Most people, when they experience back pain between the shoulder blades, associate its occurrence 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 organs of the chest: stomach, heart, respiratory system and mediastinal organs.
Such pain can be acute, which grows rapidly and passes rapidly or increases significantly with time, or chronic, which worries the patient for a long time and requires an accurate diagnosis, since it can be a symptom of a serious pathology of any chest organs. Sometimes the pain between the shoulder blades can manifest itself only after sudden physical exertion or after a long stay in a certain uncomfortable position.
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 appearance. When contacting a doctor, it is very important to describe all the slightest concomitant symptoms accompanying pain, the time of their occurrence, the provoking factors for 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.
Most often, the 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 inappropriately prescribed 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 pain syndrome.
Pain caused by pathologies of the spine
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but we will consider other possible causes of such back pain.
Intervertebral hernia
You should know that a vertebral hernia in the thoracic spine is a very rare event, as this spine does not carry as high a load as the cervical and lumbar regions. To diagnose or exclude this pathology, the neurologist, the osteopath refers the patient to magnetic resonance, CT. Changes in the intervertebral hernia are due to the fact that the fibrous ring - the outer part of the intervertebral disc from the tear begins to protrude, while the distance between the vertebrae decreases and the nerve roots are pinched. That is, the fibrous ring cracks, the nucleus pulposus (shock absorber in the center of the disc) begins to protrude into it.
When such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, physiotherapy, reflexology, and in severe cases, surgery is indicated. The difference between such pain in an intervertebral hernia of the thoracic spine from other pathologies is its localization in only one place and the pain can also radiate to the chest, which can resemble symptoms of impaired lung or heart function. With a long-term lack of treatment of an intervertebral hernia, a curvature of the spine, paraparesis of the lower extremities, a disturbance of the functions of the pelvic organs and chronic pain syndrome can occur.
Overload in combination with hypothermia of the back muscles
An overload of the back muscles can also cause pain in the shoulder blades, this is not considered a disease, but with frequent excessive loads, weight lifting, prolonged sitting in a monotonous position, the risk of developing osteochondrosis, scoliosis, intervertebral hernia increases. Most often, people whose work forces them to remain in the same position for several hours a day suffer from such pains - these are seamstresses, drivers, clerks, surgeons.
Sometimes, when such a profession is combined with an air conditioner, hypothermia can occur, a so-called back pain, when the pain becomes more intense and requires the appointment of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming , distracting ointments, massages, etc.
To prevent such complications, you should try to avoid drafts, lead a more active lifestyle, do yoga, Bodyflex, therapeutic exercises, take a professional massage course every six months.
Spinal tuberculosis
Today many doctors seem to "forget" this disease and for some reason the anti-tuberculosis services in the country are decreasing and, in fact, almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood. If a person is injured, especially in the back, or in a joint, or simply becomes very cold, with a very weakened immune system, a tuberculous outbreak often occurs at the injury site, which even on X-rays gives specific signs is not always can recognize in time.
Often in these cases, the diagnosis is only established when the person is already exhausted from terrible pain and has a number of complications. With this disease, a person can be bothered by very strong and burning pain between the shoulder blades, patients describe it as twisting or perforation in a point of the spine, and even when the focus is localized in the thoracic spine, the pain radiates in the chest, in which there is a burning sensation, heat, pains.
Tuberculosis of the spine is a very insidious disease, and when it occurs in the spine, the patient does not always have foci in the lungs, it can be an independent focus of tuberculosis infection in any part of the spine. People are used to the idea that tuberculosis is a disease that affects only the lower social strata of the population and is usually localized only in the lungs. This is a huge misunderstanding!
When the body's defenses are weakened, Koch's bacillus, which is in the body of almost every person, is activated in the most weakened organs and a slow inflammatory process begins, it can be like the kidneys, lymph nodes, female fallopian tubes, the prostate or testes in men, as well as individual vertebrae of the spine or joints of the limbs.
