When most people experience back pain between the shoulder blades, they associate its occurrence with various disorders of the spinal column, nerve roots, ligaments, intervertebral discs, or the discs themselves.But it should be remembered that such painful sensations can also be associated with other diseases of the chest organs - the stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which rapidly increases and either passes quickly or increases significantly over time, or chronic, which bothers the patient for a long time and requires an accurate diagnosis, since it can be a symptom of a serious pathology of any organs of the chest.Sometimes pain between the shoulder blades can occur only after sudden physical exertion or after being in a certain uncomfortable position for a long time.
It should be remembered 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 occurrence should be established.When contacting a doctor, it is very important to describe all the slightest accompanying symptoms that accompany the pain, the time of its occurrence, the provoking factors of its intensification, since the doctor needs to help determine the direction of the examination and sometimes it is very difficult to establish the correct diagnosis without accurate data on the nature of the pain.
Very often, untimely identification of the true cause of pain between the shoulder blades forces a person to undergo a lot of expensive and lengthy examinations, use various treatment options, which are sometimes prescribed inappropriately 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 are characterized by this pain syndrome.
Pain caused by pathologies of the spinal column
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but 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, since this part of the spine does not bear such an increased load as the cervical and lumbar regions.To diagnose or exclude this pathology, a neurologist or osteopath refers the patient to an MRI or CT scan.Changes in intervertebral hernia are due to the fact that the fibrous ring - the outer part of the intervertebral disc begins to protrude from the tear, while the distance between the vertebrae decreases and the nerve roots are pinched.That is, the fibrous ring cracks and the nucleus pulposus (the shock absorber in the center of the disc) begins to protrude into it.
If such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in severe cases surgery is indicated.The difference between such pain in intervertebral hernia of the thoracic spine from other pathologies is that it is localized in only one place, and the pain can also radiate into the chest, which may resemble symptoms of pulmonary or cardiac dysfunction.If the intervertebral hernia is left untreated for a long time, curvature of the spine, paraparesis of the lower extremities, dysfunction of the pelvic organs, and chronic pain syndrome may occur.
Overexertion in combination with hypothermia of the back muscles
Overstrain of the back muscles can also cause pain in the area of the shoulder blades; this is not considered a disease, but with frequent excessive loads, heavy lifting, prolonged sitting, or a monotonous position, the risk of developing osteochondrosis, scoliosis, and intervertebral hernias increases.Very often, such pain affects people whose work requires them to be in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when combining such a profession and air conditioning, hypothermia, a so-called lumbago may occur, when the pain becomes more intense and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of warming, distracting ointments, massage, etc.
To prevent such complications, you should try to avoid drafts, lead a maximally active lifestyle, practice yoga, Bodyflex, therapeutic exercises, and undergo a course of professional massage every six months.
Spinal tuberculosis
Today, many doctors seem to “forget” about this disease and anti-tuberculosis services in the country for some reason are falling into decline, but almost 90% of the population has been infected with Mycobacterium tuberculosis since childhood.If a person has received an injury, especially to the back or joint, or is simply very cold, with a very weakened immune system, a tuberculous focus quite often appears at the site of the injury, which even on an X-ray cannot always be recognized in time by specific signs.
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 may experience very strong, burning pain between the shoulder blades; patients describe it as twisting or drilling at one point of the spine, and also when the focus is localized in the thoracic spine, the pain radiates to the chest, in which a burning sensation, heat, and aches are felt.
Tuberculosis of the spine is a very insidious disease, and when it occurs in parts of the spine, the patient does not always have lesions 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 low social strata of the population and is localized, as a rule, only in the lungs.This is a huge misconception!
When the body’s defenses are weakened, Koch’s bacillus, which is present in almost every person’s body, is activated in the most weakened organs and a slow inflammatory process begins; these can be the kidneys, lymph nodes, female fallopian tubes, prostate or testicles in men, or individual vertebrae in the spine or joints in the limbs.
