Most people, when they feel 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 should be borne in mind that such painful sensations can be associated with other diseases of the chest organs - stomach, heart, respiratory system and mediastinal organs.
Such pain can be either acute, which grows quickly and passes quickly or increases significantly over time, or chronic, which worries the patient for a long time and requires an accurate diagnosis, because it can be a symptom of serious pathology of any chest. organs. Sometimes the pain between the shoulder blades can occur only after a sudden physical exertion or after a long stay in a certain uncomfortable position.
It should be borne in mind that pain in the interscapular region is not a disease, but a symptom, and before using any ointments for back pain or injections, the real cause of their appearance should be determined. When contacting a doctor, it is very important to describe all the least accompanying symptoms that accompany pain, the time of their occurrence, provoking factors for its intensification, as the doctor needs help in determining the direction of the examination and is sometimes very difficult. to make an accurate diagnosis without accurate data on the nature of the pain.
Very often, untimely identification of the real cause of pain between the shoulder blades forces a person to undergo numerous expensive and lengthy examinations, uses various treatment options, which are sometimes inadequately prescribed and therefore do not bring the desired result. Therefore, it is very important that the patient himself knows about the possible list of diseases that characterize this pain syndrome.
Pain caused by pathologies of the spine
We will not dwell on such obvious causes as bruises, injuries, dislocations, and vertebral fractures, but we will consider other possible causes of such back pain.
Intervertebral hernia
It should be known that a vertebral hernia in the thoracic spine is a very rare occurrence, because this spine does not carry such an increased load as the neck and lumbar part. To diagnose or rule out this pathology, a neurologist, osteopath refers the patient to MRI, CT. Changes in the intervertebral hernia occur due to the fact that the fibrous ring - 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 compressed. That is, the fibrous ring bursts, 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), physiotherapy, physiotherapy, reflexology, and in severe cases, surgery is indicated. The difference between such pain in intervertebral hernia of the thoracic spine from other pathologies is its localization in only one place, and the pain can radiate to the chest, which may resemble symptoms of impaired lung or heart function. Prolonged lack of treatment for intervertebral hernia can lead to curvature of the spine, paraparesis of the lower extremities, dysfunction of the pelvic organs and chronic pain syndrome.
Overload combined with back muscle hypothermia
Overexertion of the back muscles can also cause pain in the shoulder blades, it is not considered a disease, but with frequent excessive loads, lifting weights, prolonged sitting in a monotonous position increases the risk of osteochondrosis, scoliosis, intervertebral hernia. Very often, people whose work forces them to stay in the same position for several hours a day suffer from such pains - they are tailors, drivers, office workers, surgeons.
Sometimes, when such a profession is combined with air conditioning, hypothermia can occur, so-called. back pain, when the pain becomes more intense and requires prescribing NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming, interfering fats, massage, etc.
To prevent such complications, try to avoid drafts, lead the most active lifestyle, do yoga, Bodyflex, therapeutic exercises, take a course of professional massage every six months.
Tuberculosis of the spine
Today, many doctors seem to be "forgetting" about the disease, and the country’s anti-TB services are declining for some reason, and in fact nearly 90% of the population has been infected with Mycobacterium tuberculosis since childhood. If a person is injured, especially the back, wrist, or simply catches a bad cold, with a severely weakened immune system, a tuberculosis focus often develops at the site of injury, which is not always possible to recognize in time on X-rays.
Often, in such cases, the diagnosis is made only when the person is already exhausted from 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 in one point of the spine, and even when the focus is localized in the thoracic spine, the pain radiates to the chest.
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 accustomed 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 misconception!
When the body's defenses are weakened, Koch's bacillus is activated in the weakest organs, which is found in almost every person's body and begins a slow inflammatory process, such as kidneys, lymph nodes, female fallopian tubes, prostate or testicles in men and individual vertebrae. in the spine or joints in the limbs.
Scoliosis
According to statistical data, 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 neck or lumbar region. And since the ribs are connected to the thoracic region, 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 - intense physical overload, sedentary office work or schoolchildren sitting at a table.
With lateral and direct chest X-rays, a surgeon, neurologist, orthopedist, or osteopath may make a similar diagnosis. The therapy of such pathology should be very intensive and long - this is a massage, wearing a special corset, therapeutic exercises. In scoliosis, the leading symptom is back pain between the shoulder blades, and it is characterized by the following symptoms:
- In the early stage, the visual curvature may be subtle, but as scoliosis progresses when examining the patient from the back, the curvature becomes noticeable.
