When most people experience back pain between the shoulder blades, they attribute it to various disorders of the spinal column, nerve roots, ligaments, intervertebral discs, or the discs themselves.But we must not forget 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 quickly and quickly disappears, or increases significantly over time, or chronic, which bothers the patient for a long time and requires an accurate diagnosis, since it can be a symptom of a serious pathology of any organ of the chest.Sometimes the pain between the shoulder blades can appear only after a sudden physical exertion or in an 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 injections, the real reason for their occurrence should be established.When going to the doctor, it is very important to describe the smallest symptom accompanying the pain, the time of its onset, and the provoking factors of its exacerbation, since the doctor must help determine the direction of the examination, and sometimes it is very difficult to establish an accurate diagnosis without accurate data on the nature of the pain.
Very often, premature identification of the real cause of pain between the shoulder blades forces a person to undergo many expensive and lengthy examinations, use various treatment options, which are sometimes prescribed incorrectly and therefore do not bring the desired result.Therefore, it is very important that the patient himself knows the possible list of diseases characterized by this pain syndrome.
Pain caused by pathologies of the spine
We do not deal with obvious causes such as bruises, injuries, dislocations and vertebral fractures, but look at other possible causes of such back pain.
Intervertebral hernia
You should know that vertebral herniation in the thoracic spine is a very rare occurrence, since this part of the spine does not bear such increased load as the cervical and lumbar regions.To diagnose or rule out this pathology, the neurologist or osteopath refers 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 stretch out of the tear, while the distance between the vertebrae decreases and the nerve roots are pinched.That is, the annulus fibrosus ruptures and the nucleus pulposus (the shock absorber in the middle of the disc) begins to extend into it.
If such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in severe cases, surgery.The difference between the pain of intervertebral hernia of the thoracic spine and other pathologies is that it occurs only in one place, and the pain can radiate to the chest, which can resemble the 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.
Overload combined with hypothermia of the back muscles
Overstrain of the back muscles can also cause pain in the area of the shoulder blades;this is not considered a disease, but the risk of developing osteochondrosis, scoliosis and intervertebral hernia increases in case of frequent overloading, heavy lifting, prolonged sitting or monotonous posture.Very 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 with air conditioning, hypothermia, so-called lumbago, can occur, when the pain intensifies, and it is necessary to prescribe NSAIDs (non-steroidal anti-inflammatory drugs), warming, disturbing ointments, massage, etc.
In order to avoid such complications, one should try to avoid drafts, lead a maximally active lifestyle, practice yoga, Bodyflex, physical exercises, and undergo a professional massage every six months.
Spinal tuberculosis
Today, many doctors seem to "forget" about this disease, and for some reason the anti-tuberculosis services in the country are beginning to decline, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If someone has suffered an injury, especially to their back or joints, or is simply very cold, their immune system is very weak, then a tuberculous focus often appears at the site of the injury, which cannot always be recognized in time based on specific signs, even on X-rays.
In such cases, the diagnosis is often made only when the person is already exhausted from the terrible pain and has many complications.With this disease, a person can experience very strong, burning pain between the shoulder blades;Patients describe it as twisting or drilling at one point of the spine, and even if the focus is localized in the thoracic spine, the pain radiates to the chest, in which burning, heat and pains are felt.
Tuberculosis of the spine is a very insidious disease, and when it occurs in some parts of the spine, the patient does not always have lesions in the lungs;tuberculosis infection can be an independent focus in any part of the spine.People are used to the idea that tuberculosis is a disease that affects only the low social strata of the population and is usually localized only in the lungs.This is a huge misconception!
When the body's defenses weaken, the Koch bacillus, which is present in almost every human body, is activated in the most weakened organs and a slow inflammatory process begins;these can be the kidneys, lymph nodes, fallopian tubes in women, the prostate or testicles in men, or individual vertebrae of the spine or joints of the limbs.
Scoliosis
According to statistics, nearly 50% of the population has varying degrees of scoliosis - curvature, twisting of the spinal column, and most often a combination of the thoracic spine and the cervical or lumbar spine.And since the ribs are connected to the chest regions, the shape of the chest also changes.There are many reasons for its formation - these are congenital pathologies of ligaments and bones, as well as acquired pathologies - intense physical overload, sedentary office work or sitting at a desk for schoolchildren.
A surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis with the help of a lateral and direct chest X-ray.Therapy for such 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 the following symptoms also occur:
- 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.
