If a person has back pain in the shoulder blade area, he automatically associates it with the condition of the spine. In part they are right: this long-suffering core of our skeleton takes on heavy loads, which can only affect its conditions.
But pain in this area of the back often signals a disturbance of the internal organs. The nature of the pain corresponds to the disease, so at the doctor's appointment it is important to describe its manifestations in as much detail as possible.
What are the causes of shoulder pain
Pathological changes in:
- vertebral column;
- internal organs;
- surrounding structures.
It hurts in the scapular area and with some rare diseases:
- Fractures of the spine and its systemic injuries;
- Spinal metastases in stomach and sometimes other organ cancer.
Pain according to the type of disease is localized:
- Above the shoulder blades;
- Under the shoulder blades;
- Between the shoulder blades;
- In the shoulder blades.
Symptoms associated with pathologies of the internal organs
The stomach, lungs, liver, and heart can project their pain under the shoulder blade, right or left.
If it hurts on the left, this may be a sign:
- Peptic ulcer of the stomach: the pains are of a periodic nature, associated with exacerbations of a seasonal nature. They are accompanied by pain in the upper abdomen. During the increase in pain, vomiting occurs;
- Myocardial infarction: the disease is accompanied by acute retrosternal pain, which extends under the left shoulder blade. Cardiac ischemia has similar signs, but pain sensations in the left hand also occur in this case;
- Breakthrough of a stomach ulcer: the patient's body is covered with cold sweat, he can feel bad until the opening of vomiting. The patient tries to alleviate the pain by changing position, but these actions do not give the expected effect;
- Intercostal neuralgia: Pain under the left shoulder blade comes in attacks, aggravated by minimal physical exertion. It tingles and burns in the region of the heart. It hurts to cough and take a deep breath.
It can hurt under the right shoulder blade when:
- Psychological failures in the body. At the same time, the patient feels heat in the chest, may complain of squeezing and tingling in the heart muscle;
- Pathological changes in the gallbladder: additional symptoms - bitterness in the mouth after fatty, salty and fried foods, pain in the right hypochondrium;
- Pleurisy and pneumonia - pain under the right shoulder blade is reflected when coughing;
- Kidney disease: in this case the cough also leads to increased pain, but, unlike lung diseases, the patient has difficulty urinating.
Pain associated with pathologies of the spine
Spine problems can occur after injuries, fractures, or bruises. But there are also diseases that have no obvious cause. And all of them are manifested by pain in the scapular region.
With any pathology of the spine, the pain between the shoulder blades must be combined:
- rigidity;
- Feeling of goosebumps
- Numbness.
Interscapular pain when coughing is typical of heavy smokers.
Osteochondrosis
If the nutrition of the tissues is disturbed, dystrophic changes occur in them. In the spine, this process affects the intervertebral discs. They can no longer withstand the pressure exerted on them by the vertebrae. The loss of elasticity of the disc leads to compression of the spine. The nerve endings in the spinal cord come under pressure - this is where severe pain occurs.
The body tries to protect the spine from heavy loads by growing bone tissue along the edges of the vertebral processes. The bone growths are called osteophytes. They can be removed, but against the background of osteochondrosis they will grow back.
Pain in osteochondrosis is localized at the site of damage to the spine. If the cervical region is affected, the patient has pain in the morning on the right side of the neck. The pain radiates to the shoulder and arm, is felt above the shoulder blade. The head may feel dizzy, the torment is aggravated by a deep breath and cough.
Osteochondrosis of the thoracic region manifests itself as pain between the shoulder blades, to the right and left of the spine. The pain can be made worse by sneezing, coughing, and sudden movements. When you try to straighten your shoulders, your chest and interscapular area will start to crackle.
It becomes difficult for a person to breathe from the chest, as the mobility of the ribs decreases and unconsciously switches to breathing with the stomach.
Treat osteochondrosis with a conservative method. The patient is prescribed:
- Pain relievers and anti-inflammatory drugs;
- Physiotherapy procedures;
- therapeutic gymnastics;
- reflexology;
- massages;
- Traction of the spine;
- Manual therapy.
If none of the treatment methods don't work, the surgeons get to work.
Spondyloarthrosis
Symptoms of this disease are similar to osteochondrosis. But in this case, the intervertebral disc is displaced, not exhausted. The hyaline cartilage is forced to take on the load. Under such extreme conditions, its tissue thins and loses the ability to perform its functions.
If spondyloarthrosis is left untreated, the entire joint can become inflamed and therefore completely lose mobility. The patient's condition is aggravated by osteophytes.
Scoliosis
The curvature of the spine relative to its axis to the right or left is common: almost half of humanity is affected by this disease. But for the most part, the disease is not pronounced, and therefore pains appear periodically, if a person has excessively strained his back, or has been standing or sitting in one position for a long time.
