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 shoulders
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 pain referred to pulmonary and cardiac diseases, and diseases of the gastrointestinal tract, as well as pain in radicular syndromes, trauma and osteochondrosis. Let's take a closer look at the common causes of pain in the back and shoulder blades.
INJURY
Scapula injuries occur in two ways - with direct impact (impact, fall) and indirect, with loads along the axis of the upper limbs (fall on the elbow, sharp contraction of the muscles of the shoulder girdle). In the first case, simultaneous damage to the spine and rib fractures are possible. Such injuries occur in 50% of serious road accidents. Severe pain, limited mobility, and severe swelling of the tissues surrounding the shoulder blade may also be seen with severe bruising.
Osteochondrosis
Osteochondrosis is a common causebackacheANDspineany localization, and also inshoulder blade area. Degenerative-dystrophic processes in the joints and intervertebral discs, as a result of malnutrition and cartilage regeneration, lead to the formation of protrusions and hernias, back muscle spasms and a decrease in the height of the intervertebral discs. Spinal nerves can be compressed; the pain may be caused by radicular syndrome.
Pain is provoked by bending or turning the body, lifting weights. Due to the accompanying inflammation of the back muscles, the pain may increase when lifting and abducting the arms. Possible stiffness of the spine, bending, forced position of the patient with a slight forward bend. The pain can be aching, shooting, encirclement 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 appears, mainly in the coronary plane. As a result, the normal distribution of loads and biomechanics is disrupted. Predisposing factors for scoliosis are wrong 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 muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by aching pain that goes away when lying down and intensifies 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 resemble a question mark "? ", and a hump may begin to form. 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 muscle tension and spasm, as they are subjected to excessive stress. At the same time it feelsback muscle painand in the regionshoulder blades
Spondyloarthrosis, spondyloarthritis
Spondyloarthrosis is degenerative-dystrophic changes in the intervertebral joints, caused by the malnutrition of the articular cartilage, which leads 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, which leads 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 joint destruction, and in the second case, the primary inflammation leads to degenerative-dystrophic changes.
Pain in spondyloarthritis and spondyloarthrosis is painful in nature and intensifies at night. A characteristic symptom is stiffness and stiffness of the spine in the morning, which goes away after gymnastics or physical activity. The course of the disease is chronic, undulating, with periods of exacerbations and improvements. Pain can be located not only between the shoulder blades, but throughout the spine.
Protrusion and hernia
Prolapses and herniations of the intervertebral discs are a consequence of advanced osteochondrosis of the spine. The intervertebral disc, which has lost its elasticity and elasticity, or rather the peripheral part, which is called the fibrous ring, protrudes under the influence of loads and forms a protrusion. If the annulus fibrosus ruptures, the inner contents of the disc fall out, forming a herniated disc. Both protrusions and herniations of the intervertebral discs can cause entrapment of the spinal cord roots that exit through the intervertebral foramina. Acute pain, protective tension and muscle spasm occur. The pain can radiate to the shoulder, elbow, forearm and is often localized in the area of the shoulder blade (with a hernia or protrusion in the thoracic spine).
Radiculitis
Acute pain that begins in the interscapular region and continues along the intercostal spaces is the most common sign of radiculitis. It is caused by compression of the spinal nerves by a herniated or prolapsed 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.
Humeroscapular periarthrosis
Humeroscapular periarthrosis is a disease associated with pain in the shoulder and scapula, caused by arthrosis 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 cervicothoracic spine. Humeral periarthrosis is the most common cause of acute pain in the shoulders and shoulder joint.
The pain appears gradually, intensifying from episodic pain during physical activity, with a large range of movements in the shoulder joint (arm swing, throwing, when putting the arm behind the back). Then the pain becomes constant, hurts even at rest. Because of it, the patient cannot sleep on the affected side.Pain inshoulder andgives back to the shoulder blade. Possible pain during movement. It is characterized by a sharp limitation of mobility in the shoulder joint, the patient is unable to raise or abduct his arm.
Neuralgia
Painful pain in the area of the shoulder blades, radiating along the nerves between the ribs, is a sign of neuralgia, a chronic neurological disease. A characteristic symptom is increased pain when you cough, sneeze or move - the pain becomes sharp, strong. The cause of the disease is the irritation of the roots of the spinal cord due to diseases of the spine, spondyloarthritis and spondyloarthrosis, muscle inflammation. Aggravation can be provoked by currents, hypothermia and physical activity.
Heart dissases
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 heart disease, atherosclerosis of the coronary vessels. Acute severe pain under the left shoulder that does not go away for a long time is a sign of ischemia or myocardial infarction. The nature of the pain is different - from pain, constant, to acute, with shooting pains in the left shoulder and forearm, neck on the left. A characteristic symptom is that the pain is relieved by nitrates (drugs for the treatment of heart failure) - nitroglycerin, isoket, nitrosorbide.
