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 must be remembered that such painful sensations can also be associated with other diseases of the thoracic organs - the stomach, heart, respiratory system, and mediastinal organs.
Such pain can be acute, growing rapidly and quickly passing or significantly increasing over time, or chronic, worrying the patient for a long time and requiring accurate diagnosis, since it can be a symptom of a serious pathology of any chest. organsSometimes 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 back pain ointments or injections, the real cause of its occurrence should be established. When communicating with a doctor, it is very important to describe all the slightest concomitant symptoms that accompany the pain, the time of their appearance, the factors that provoke their intensification, since the doctor needs help in determining the direction of the examination, and sometimes , It is very difficult. establish the correct diagnosis without precise data on the nature of the pain.
Very often, premature 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 prescribed inappropriately, and therefore, do not provide the desired result. Therefore, it is very important for the patient himself to know the possible list of diseases that are 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 occurrence, as this spine does not bear such a high load as the cervical and lumbar regions. To diagnose or exclude this pathology, the neurologist, osteopath directs the patient to MRI, CT. Changes in intervertebral hernia are due to the fact that the annulus fibrosus - 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 annulus fibrosis cracks, the nucleus pulposus (shock absorber in the center of the disc) begins to protrude into it.
When such a hernia is found, doctors prescribe NSAIDs (anti-inflammatory drugs), physical therapy, physical therapy, 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 one place, and the pain can also radiate to the chest, which may resemble the symptoms of pulmonary or heart failure. With a lack of long-term treatment of an intervertebral hernia, a curvature of the spine, paraparesis of the lower extremities, a disorder of the functions of the pelvic organs, and a chronic pain syndrome can occur.
Overexertion in combination with hypothermia of the back muscles
Overstrain of the back muscles can also cause pain in the shoulder blades, this is not considered a disease, but with frequent excessive loads, lifting weights, sitting for a long time in a monotonous position, the risk of developing osteochondrosis increases, scoliosis, intervertebral hernia. Very often, such pains are suffered by people whose work requires them to stay in the same position for several hours a day: seamstresses, drivers, office workers, surgeons.
Sometimes, when such a profession is combined with an air conditioner, hypothermia can occur, the so-called back pain, when the pain becomes more severe and requires the appointment of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming, ointments. distraction, 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.
tuberculosis of the spine
Today, many doctors seem to "forget" about this disease, and tuberculosis services in the country for some reason are declining, 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 gets very cold, with a very weakened immune system, a tuberculous focus often develops at the site of the injury, which even on radiographs for signs specific is not always possible to recognize in time.
Often, in such cases, the diagnosis is established only when the person is already exhausted from terrible pain and has a number of complications. With this disease, a person may be disturbed by a very strong burning pain between the shoulder blades, patients describe it as a twisting or perforation 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, 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 localized, as a rule, only in the lungs. This is a big mistake!
When the body's defenses are weakened, Koch's bacillus, which is in the body of almost all people, is activated in the weakest organs and begins a slow inflammatory process, it can be like the kidneys, lymph nodes, tubes fallopian tubes in women, the prostate or testicles in men, as well as individual vertebrae in the spine or joints in the limbs.
Scoliosis
According to statistics, almost 50% of the population have various degrees of development of scoliosis: curvature, torsion 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 thorax also changes. There are many reasons for its development: these are congenital pathologies of the ligaments, bones, and acquired - intense physical overload, sedentary office work, or schoolchildren sitting at a desk.
With direct and lateral chest radiographs, a surgeon, neurologist, orthopedist, or osteopath can make a similar diagnosis. Therapy of such a pathology should be very intense and prolonged - this is a 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:
- At an early stage, the visual curvature may be subtle, but with the progression of scoliosis when examining the patient from behind, the curvature becomes noticeable.
- With scoliosis, there is an increase in the fatigue of the back muscles.
- The position of the shoulders and arms can be at different heights.
- The pain that bothers the patient in the chest is most often localized on one side.
- Between the shoulder blades, the pain can be periodic due to severe overexertion or prolonged standing or sitting, and it can also be constant.
osteochondrosis
Since the primary stages of osteochondrosis are found today even in ten-year-olds, this pathology can rightly be called the scourge of a modern city dweller. More recently, this disease was considered a disease of the elderly, but modern life, an incorrect 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 pinching of the nerve roots. The following symptoms are characteristic of osteochondrosis:
- Constant aching pain in the back, aggravated by sneezing, coughing, a sharp change in body position, during physical exertion
- As you straighten your shoulders, you can hear a crack between your shoulder blades.
- Chest pain can be described as "the gamble is worth it. "
- Reduced mobility of the ribs provokes shortness of breath, and the person, as it were, begins to breathe in 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 in rare cases it can also be in the area of the shoulder blades. This occurs in situations where compression of the nerve roots in the thoracic region occurs during excessive stress, hypothermia, trauma, infectious diseases, or osteochondrosis of the thoracic region.
With intercostal neuralgia, symptoms, pain increase with pressure on the chest, with coughing and can bother the patient both day and night. Since pain in osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, qualified orthopedists, neurologists, osteopaths and surgeons should be contacted to clarify the diagnosis.
spondyloarthrosis
This disease is very similar to osteochondrosis, depending on the nature of the pain, depending on the factors that increase it during exercise, the change in body position. It is also chronic, with periods of exacerbations and remissions. It is possible to distinguish spondyloarthrosis from osteochondrosis only with the help of X-ray, MRI or CT scan. With this disease, the cartilage is destroyed and replaced by bone tissue, due to which bony protrusions can be found on the vertebrae.
Myositis of the back muscles.
After any hypothermia, SARS, influenza, muscle strain, back injury, inflammation in muscle tissue - myositis can occur. Like any disease, it can be acute or chronic. The pain in this case can be in any part of the spine, they are aching in nature, and also increase with palpation, movement and physical exertion. This is not a dangerous condition, and the use of warming ointments to relieve back pain usually helps.
Diseases of the internal organs.
As we have already said, pain in the shoulder blades in the back is not always a sign of spinal diseases, almost all diseases of the mediastinal organs, heart, stomach, pancreas and gallbladder can contribute to the appearance of pain in the back. . . In our time of oncological stress, 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 pectoris are diseases that can also be the cause of such pain. with angina, for example, the pain never lasts more than 5 minutes, and with nitroglycerin it usually goes away immediately. However, in an acute attack, if severe pain lasts more than 5 minutes, blood pressure drops, 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 appearance of pain in the thoracic 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 may be pulmonary pathologies. Usually, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections, influenza. 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 a subfebrile condition , and back pain can appear on the right, on the left, when inhaling, especially aggravated by deep inspiration. The main criterion for distinguishing pulmonary 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.
- Metastasis to the vertebrae from stomach cancer, for example, can also cause pain.
- Spontaneous fractures with irrational loads.
- Ankylochian 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 inflexible and is radiologically described as a bamboo stick.