Early scoliosis cannot be determined visually, therefore, if pain occurs in the scapular region, it is in the patient's best interest to consult a doctor. He will prescribe an x-ray - direct and lateral.
With the further development of scoliosis, it can be detected independently: the "zigzags" of the spine become clearly pronounced. Running scoliosis is also determined by the relative position of the shoulders - one will be lower than the other.
Treatment of scoliosis is a long-term affair even at its high intensity. Massage, special exercises and wearing a corset will help get rid of the curvature of the spine.
Intervertebral hernia
The intervertebral disc is composed of:
- Gelatinous core;
- Fibrous ring, consisting of fibers;
- The two thin layers of cartilage that cover the discs above and below.
The nucleus is located inside the ring, and the cartilage tissue, closing the structure, simultaneously serves as a conductor of nutrition from the vessels of the vertebral body to the disc.
Pathological changes in the vertebrae lead to disruption of metabolic processes in the intervertebral discs. Their thickness decreases, the fibrous ring cracks under the influence of loads, opening the way to the outside of the gelatinous mass of the nucleus. This process is accompanied by severe pain. It is concentrated in one point, but sometimes there is a return to the lung and heart regions.
An intervertebral hernia in the thoracic region is extremely rare, therefore, when pain appears in the scapular region, the patient is first checked for other diseases.
An intervertebral hernia is treated with anti-inflammatory drugs, physiotherapy, and special exercises. In severe conditions, only surgery can help.
Spinal tuberculosis
Tuberculosis microbacteria can affect any part of the spine, but 60% of cases occur in the thoracic region. Most often, men suffer from this disease. Basically, a couple of vertebrae are involved in the process, but there are cases where TB spreads to three or more.
Symptoms of the disease can vary depending on the number of affected vertebrae. But there is one constant symptom: it is pain. If it is felt between the shoulder blades, this indicates a lesion of the cervical vertebra.
It also hurts with tuberculosis of the thoracic region, but then the pain will radiate (give way) to the chest, groin or abdomen. Patients complain of burning, twisting, "perforation" in the back.
Tuberculosis of the spine is difficult to diagnose, severe pain appears already at the stage of the appearance of various complications. If you have the slightest suspicion of this disease, immediately go to a specialist for an examination.
Overvoltage and hypothermia
If the back is excessively overloaded, painful sensations may also appear in the shoulder area. By itself, this phenomenon is not considered a disease, but constant overload can cause osteochondrosis, spinal curvature and the formation of intervertebral hernias.
Tailors, drivers, surgeons, people who perform sedentary jobs, etc. complain of back pain. If hypothermia (drafts, a working air conditioner) is added to the overvoltage, it can teach a back pain: severe pain concentrated under the shoulder blades or in the spine.
This problem is treated with warming ointments, anti-inflammatory drugs and massage.
Myositis
Flu, SARS, severe hypothermia can lead to myositis - inflammation of the muscle tissue. Most often, this disease affects the muscles located in the scapular region. This condition does not threaten the body with anything terrible, but the aching pain creates discomfort.
Pain in the shoulder blades
Pain occurs for several reasons:
- Fracture or injury resulting from a fall. The shoulder joint swells, it hurts to move the limb;
- Osteomyelitis (inflammation of the bone tissue): accompanied by fever, fever from intoxication of the whole organism;
- Pterygoid scapula - this effect is caused by damage to the serratus anterior (located on the side of the chest), paralysis of the rhomboid, trapezius muscles or their traumatic rupture (from which acrobats and circus gymnasts, professional athletes suffer).
If the synovial bursa is inflamed, the scapula begins to crackle. In addition to this problem, the patient is concerned about the heaviness and clicks in the shoulder joint.
Diagnostics
Since pain in the scapular area of the back signals one of many diseases, the examination is carried out according to several methods:
- chest x-ray;
- Laboratory research;
- ultrasound;
- Magnetic resistance or computed tomography;
- ECG.
All examinations are prescribed by the surgeon: if your back hurts, first of all go to him. But in the future, based on the results of the research, he will need advice:
- Orthopedic;
- Gastroenterologist;
- Neurologist;
- pulmonologist.
If for any reason the doctor did not pay attention to the accompanying symptoms, consult on their own initiative.
Treatment
Self-medication for pain in the scapular area is categorically contraindicated. The most the patient can afford is to take pain relievers and analgesics. Reception should be single and only if it is necessary to stop the pain syndrome before visiting the doctor.
Treatment is prescribed by a doctor: usually, to relieve the condition, it is enough to take analgesics, chondroprotectors, anti-inflammatory drugs. In addition, the doctor paints a treatment regimen designed to eliminate the root causes of pain in the scapular region.