Most people, when experiencing back pain between the shoulder blades, associate their appearance with various disorders of the spine, 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 organs of the chest - the stomach, heart, respiratory system and mediastinal organs.
Such pain can be either acute, which develops rapidly and quickly passes or significantly increases over time, or chronic, which worries the patient for a long time and requires accurate diagnosis, since it can be a symptom of a serious pathology of nany chest. organs. Sometimes the pain between the shoulder blades can occur 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 ointments for back pain or injections, the true cause of their occurrence should be established. When contacting a doctor, it is very important to describe all the slightest concomitant symptoms that accompany the pain, the time of their appearance, provoking factors of its intensification, since the doctor needs help in determining thedirection of the examination and it is sometimes very difficult to establish the correct diagnosis without precise data on the nature of the pain.
Very often, the untimely identification of the true cause of the pain between the shoulder blades forces a person to undergo many expensive and time-consuming examinations, to use various treatment options, which are sometimes prescribed inappropriately and therefore do not bring thedesired result. Therefore, it is very important for the patient himself to know about 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 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, since this spine does not bear such an increased load as the cervical and lumbar regions. To diagnose or exclude this pathology, the neurologist, the osteopath directs the patient to the MRI, the scanner. Changes in intervertebral hernia are due to the fact that the fibrous ring - the outer part of the intervertebral disc of 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 (damper in the center of the disc) begins to protrude into it.
When such a hernia is discovered, 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 and other pathologies is its localization in one place, and the pain may also radiate to the chest, which may resemble symptoms of impaired functionpulmonary or cardiac. With a lack of long-term treatment of an intervertebral hernia, curvature of the spine, paraparesis of the lower extremities, disorder of the functions of the pelvic organs and chronic pain syndrome can occur.
Overstrain in combination with hypothermia of the back muscles
Overstrain of the back muscles can also cause pain in the shoulder blades, it is not considered a disease, but with frequent excessive loads, weight lifting, prolonged sitting in a monotonous position, the risk of developing aosteochondrosis, scoliosis, intervertebral hernia increases. Very often, people whose work requires them to stay in one position for several hours a day suffer from such pain - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when such a profession is combined with an air conditioner, hypothermia, a so-called back pain, can occur, when the pain becomes more severe and requires the appointment of NSAIDs (nonsteroidal anti-inflammatory drugs), theuse of warming, distracting ointments, massage, etc.
To prevent such complications, you should try to avoid drafts, lead the most active lifestyle, do yoga, Bodyflex, therapeutic exercises, take a professional massage course every six months.
Tuberculosis of the spine
Today, many doctors seem to "forget" about this disease, and for some reason the country's tuberculosis services are in decline. In fact, nearly 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 focus often occurs at the site of injury, which even on X-rays byspecific signs, is not always possible to recognize in time.
Often in such cases the diagnosis is made only when the person is already exhausted by terrible pain and has a number of complications. With this disease, a person can be disturbed by very strong burning pain between the shoulder blades, patients describe it as twisting or drilling at one point in the spine, and also when the focus is localized in the thoracic spine, the pain radiates to the chest, in which there is a burning sensation, heat, aches .
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 inany 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 localized, as a rule, 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 nodeslymphatics, the female fallopian tubes, the prostate or the testicles in men, as well as the individual vertebrae of the spine or the joints of 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 it is the thoracic spine in combination with the cervical or lumbar regions. And since the ribs are connected to the thoracic regions, the shape of the chest also changes. There are many reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired pathologies - 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. The therapy of such a pathology should be very intensive and long - this is massage, wearing a special corset, therapeutic exercises. In scoliosis, back pain between the shoulder blades is the main symptom, and the following symptoms are also inherent in it:
- At an early stage the visual curvature may be subtle, but as the scoliosis progresses when examining the patient from behind the curvature becomes noticeable.
- With scoliosis, there is an increase in back muscle fatigue
- Position of shoulders and arms can be at different heights
- The pain that bothers the patient in the chest is more often localized on one side
- Between the shoulder blades, the pain can be both periodic due to severe overstrain or prolonged standing or sitting, and can also be constant.
Osteochondrosis
Since the first stages of osteochondrosis are found today 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 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 the pinching of the nerve roots. The following symptoms are characteristic of osteochondrosis:
- Constant aching pain in the back, aggravated by sneezing, coughing, a sudden change in body position, during physical exertion
- When you straighten your shoulders, you may hear a crack between your shoulder blades
- Chest pain can be described as if "it's worth it"
- Reduced mobility of the ribs leads to difficulty in breathing, and the person, as it were, begins to breathe into the stomach
- Movement in the hands is limited, weakness, tingling or numbness in the hands 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 be in the shoulder blades. This occurs in situations where the compression of the nerve roots in the chest region occurs during excessive stress, hypothermia, trauma, infectious diseases or osteochondrosis of the chest region.
With intercostal neuralgia, symptoms, pain increase with pressure on the chest, with coughing, and can disturb the patient day and night. Since pain in osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, to clarify the diagnosis, one should contact qualified orthopedists, neurologists, osteopaths and surgeons.
Spondylarthrosis
This disease is very similar to osteochondrosis, depending on the nature of the pain, depending on the factors that increase it during exertion, change in body position. 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, the cartilage is destroyed and replaced by bone tissue, so bony protrusions can be found on the vertebrae.
Back muscle myositis
After any hypothermia, SARS, flu, muscle strains, back injuries, 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, it is aching in nature, and also increases with palpation, movement, physical exertion. It is not a dangerous condition, and the use of warming and analgesic ointments for back pain usually helps.
Diseases of internal organs
As we have already said, pain in the shoulder blades of the back is not always a sign of diseases of the spine, almost all diseases of the mediastinal organs, heart, stomach, pancreas andgallbladder can contribute to the onset of pain in the back. . In our era 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 in pain in the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina pectoris are diseases that can also cause such pain. With angina. for example, the pain never lasts longer than 5 minutes, and with nitroglycerin it usually subsides immediately. However, during an acute attack, if the severe pain lasts more than 5 minutes, blood pressure drops, cold sweats appear, the skin is pale, 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 occurrence of pain in the chest region both in front and back. Also, the development of oncological diseases of the stomach, pancreas can provoke such sensations.
Diseases of the respiratory system
If the patient, in addition to back pain, is worried about coughing, even a slight increase in body temperature, then the cause may be lung pathologies. Usually such diseases 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 inthe background of a subfebrile state, and back pain can appear on the right, on the left, during inspiration, especially aggravated by deep inspiration. The main criterion for distinguishing lung pathology from other causes is the presence of temperature, not even elevated, and cough.
Other diseases
- Osteoporosis with vertebral body fractures, for example, against the background of long-term use of steroid hormones or decreased estrogen in postmenopausal women.
- Metastases to the vertebrae from stomach cancer, for example, can also cause pain.
- Spontaneous fractures with irrational loads.
- Ankylochia spondylitis (Bechterew's disease) is a systemic disease. Affecting 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 inflexible and is radiologically described as a stick of bamboo.