If a person has back pain in the area of the shoulder blades, he automatically associates it with the condition of the spine. They are partly right: this long-lasting core of our skeleton takes on heavy loads, which cannot but affect its condition.
But often the pain in this part of the back signals a disorder in the internal organs. The nature of the pain corresponds to the disease, so it is important to describe its manifestations in as much detail as possible at the doctor's examination.
What causes shoulder pain
Pathological changes in:
- spine;
- internal organs;
- surrounding structures.
Scapular pain and some rare diseases:
- Fractures of the spine and its systemic lesions;
- Spinal metastases in cancer of the stomach and sometimes other organs.
Pain according to the type of disease is localized:
- Above the blades;
- Under the shoulder blades;
- Between the blades;
- In the shoulder blades.
Symptoms associated with pathologies of 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 side, this could be a sign:
- Peptic ulcer of the stomach: pains are periodic in nature, associated with exacerbations of a seasonal nature. They are accompanied by pain in the upper abdomen. Vomiting occurs during pain intensification;
- Myocardial infarction: the disease is accompanied by acute retrosternal pain, which extends below the left shoulder blade. Cardiac ischemia has similar signs, but in this case feelings of pain also occur in the left arm;
- Stomach ulcer puncture: the patient's body is covered with cold sweat, he may feel sick to the opening for vomiting. The patient tries to alleviate the suffering by changing position, but these procedures do not give the expected effect;
- Intercostal neuralgia: pain below the left shoulder blade occurs in seizures and is exacerbated by the slightest physical exertion. It tingles and burns in the area of the heart. It hurts to cough and take a deep breath.
It can hurt under the right shoulder blade when:
- Mental failures in the body. At the same time, the patient feels warmth in the chest, may complain of tightness 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;
- Pleuritis and pneumonia: pain under the right shoulder blade is reflected in cough;
- Kidney diseases: in this case, the cough also leads to increased pain, but, unlike lung diseases, the patient has difficulty urinating.
Pain associated with spinal pathologies
Spine problems can occur after injuries, fractures or bruises. But there are also diseases that have no obvious causes. And they all manifest with pain in the scapular area.
With any pathology of the spine, pain between the shoulder blades must be combined:
- stiffness;
- Feeling tingling;
- Numbness.
Interscapular pain when coughing is typical for heavy smokers.
Osteochondrosis
If the nutrition of the tissues is disturbed, dystrophic changes occur in them. In the spinal column, this process involves the intervertebral discs. They can no longer resist the pressure exerted on them by the vertebrae. Loss of disc elasticity leads to spinal compression. The nerve endings of the spinal cord are under pressure - there is severe pain.
The body tries to protect the spine from heavy loads by growing bone tissue along the edges of the spine. Bone growths are called osteophytes. They can be removed, but on the background of osteochondrosis, it will grow again.
The pain in osteochondrosis is localized at the site of spinal cord injury. If the cervical region is affected, the patient has pain in the right side of the neck in the morning. The pain spreads to the shoulder and arm, felt over the shoulder blade. He may feel dizzy, aggravated by deep breathing and coughing.
Osteochondrosis of the thoracic region manifests as pain between the shoulder blades - to the right and left of the spine. The pain may be aggravated by sneezing, coughing and sudden movements. When you try to straighten your shoulders, your chest and interscapular area begin to crack.
It becomes difficult for a man to breathe from the chest, because the mobility of the ribs decreases, and he unconsciously switches to breathing through the abdomen.
Treat osteochondrosis with a conservative method. The patient is prescribed:
- Painkillers and anti-inflammatory drugs;
- Physiotherapy procedures;
- Therapeutic gymnastics;
- Reflexology;
- Massages;
- Spinal traction;
- Manual therapy.
If none of the treatment methods succeed, the surgeons go to work.
Spondylarthrosis
The symptoms of this disease are similar to osteochondrosis. But in this case, the intervertebral disc is displaced, not exhausted. Hyaline cartilage is forced to take the load. In such extreme conditions, its tissue becomes thinner and loses its ability to perform its functions.
If spondyloarthritis is not treated, the entire joint can become inflamed and then lose mobility completely. The patient's condition is aggravated by osteophytes.
Scoliosis
Curvature of the spine in relation to its axis on the right or left is common - almost half of humanity is affected by this disease. But for most, the disease is not pronounced, so the pain appears periodically - if the person has strained his back, or stood for a long time or sat in one position.
Early scoliosis cannot be determined visually, therefore, if pain occurs in the scapular region, it is in the patient's interest to consult a doctor. He will transcribe an X-ray - direct and lateral.
