tract back to the spinal cord. Pain in the area of the shoulder blades can occur with hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainare locatedin the back between the shoulder blades, moreto the right.
Lung diseases
Pain in the shoulder blades can occur with a number of diseases of the lungs and bronchi. Most often these are pneumonia, acute bronchitis, asthma and other pathologies. Patients with lung cancer oftenback pain in the area of the shoulder blades.
Areas of pain in the back in the area of the shoulder blades
Pain in the area of the shoulder blades during inhalation or exhalation is a characteristic sign of intercostal neuralgia, vertebral osteochondrosis with protrusion or herniation of the intervertebral disc, inflammation of the back muscles and radiculitis. The reason for the pain is that the act of breathing is ensured by the coordinated contraction of a large number of muscles, and movements even in such a volume can cause increased pain in the above diseases.
Pain in sternum and shoulder blades
Pain in the sternum and shoulder blades is often located with the glenohumeral joint. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of loads, which is why pathological changes begin at the point of attachment of the clavicle and ribs to the sternum (Tietze syndrome).
Pain in the sternum and shoulder blades also occurs with diseases of the lungs and heart.
Pain in the right or left shoulder blade
Pain in the shoulder blade on the left can be reflected in heart diseases, as mentioned above. Pain in the right shoulder blade is characteristic of acute or chronic cholecystitis, gallstones.
Pain in the shoulder blades and neck
Lumbago,in the shoulder and neck areapossible with osteochondrosis of the cervical and thoracic spine. This symptom is also characteristic of a hernia or protrusion. Referred pain in the neck and shoulder blade is seen in certain diseases of the heart and lungs (angina, lung cancer, pneumonia).
Types of shoulder pain
Aching pain in shoulder blade
Pain in the shoulder blade on the left is observed with heart disease, on the right - with diseases of the biliary tract, cholelithiasis. The pain is accompanied by glenohumeral joint pain, neuralgia and radiculitis. Pain in the back and shoulder area is also possible with spondyloarthritis and ankylosing spondylitis.
Pressure pain in shoulder blade
Pressing pain in the shoulder blade is characteristic of myositis or inflammatory muscle diseases. The shoulder blades are surrounded by a series of muscles, the inflammation of which leads not only to pain, but also to limited mobility of the shoulder girdle. Severe inflammation of the soft tissues and ligaments of the shoulder joint can also be accompanied by pain.
Dull pain on inhalation
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed with pneumonia, lung cancer, neuromuscular pathologies and myositis. This symptom is also a sign of injury, back bruising and soft tissue hematoma. Dull pain in the back and shoulder blades accompanies certain spinal cord conditions, such as multiple sclerosis.
Throbbing pain in shoulder blade
Throbbing pain in the shoulder blade, which increases with movement, sneezing and coughing, is a sign of back injury, fracture and tears of the shoulder blade. The mechanism of injury is usually a direct physical impact or an indirect impact transmitted along the axis of the upper limbs, for example, when falling on the elbow.
When moving (walking) pain in shoulder blades
Pain in the shoulder blades when walking can occur with hernias and protrusions of the thoracic spine. Axial loads on the spine that occur during movement and heel strike are transferred to the affected intervertebral disc and cause pain.
Burning in the region of the shoulder blades
A burning sensation in the area of the shoulder blades is a possible sign of an acute myocardial infarction. Ischemia (circulatory failure and oxygen deficiency in the heart muscle) of the myocardium is accompanied by severe pain, painful shock and a drop in blood pressure. However, if the posterior lateral wall of the left ventricle and the diaphragm of the heart are damaged, the pain can mimic vertebral osteochondrosis, poor-quality food poisoning, acute surgical pathology, and many other diseases.
Burning and tingling in the skin in the interscapular region can be a symptom of herniated or protruding intervertebral discs of the thoracic and cervical spine. This symptom occurs in multiple sclerosis and other diseases of the spinal cord.
Shoulder pain and nausea
Pain in the left shoulder blade with nausea and vomiting may also indicate an acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (clogging of the lumen of the bile duct with a stone) - pain is more localized on the right, nausea is caused by poisoning.
How to relieve shoulder pain
For diseases of the spine and many other diseases, pain relief is facilitated by rest and bed rest. An effective way to combat pain is the prescription of analgesics, mainly non-steroidal anti-inflammatory drugs. In some cases, dry heat, distractions, and anti-inflammatory agents in the form of ointments and gels on the skin help. Patches with anti-inflammatory drugs are widely used, the effect of which is limited to the area of application and is not accompanied by significant side effects.
It is important to remember that any pain is an indication to consult a doctor. The reason is that long-term use of pain relievers increases the risk of serious and dangerous complications. Therefore, their use as medical care is aimed at relieving pain before visiting a doctor. After determining the cause, the treatment is adjusted taking into account the diagnosis and the individual characteristics of the patient.
How is shoulder pain diagnosed?
To diagnose the causes of pain in the shoulder blades, a clinical examination by a doctor is used, which allows one to identify mild symptoms and signs characteristic of a particular disease. A skin sensitivity study, reflex testing, assessment of range of motion in the shoulder joint and spine, etc. are carried out. To confirm the diagnosis, instrumental methods such as EKG, ultrasound, CT or MRI are used.
Magnetic resonance imaging is a universal method for diagnosing the causes of back pain associated with pathologies of the spine, spinal cord, joints and soft tissues. The procedure is safe, highly accurate and allows you to obtain detailed images of the area of interest. The method is based on the natural phenomenon of magnetic resonance, which is created using only magnetic fields and radio waves that are safe for human health.
Treatment of shoulder blade pain
The treatment of back and shoulder pain is aimed at the cause of the disease (etiotropic treatment), the mechanisms of its occurrence (pathogenetic treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the diagnosis and the patient's condition. For example, consider a treatment plan for vertebral osteochondrosis.
To eliminate the degenerative-dystrophic phenomena and improve the nutrition of the soft tissues of the spine, chondroprotectors, vitamin therapy, drugs that improve blood microcirculation, therapeutic exercises and physiotherapy are prescribed. To relieve tension in the back muscles, massage is done and muscle relaxants are prescribed. When a herniated spinal nerve is pressed, physical influence is used - underwater traction, manual therapy. To combat pain, analgesics are prescribed.
Treating shoulder blade pain at home
Treatment at home is possible only if the patient has consulted a doctor, undergone an examination, during which an accurate diagnosis has been determined. In most cases, the causes of pain in the shoulder blade and back do not require urgent hospitalization; treatment is carried out at home, according to the doctor's prescriptions. However, more often the opposite happens - patients try to get treatment at home, do self-diagnosis and use uncontrolled painkillers. The result of self-diagnosis and self-treatment is chronic pain and the side effects of painkillers. Patients often come to the doctor late when the disease causes complications. In case of serious diseases, delayed treatment significantly worsens the prognosis and reduces the possibility of complete recovery. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I see for shoulder pain?
With clarificationcauses and treatment of shoulder and back painit is treated by a neurologist, since in most cases the pain syndrome is of neurogenic origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are treated by a traumatologist, but even in this case, if there are neurological symptoms, a consultation with a neurologist is required. In extreme cases, if you have back pain, you should at least contact a therapist so that he can make a preliminary diagnosis and refer the patient to a consultation with another specialist. The worst thing is if the patient does not see a doctor and self-medicates - the consequences of such "treatment" lead to complications, chronicity of the disease and in some cases pose a threat to human health and life.