- In case of scoliosis, increased fatigue of the back muscles occurs
- 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 can be intermittent due to severe overexertion or prolonged standing or sitting, or it can be constant.
Osteochondrosis
Since the primary stages of osteochondrosis can now be found even in ten-year-old children, this pathology can rightly be called the scourge of the modern city dweller.More recently, this disease was considered a disease of the elderly, but modern life, an 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 in the surrounding tissues around the damaged vertebrae, as well as pinching of the nerve roots.The following symptoms are characteristic of osteochondrosis:
- Persistent, aching back pain that is aggravated by sneezing, coughing, sudden changes in posture, and physical activity
- When straightening the shoulders, you can hear a crunch between the shoulder blades
- Chest pain can be described as a stake
- Reduced mobility of the ribs leads to difficulty in breathing, and the person begins to breathe with his stomach.
- Hand movement is limited, weakness, tingling or numbness is felt in the hands.
Intercostal neuralgia
Intercostal neuralgia usually affects a person with pain on one side of the chest, but in rare cases it can also occur around the shoulder blades.This occurs in situations where compression of the nerve roots of the thoracic region occurs due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the thoracic region.
In the case of intercostal neuralgia, the symptoms and pain are intensified by pressure on the chest, when coughing, and can disturb the patient day and night.Since the pain caused by osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, you should consult qualified orthopedists, neurologists, osteopaths and surgeons to clarify the diagnosis.
Spondyloarthrosis
This disease is very similar to osteochondrosis, in terms of the nature of the pain, the factors that increase the load, and the changes in the body position.It is also chronic in nature, with periods of exacerbation and remission.Spondyloarthrosis can only be distinguished from osteochondrosis by X-ray, MRI or CT.In this disease, the cartilage is destroyed and replaced by bone tissue, so there are bony protrusions on the vertebrae.
Spinal myositis
After hypothermia, acute respiratory viral infection, influenza, muscle strain or back injury, inflammation of the muscle tissue can occur - myositis.Like all diseases, it can be acute or chronic.The pain can occur anywhere in the spine;it is painful in nature and is increased by touch, movement and physical activity.This is not a dangerous condition, and the use of warming and pain-relieving ointments for back pain usually helps.
Diseases of internal organs
As already mentioned, pain in the area of the shoulder blades on the back is not always a sign of spinal diseases;almost all diseases of the mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to the appearance of back pain.In our age full of oncological tension, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach and lungs can also manifest as pain in the area of the shoulder blades.
Diseases of the cardiovascular system
Coronary heart disease, heart attack, angina pectoris are diseases that can also cause such pain.In case of angina pectoris.for example, the pain never lasts more than 5 minutes and usually goes away immediately if you take nitroglycerin.However, in the case of an acute attack, if the severe pain lasts longer than 5 minutes, the blood pressure drops, a cold sweat appears, or the skin is pale, an ambulance should be called immediately.
Diseases of the gastrointestinal tract
Stomach ulcer, pancreatitis, gallbladder inflammation are three diseases that can also be responsible for the occurrence of chest pain both in the front and back.In addition, the development of stomach and pancreatic cancer can also cause such feelings.
Respiratory diseases
If, in addition to back pain, the patient is also bothered by a cough, an increase in body temperature, even a mild one, this may be due to lung pathology.Diseases such as pneumonia or pleurisy are typically preceded by hypothermia, acute respiratory viral infections and influenza.Recently, the development of atypical forms of pneumonia has become more common, when pneumonia is caused by pathogens such as mycoplasma or chlamydia, it is not associated with a very high temperature, but it can occur against the background of a low fever, and when inhaling, there may be pain in the right, left side of the back, especially aggravated by deep breathing.The main criteria for distinguishing lung pathology from other causes are fever, even if it is not high, and cough.
Other diseases
- Osteoporosis with fracture of the vertebral bodies, say due to long-term use of steroid hormones or a decrease in estrogen in postmenopausal women.
- For example, metastases in the vertebrae of stomach cancer can also cause pain
- Spontaneous fractures due to irrational loads.
- Ankylosing spondylitis (Bechterew's disease) is a systemic disease.It affects men more often, in which the vertebrae are affected against the background of the inflammation and ossification of the ligaments occurs.As a result, the spine becomes inflexible and radiographically described as a bamboo pole.