If a person has back pain in the area of the shoulder blades, he automatically associates this with the condition of the spine. They are partly right: this long-suffering core of our skeleton takes on heavy loads, which cannot but affect its condition.
But often pain in this area of the back signals a disorder in 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 causes shoulder pain
Pathological changes in:
- spine;
- internal organs;
- surrounding structures.
It hurts in the scapular area and with some rare diseases:
- Fractures of the spine and its systemic lesions;
- Metastases in the spine in cancer of the stomach, and sometimes other organs.
Pain in accordance with the type of disease is localized:
- Above the shoulder blades;
- Under the shoulder blades;
- Between the shoulder blades;
- In 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, this may 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. During the increase in pain, vomiting occurs;
- Myocardial infarction: the disease is accompanied by acute retrosternal pain, extending under the left shoulder blade. Cardiac ischemia has similar signs, but in this case, pain sensations also occur in the left hand;
- Breakthrough of a stomach ulcer: the patient's body is covered with cold sweat, he can feel sick up to the opening of vomiting. The patient tries to alleviate suffering 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 the slightest 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, he 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;
- Renal diseases: in this case, coughing also leads to increased pain, but, unlike pulmonary diseases, the patient has difficulty urinating.
Pain associated with pathologies of the spinal column
Spinal problems can occur after injuries, fractures or bruises. But there are also diseases that have no obvious causes. And all of them are manifested by pain in the scapular region.
With any pathology of the spine, pain between the shoulder blades must be joined:
- stiffness;
- Feeling of goosebumps;
- Numbness.
Interscapular pain when coughing is typical for heavy smokers.
Osteochondrosis
If tissue nutrition is disturbed, dystrophic changes occur in them. In the spinal column, this process affects the intervertebral discs. They can no longer resist the pressure exerted on them by the vertebrae. The loss of disc elasticity leads to compression of the spine. The nerve endings of the spinal cord get under pressure - hence the severe pain occurs.
The body tries to protect the spine from heavy loads by growing bone tissue along the edges of the vertebral processes. Bone growths are called osteophytes. They can be removed, but against the background of osteochondrosis, they will grow again.
Pain in osteochondrosis is localized at the site of damage to the spinal column. 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 over the shoulder blade. The head may feel dizzy, the torment is aggravated by a deep breath and coughing.
Osteochondrosis of the thoracic region manifests itself as pain between the shoulder blades - to the right and left of the spinal column. Pain can be aggravated by sneezing, coughing, and sudden movements. When you try to straighten your shoulders, the chest and interscapular zone begin to crackle.
It becomes difficult for a person to breathe from the chest, as the mobility of the ribs decreases, and he unconsciously switches to breathing with his stomach.
Treat osteochondrosis with a conservative method. The patient is prescribed:
- Painkillers and anti-inflammatory drugs;
- Physiotherapy procedures;
- Therapeutic gymnastics;
- Reflexology;
- Massages;
- Traction of the spine;
- Manual therapy.
If none of the methods of treatment does not work, surgeons get down to business.
Spondylarthrosis
Symptoms of this disease are similar to osteochondrosis. But in this case, the intervertebral disc is displaced, not depleted. The hyaline cartilage is forced to take on the load. In such extreme conditions, its tissue becomes thinner and loses its ability to perform its functions.
If spondylarthrosis is not treated, the entire joint may become inflamed, and then completely lose mobility. The patient's condition is aggravated by osteophytes.
Scoliosis
The curvature of the spinal column relative to its axis to the right or left is common - almost half of humanity is affected by this disease. But for the majority, the disease is not pronounced, and therefore the pains appear periodically - if a person overstrained his back, or stood or sat in one position for a long time.
Early scoliosis cannot be visually determined, therefore, if pain occurs in the scapular region, it is in the patient's interests 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 spinal column become clearly pronounced. Running scoliosis is also determined by the relative position of the shoulders - one of them will be lower than the other.
Treatment of scoliosis is a long-term affair 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 is made up 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 cartilaginous 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 at one point, but sometimes there is a return to the pulmonary and cardiac 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.
Tuberculosis of the spine
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 when tuberculosis spreads to three or more.
Symptoms of the disease may 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 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 the appearance of various complications. If you have the slightest suspicion of this disease, immediately go to a specialist for examination.
Overvoltage and hypothermia
If the back is excessively overloaded, painful sensations may also appear in the scapular area. In itself, this phenomenon is not considered a disease, but constant overload can cause osteochondrosis, spinal curvature, and the formation of intervertebral hernias.
Seamstresses, drivers, surgeons, people doing sedentary work, etc. complain about back pain. If hypothermia (drafts, a working air conditioner) is added to the overvoltage, then a backache can be taught - severe pain concentrated below the shoulder blades, or in the spine.
This trouble 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 scapular region. This condition does not threaten the body with anything terrible, but 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 bone tissue): accompanied by fever, fever due to intoxication of the whole organism;
- Pterygoid scapula: this effect is caused by damage to the anterior dentate (located on the side of the chest), paralysis of the rhomboid, trapezius muscles or their traumatic rupture (which circus acrobats and gymnasts, professional athletes suffer from).
If the synovial bag is inflamed, the shoulder blade begins to crackle. In addition to this trouble, the patient is concerned about heaviness and clicks in the shoulder joint.
Diagnostics
Since pain in the scapular zone of the back signals one of the many diseases, the examination is carried out according to different 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 research, he will need advice:
- Orthopedist;
- Gastroenterologist;
- Neurologist;
- Pulmonologist.
If for any reason the doctor did not pay attention to the accompanying symptoms, go consult on your own initiative.
Treatment
Self-medication for pain in the scapular area is categorically contraindicated. The maximum that the patient can afford is to take painkillers and analgesics. The 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 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 root causes of pain in the scapular region.