- With scoliosis, there is an increase in back muscle fatigue
- The position of the shoulders and arms can be at different heights
- The pain that disturbs the patient in the chest is more often localized on one side
- Between the shoulder blades, the pain can be periodic due to strong overexertion or a long standing or sitting position, and it can also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis today are found even in ten-year-old children, this pathology can rightly be called a plague of the modern city dweller. In recent times, this disease has been considered a disease of the elderly, but the modern way of life, irregular, sedentary lifestyle, leads to the early development of dystrophic changes in the joints and spine. The cause of back pain is stimulated by an inflammatory process that develops in the surrounding tissues around the damaged vertebrae, as well as due to pinched nerve roots. Osteochondrosis is characterized by the following symptoms:
- Constant, painful back pain, intensified by sneezing, coughing, sudden change of body position, during physical exertion
- When you straighten your shoulders, you can hear a squeak between your shoulders
- Chest pain can be described as "a bet worth it"
- Decreased rib mobility leads to difficulty breathing, and the person, so to speak, begins to breathe in the abdomen
- Movements in the hands are limited, there is weakness, tingling or numbness in the hands.
Intercostal neuralgia
Intercostal neuralgia usually afflicts a person with pain in one side of the chest, but in rare cases it can also be in the scapular region. This occurs in situations where nerve root compression occurs in the thoracic region during excessive stress, hypothermia, trauma, infectious diseases, or osteochondrosis of the thoracic region.
With intercostal neuralgia symptoms, the pain intensifies when pressing on the chest, with a cough and can disturb the patient both day and night. As pain in osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, qualified orthopedists, neurologists, osteopaths and surgeons should be consulted to clarify the diagnosis.
Spondylarthrosis
This disease is very similar to osteochondrosis, in the nature of pain, according to the factors that intensify it during exercise, change of body position. It is also chronic, with periods of exacerbation and remission. Spondylarthrosis can be distinguished from osteochondrosis only with the help of X-rays, MRI or CT. In this disease, the cartilage is destroyed and replaced by bone tissue, so bone protrusions can be found on the vertebrae.
Myositis of the back muscles
After any hypothermia can occur SARS, influenza, muscle strain, back injury, inflammation in muscle tissue - 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 painful by nature, and also increases by palpation, movement, physical exertion. This is not a dangerous condition, and using ointments to warm up and relieve back pain usually helps.
Diseases of internal organs
As we have already said, pain in the shoulder blades on the back is not always a sign of a disease of the spine, almost all diseases of the mediastinal organs, heart, stomach, pancreas and gallbladder can contribute to back pain. In our time of oncological tensions, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach and lungs can also be manifested by pain in the shoulder blades.
Diseases of the cardiovascular system
Ischemic heart disease, myocardial infarction, angina are diseases that can also be the cause of such pain. With angina. for example, the pain never lasts longer than 5 minutes, and with nitroglycerin it usually disappears immediately. However, in an acute attack, if the severe pain lasts more than 5 minutes, the blood pressure decreases, cold sweat appears, the skin turns pale, an ambulance should be called immediately.
Diseases of the gastrointestinal tract
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can be responsible for the appearance of pain in the thoracic region, both front and back. Also, the development of oncological diseases of the stomach, pancreas can cause such sensations.
Diseases of the respiratory system
If the patient, in addition to back pain, worries about cough, increase in body temperature, even slightly, the cause may be lung pathology. Usually, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections, and influenza. Recently, there are more and more cases of atypical forms of pneumonia, when pneumonia is caused by pathogens such as mycoplasma or chlamydia, not accompanied by very high fever, but may occur on the background of subfebrile condition and back pain may appear right, left, on inhalation, especially intensified by deep inhalation. The main criterion for distinguishing lung pathology from other causes is the presence of fever, even high, and cough.
Other diseases
- Osteoporosis with vertebral body fractures, for example, on the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Stomach cancer metastases, for example, can also cause pain.
- Spontaneous fractures with irrational loads.
- Ankylosing spondylitis (Bechterew's disease) is a systemic disease. It affects more often than men, in whom, on the background of inflammation, the vertebrae are affected and ligament ossification occurs. As a result, the spine becomes inflexible and is radiologically described as a bamboo stick.