Problems with the gastrointestinal tract
Diseases of the gastrointestinal tract are a common cause of back pain in the shoulder blade area. Pain is reflected in nature and occurs due to the fact that part of the pain impulses from the solar plexus and receptors in the gastrointestinal tract return to the spinal cord. Pain in the shoulder area can occur with a hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainare localizedin the back between the shoulder blades, moreon the right.
Lung diseases
Pain in the shoulders 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 shoulder area.
Back pain areas in the shoulder area
Pain in the shoulder area during inhalation or exhalation is a characteristic sign of intercostal neuralgia, spinal osteochondrosis with protrusion or herniation of the intervertebral disc, inflammation of the back and radicular muscles. The reason for the pain is that the act of breathing is provided by the coordinated contraction of a large number of muscles, and movements even in such volume can provoke increased pain in the above diseases.
Pain in sternum and shoulders
Pain in the sternum and shoulder blades is often found with glenohumeral periarthrosis. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of loads, therefore 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 lung and heart diseases.
Shoulder pain on the right or left side
Pain in the shoulder blade on the left can be reflected in heart disease, as mentioned above. Pain in the right shoulder is characteristic of acute or chronic cholecystitis, gallstones.
Shoulder and neck pain
Backache,in the shoulder and neck areapossible with osteochondrosis of the cervical and thoracic spine. This symptom is also characteristic of a hernia or protrusion. Pain referred to the neck and shoulder blade is observed in some heart and lung diseases (angina pectoris, lung cancer, pneumonia).
Types of shoulder pain
Aching pain in shoulder blade
Aching pain in the shoulder blade on the left is observed with heart disease, on the right - with diseases of the biliary tract, cholelithiasis. Painful pain is associated with glenohumeral periarthrosis, neuralgia and radicular radiculitis. Aching pain in the back and shoulder area is also possible with spondyloarthritis and spondyloarthrosis.
Pressing pain in shoulder blade
Pressure 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 during inhalation
Dull pain in the back and shoulder blades, aggravated by inhalation, can be observed with pneumonia, lung cancer, neuromuscular pathology and myositis. This symptom is also a sign of injury, back bruises and soft tissue hematoma. Dull pain in the back and shoulder blades is accompanied by some diseases of the spinal cord, such as multiple sclerosis.
Throbbing pain in shoulder blade
Throbbing pain in the shoulder, which intensifies with movement, sneezing and coughing, is a sign of back damage, fractures and tears of the scapula. The mechanism of injury is most often a direct physical impact or an indirect impact transmitted along the axis of the upper limbs, for example, when falling on the elbow.
During movement (standing) pain in shoulder blades
Pain in the shoulder blades while walking can occur with hernias and protrusions of the thoracic spine. Axial loads on the spine that occur when you move and hit the ground with your heel are transferred to the diseased intervertebral disc and provoke pain.
Burning in the area of the shoulder blades
A burning sensation in the shoulder area is a possible sign of acute myocardial infarction. Ischemia (failure of blood circulation and lack of oxygen in the heart muscle) of the myocardium is accompanied by severe pain, painful shock and a drop in blood pressure. However, if the posterolateral wall of the left ventricle and the septum of the heart are damaged, the pain can imitate spinal osteochondrosis, poisoning from poor quality food, acute surgical pathology and many other diseases.
Burning and tingling in the skin in the interscapular area can be a symptom of a 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
Left shoulder pain with nausea and vomiting may also indicate acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (blockage of the lumen of the bile duct with stones) - the pain is localized more on the right, nausea is caused by intoxication.
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 to prescribe 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 analgesics 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 characteristic signs of a particular disease. A study of skin sensitivity, reflex testing, evaluation of the range of motion in the shoulder joint and spine, etc. is done. To confirm the diagnosis, instrumental methods such as ECG, ultrasound, CT or MRI are used.
Magnetic resonance imaging is a universal method for diagnosing the causes of back pain related to 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 physical phenomenon of magnetic resonance, which is created using only magnetic fields and radio waves that are safe for human health.
Shoulder blade pain treatment
The treatment of pain in the back and shoulder blades 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 condition of the patient. As an example, consider a treatment plan for spinal osteochondrosis.
To eliminate 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 performed and muscle relaxants are prescribed. When a herniated spinal nerve is pressed, physical influence is used - underwater traction, manual therapy. Analgesics are prescribed to combat pain.
Shoulder blade pain treatment at home
Treatment at home is possible only if the patient has consulted a doctor, undergone an examination, during which an accurate diagnosis was made. In most cases, the causes of shoulder and back pain do not require emergency hospitalization; treatment is carried out at home, in accordance with the doctor's prescriptions. However, the opposite is more often the case - patients try to treat themselves at home, self-diagnose and use painkillers uncontrollably. The result of self-diagnosis and self-medication is chronic pain and side effects of analgesics. Patients often come to the doctor late when the disease causes complications. In case of severe diseases, late treatment significantly worsens the prognosis and reduces the likelihood of a complete recovery. That is why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I consult for shoulder pain?
ClarifyingCauses and treatment of shoulder and back painis 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 cord 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 visit a doctor and self-medicate - the consequences of such "treatment" lead to complications, chronicity of the disease and in some cases pose a threat to human health and life.