Scoliosis
According to statistics, almost 50% of the population has various degrees of scoliosis development: curvature, twisting of the spine, and most often it is the thoracic spine in combination with the cervical or lumbar regions. And since the ribs are connected with the thoracic regions, the shape of the chest also changes. There are many reasons for its development - these are congenital pathologies of ligaments, bones and acquired - intense physical overload, sedentary office work or schoolchildren sitting at a desk.
With lateral and direct chest x-rays, a surgeon, neurologist, orthopedist, or osteopath can make a similar diagnosis. Therapy of such a pathology should be very intensive and long - this is a massage, wear a special corset, therapeutic exercises. In scoliosis, back pain between the shoulder blades is the main symptom and the following symptoms are also inherent:
- At an early stage, the visual curvature may be subtle, but as the scoliosis progresses when the patient is examined from behind, the curvature becomes evident.
- With scoliosis, there is increased fatigue of the back muscles
- The shoulders and the position of the arms can be at different heights
- The pain disturbing the patient in the chest is localized more often in one side
- Between the shoulder blades, the pain can be either periodic due to overexertion or a long standing or sitting position, and it can also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are found today even in ten-year-old children, this pathology can rightly be called the scourge of a modern citizen. More recently, this disease has been considered a disease of the elderly, but modern life, an incorrect and sedentary lifestyle, leads to the early development of dystrophic changes in the joints and spine. The cause of back pain is promoted by the inflammatory process that develops in the surrounding tissues around the damaged vertebrae, as well as by pinched nerve roots. The following symptoms are characteristic of osteochondrosis:
- Constant and aching pain in the back, aggravated by sneezing, coughing, abrupt change in body position, during physical exertion
- When you straighten your shoulders, you hear a creak between your shoulder blades
- Chest pain can be described as "the stakes were worth it"
- Reducing the mobility of the ribs leads to difficulty in breathing and the person, as it were, begins to breathe in the stomach
- Hand movement is limited, there is weakness, tingling or numbness in the hands.
Intercostal neuralgia
Intercostal neuralgia usually bothers a person with pain in 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 during excessive stress, hypothermia, trauma, infectious disease, or osteochondrosis of the thoracic region.
With intercostal neuralgia, symptoms, pain increase with pressure on the chest, with cough and can disturb the patient both day and night. Since pain in 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, according to the nature of the pain, according to the factors that increase it during exercise, to the change in the position of the body. It is also chronic, with periods of exacerbations and remissions. It is possible to distinguish spondylarthrosis 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, SARS, flu, muscle fatigue, back injury, inflammation of muscle tissue can occur - myositis. Like any disease, it can be acute or chronic. The pain in this case can be in any part of the spine, they are painful in nature and also increase with palpation, movement, physical exertion. This is not a dangerous condition, and the use of warming ointments and pain relievers for back pain usually help.
Diseases of the internal organs
As we have already said, pain in 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 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 of the mediastinal organs, stomach and lungs can also manifest itself with pain in the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina are diseases that can also be the cause of such pain. With angina. for example, pain never lasts more than 5 minutes and with nitroglycerin it usually clears up immediately. However, in an acute attack, if intense pain lasts more than 5 minutes, blood pressure decreases, cold sweat appears, pallor of the skin, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Stomach ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the onset of pain in the chest region both in front and behind. Also, the development of oncological diseases of the stomach and pancreas can cause such sensations.
Diseases of the respiratory system
If the patient, in addition to back pain, is worried about a cough, an increase in body temperature, even a slight one, the cause could be lung diseases. Usually, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections, flu. 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 subfebrile conditions and back pain may appear on the right, left, during inhalation, particularly aggravated by deep inhalation. The main criterion for distinguishing lung pathology from other causes is the presence of temperature, not even high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, say, against the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Stomach cancer metastases to the vertebrae, for example, can also cause pain.
- Spontaneous fractures with irrational loads.
- Ankylosing spondylitis (Bechterew's disease) is a systemic disease. It affects more often than men, in which, against the background of inflammation, the vertebrae are affected and ossification of the ligaments occurs. As a result, the spine becomes rigid and is radiologically described as a bamboo stick.