Scoliosis
According to statistics, almost 50% of the population has varying degrees of development of scoliosis - curvature, twisting of the spinal column, and most often it is the thoracic spine in combination with the cervical or lumbar spine.And since the ribs are connected to the thoracic regions, the shape of the chest also changes.There are quite a few reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired ones - intense physical overload, sedentary office work or, for schoolchildren, sitting at a desk.
With a lateral and direct chest x-ray, a surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis.Therapy for such a pathology must be very intensive and long-term - this includes massage, wearing a special corset, and therapeutic exercises.With scoliosis, back pain between the shoulder blades is the leading symptom, and it also has the following symptoms:
- At an early stage, the curvature may be visually subtle, but as scoliosis progresses, when examining the patient from behind, the curvature becomes noticeable.
- With scoliosis, there is increased fatigue of the back muscles
- Shoulders and arm position may be at different heights
- The pain that bothers the patient in the chest is often localized on one side
- The pain between the shoulder blades can be intermittent from severe overexertion or prolonged standing or sitting, or it can also be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are now found even in ten-year-old children, this pathology can rightfully be called the scourge of a modern city dweller.More recently, this disease was considered a disease of older people, but modern life, an unhealthy, sedentary lifestyle, leads to the early development of dystrophic changes in the joints and spine.The cause of back pain is the inflammatory process that develops in the surrounding tissues around damaged vertebrae, as well as due to pinched nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant, aching back pain, aggravated by sneezing, coughing, sudden changes in body position, and physical activity
- When straightening your shoulders, you can hear a crunch between the shoulder blades
- Chest pain can be described as feeling like there's a stake
- Reduced mobility of the ribs leads to difficulty breathing, and the person begins to breathe with his 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 in 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 due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the thoracic region.
With intercostal neuralgia, the symptoms and pain intensify with pressure on the chest, when coughing, and can bother the patient day and night.Since pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to differentiate, to clarify the diagnosis, you should contact qualified orthopedists, neurologists, osteopaths, and surgeons.
Spondyloarthrosis
This disease is very similar to osteochondrosis, in terms of the nature of the pain, the factors that intensify it with load, and changes in body position.It is also chronic in nature, with periods of exacerbations and remissions.It is possible to distinguish spondyloarthrosis from osteochondrosis only with the help of X-rays, MRI or CT.With this disease, cartilage is destroyed and replaced by bone tissue, so bony protrusions can be found on the vertebrae.
Back muscle myositis
After any hypothermia, acute respiratory viral infection, flu, muscle strain, or back injury, inflammation in the muscle tissue can occur - myositis.Like any disease, it can be acute or chronic.The pain can be in any part of the spine; it is aching in nature and also intensifies with palpation, movement, and physical activity.This is not a dangerous condition, and using warming and pain-relieving ointments for back pain usually helps.
Diseases of internal organs
As we have already said, pain in the area of the shoulder blades on the back is not always a sign of diseases of the spine; almost all diseases of the mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to the appearance of pain in the back.In our time of oncological tension, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach, and lungs can also manifest as pain in the area of the shoulder blades.
Diseases of the cardiovascular system
Coronary heart disease, myocardial infarction, angina pectoris are diseases that can also cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes and when taking nitroglycerin it mostly goes away immediately.However, in the event of an acute attack, if severe pain lasts more than 5 minutes, blood pressure decreases, cold sweat appears, or pale skin, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Gastric ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the occurrence of pain in the thoracic region both in front and behind.Also, the development of cancer of the stomach and pancreas can cause such sensations.
Respiratory system diseases
If the patient, in addition to back pain, is bothered by a cough, an increase in body temperature, even a slight one, the cause may be lung pathologies.Typically, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections, and 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 low-grade fever, and back pain may appear on the right, left, when inhaling, especially intensifying with a deep breath.The main criterion for distinguishing lung pathology from other causes is the presence of fever, even not 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 of stomach cancer, for example, can also cause pain
- Spontaneous fractures due to irrational loads.
- Ankylochial spondylitis (Bechterew's disease) is a systemic disease.It affects more often 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 described radiographically as being like a bamboo stick.