With the further development of scoliosis, it can be detected on its own: "zigzags" of the spine become clearly expressed. Scoliosis in running is also determined by the relative position of the shoulders - one of them will be lower than the other.
The treatment of scoliosis is a long-term thing even at its high intensity. Massages, special exercises and wearing a corset will help get rid of the curvature of the spine.
Intervertebral hernia
The intervertebral disc consists of:
- Gelatinous core;
- Fibrous ring, consisting of fibers;
- Two thin layers of cartilage covering the discs above and below.
The nucleus is located inside the ring, and the cartilaginous tissue, enclosing the structure, at the same time serves as a conduit of nutrition from the vessels of the vertebral body to the disc.
Pathological changes in the vertebrae lead to disorders of metabolic processes in the intervertebral discs. Their thickness decreases, the fibrous ring breaks under the influence of the load, opening the way out of the gelatinous mass of the core. This process is accompanied by severe pain. It is concentrated at one point, but sometimes there is a return to the pulmonary and cardiac regions.
Intervertebral hernia in the thoracic region is extremely rare, therefore, when pain occurs in the scapular region, the patient is first examined for other diseases.
Intervertebral hernia is treated with anti-inflammatory drugs, physiotherapy and special exercises. In severe cases, only surgery can help.
Tuberculosis of the spine
Tuberculosis microbacteria can affect any part of the spine, but 60% of cases occur in the thoracic region. Men most often suffer from this disease. Basically, several vertebrae are involved in the process, but there are cases when tuberculosis spreads to three or more.
The symptoms of the disease can vary depending on the number of vertebrae affected. But there is one constant symptom - it's pain. If it is felt between the shoulder blades, it indicates a lesion of the cervical spine.
It also hurts with tuberculosis of the thoracic region, but in that case the pain will radiate (give) to the chest, groin or abdomen. Patients complain of burning, twisting, "drilling" in the back.
Tuberculosis of the spine is difficult to diagnose, severe pain appears already at the stage of various complications. If you have the slightest suspicion of this disease, go to a specialist for an examination immediately.
Surge and hypothermia
If the back is overloaded, painful sensations in the scapular area can also occur. By itself, this phenomenon is not considered a disease, but constant overload can cause osteochondrosis, curvature of the spine and the formation of intervertebral hernias.
Tailors, drivers, surgeons, people who do sedentary work, etc. they complain of back pain. If hypothermia (draft, working air conditioner) is added to the surge, then back pain can be learned - severe pain concentrated under the shoulder blades, or in the spine.
This problem is treated with warming ointments, anti-inflammatory drugs and massages.
Myositis
Influenza, SARS, severe hypothermia can lead to myositis - inflammation of muscle tissue. Most often, this disease affects the muscles located in the area of the shoulder blade. This condition does not threaten the body with anything terrible, but excruciating pain creates discomfort.
Shoulder pain
Pain occurs for several reasons:
- Fracture or injury caused by a fall. The shoulder joint swells, it hurts to move the limb;
- Osteomyelitis (inflammation of bone tissue): accompanied by fever, fever due to intoxication of the whole organism;
- Pterygoid scapula: This effect is caused by damage to the front tooth (located on the side of the chest), paralysis of rhomboid, trapezius muscles or their traumatic rupture (which affects circus acrobats and gymnasts, professional athletes).
If the synovial sac is inflamed, the scapula begins to crack. In addition to this problem, the patient is worried about the weight and clicks in the shoulder joint.
Diagnosis
Since pain in the scapular area on the back signals one of many diseases, the examination is performed by different methods:
- chest x-ray;
- Laboratory research;
- ultrasound;
- Magnetic resistance or computed tomography;
- ECG.
All examinations are prescribed by a surgeon - if your back hurts, go to him first. But in the future, based on research, he will need advice:
- Orthopedist;
- Gastroenterologist;
- Neurologist;
- Pulmonologist.
If for any reason the doctor did not pay attention to the accompanying symptoms, go for a consultation on your own initiative.
Treatment
Self-treatment of pain in the scapular area is categorically contraindicated. The maximum that a patient can afford is to take painkillers and analgesics. Admission should be one-time and only if it is necessary to stop the pain syndrome before visiting the doctor.
Treatment is prescribed by a doctor: usually, to alleviate the condition, it is enough to take analgesics, chondroprotectors, anti-inflammatory drugs. In addition, the doctor paints a treatment regimen designed to eliminate the underlying causes of pain in the scapular region.