What do back pain in the shoulder blades say?

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Back pain in the shoulder blades is a characteristic symptom not only of diseases of the spine, but also of pathologies of internal organs. Why should you see a doctor and with which specialist to make an appointment? Effective methods of getting rid of discomfort.

If you are worried about back pain in the shoulder blades, such a symptom may indicate diseases of the spine or shoulder girdle, nerve pathology, somatic diseases. Careful collection of the history and complaints of patients allows you to identify the cause of the problem and decide on further treatment.

Often, back pain in the shoulder blades is the first signal of pathological changes in the body. And the definition of the provoking factor allows you to prevent exacerbation of the disease at an early stage. The symptom can occur in one half of the body or spread to the arm, appear during inhalation - all of this is important when diagnosing.

The causes of pain and its location

As a rule, discomfort in the shoulder blades appears when moving. For example, a prolonged static position of the body, an awkward turn. In this case, the pain under the scapula signals damage.

Important!Unilateral localization of pain (on the left under the scapula or on the right) is rare. This is due to the symmetrical arrangement of the nerve roots of the spinal cord.

Traumatic injury

Painful sensations can signal muscle or bone damage. In this case, the symptom is diffuse and of varying intensity. The pain appears suddenly and persists.
Injuries that can cause shoulder blade pain:

  1. Fractures, cracks. A serious injury in which the pain is concentrated directly in the scapula. The symptom is aggravated with minimal movement so that the patient cannot move.
  2. Bruises. The discomfort is superficial, it occurs due to damage to the muscle structure and is localized in the lower part of the shoulder blades. On examination it is possible to detect signs of inflammation, swelling of the tissues. Symptoms persist for 14 to 21 days.
  3. Subluxation or displacement of the vertebrae. Joint pain occurs under the shoulder blades or at their level. The discomfort can be exacerbated by the compression of the nerve roots.

With injuries in the damaged area, edema of soft tissues is observed, pain appears suddenly. Often a creaking sound appears when moving.

Spinal protrusion and herniation

With this pathology, the spinal cord and nerve roots are squeezed, which is accompanied by impaired sensitivity and sharp pain under the right and left scapula.

Possible placement of discomfort:

  1. Back pain under the scapula on the left or right. Indicates a lesion of 6 to 12 discs with possible involvement of the lumbar spine in the pathological process. As the latter is under increased stress, there is a high risk of developing spinal hernias.
  2. Above the shoulder blades. The protrusion is localized in the cervical spine or segment 1-3. The discomfort becomes more pronounced with the movement of the head.
  3. Between the shoulder blades. Pain is observed when 3 to 6 segments of the spine are affected. It becomes more pronounced with deep breathing, turning the body, removing the upper limbs to the sides.

To note!With protrusion, the pain persists even at rest. This is due to compression of the nerve roots and muscle spasms.

Osteochondrosis

If the back hurts at the shoulder blades, the symptom may indicate osteochondrosis of the thoracic spine. The symptom is due to entrapment of the spinal cord or nerve roots and deformation of the intervertebral disc. The disease progresses gradually, causing more and more acute symptoms.

The area of discomfort is determined by the location of the lesion:

  1. 2-6 segments. The discomfort is localized in the shoulder blades, irradiation to the arm and neck is possible. Increased intracranial pressure, dizziness due to compression of blood vessels are possible.
  2. 6-12 segments. There is pain under the scapula on the left or right back and extends to the lower back.

To note!With osteochondrosis, the pain is one-sided.

Spondylarthrosis

This pathology is also characterized by the unilateral development of the pain syndrome. With spondylarthrosis there is a violation of mobility, a feeling of stiffness due to damage to the intervertebral discs and facet joints.

Symptoms depend on the neglect of pathological changes:

  1. Destruction of cartilage tissue. It develops against the background of reduced blood circulation and a violation of the integrity of connective tissue. The cartilage element becomes brittle - quickly damaged and slowly renewed. The situation is aggravated by microtraumas due to intense physical exertion. In this case, the pain radiates to the shoulder blades and lower back.
  2. Deformation of the intervertebral disc. The thickening of the tissue is accompanied by reduced mobility, as well as pain in the shoulder blades and back. In this context, the destructive processes intensify.
  3. The formation of bone growths. Appear in the advanced form of spondylarthrosis. They cause damage to blood vessels, muscle tissue, nerves and joints.

With spondylarthrosis, the pain occurs after physical exertion and can be localized to the shoulder blades or between them. At rest, the symptom disappears.

Scoliosis

It is accompanied by a curvature of the spine in the transverse direction due to the tension of the muscles which support the posture. In this case, the spinal cord and nerves are squeezed, discomfort is observed under the scapula.

Scoliosis of the spine

Other symptoms of scoliosis:

  1. Deformation of the chest. There is displacement of the ribs and vertebrae, which leads to damage to the spinal cord and its branches. Because of this, back pain is observed on the left under the scapula or on the right.
  2. Respiratory disorder. Due to the deformation of the chest, dysfunction of the lungs is observed - one of them is squeezed, the second tries to compensate for the deficit in gas exchange.
  3. Violation of cardiac activity. Due to the asymmetric spine, shortness of breath is present, the skin becomes pale, the heart rate changes.

To note!Scoliosis is characterized by compression of the spinal cord, so the discomfort is localized between or under the shoulder blades. The pathological focus has clear contours and can spread to neighboring areas only with muscle spasms.

Kyphosis

Kyphosis is a back curvature of the spine, in which the shoulder girdle is pulled forward, a hoop appears. In this case, the pain is localized above the shoulder blades, is bilateral in nature, radiates to the neck, arm.

Vertebral kyphosis

Mechanisms of pain formation in kyphosis:

  1. Muscular. The curvature of the spine leads to an overstrain of the muscles of the neck area and their spasm, which is accompanied by pain in the shoulder blades.
  2. Neurogenic. Against the background of the curvature of the spine, the distance between the vertebrae decreases. This leads to damage to the branches of the spinal cord and the appearance of pain in the shoulder blades, which can spread to the neck, collarbone, shoulder.

With kyphosis, the vertebral artery is compressed, which leads to deterioration of cerebral circulation, dysfunction of internal organs.

Radiculitis

The pathology is characterized by a pinching of the lumbar roots that form the sciatic nerve. With the defeat of the upper part, the pain is localized under the scapula and below. The discomfort is bilateral, it is accentuated with sudden movements.

If left untreated, sciatica is accompanied by other symptoms:

  • burning pain in the back (under the shoulder blades and lower back) - indicates pinching of the spinal roots;
  • lumbago with irradiation in the leg;
  • convulsions;
  • violation of sensitivity in the buttocks, lower back;
  • numbness along the nerve (can be seen in the lower leg, thigh, foot).

Neuralgia

Inflammation of the nerve fibers in this anatomical region can cause pain under the shoulder blades. Hypothermia is a common cause of pathology.

Neuralgia causes pain in the shoulder blades

Inflammation can affect structures such as:

  • Intercostal nerves. 1-4 pairs located along the lower edge of the ribs are affected. The pain is localized under the shoulder blades and below, in the lateral parts of the chest, less often extends to its anterior sections.
  • Supraspinatus and suprascapular nerves. Characterized by the appearance of pain in the region of the shoulder blades of the back in the region of the collarbone. Sometimes the symptom spreads to the shoulders.
  • The infraspinatus and subscapularis nerves. Discomfort is felt under the scapula on the left or right. As the inflammation spreads to the muscles, the pain increases when you move your hands.

To note!With neuralgia, the pain is often one-sided in nature - the symptom is localized in the part that has suffered hypothermia.

Shoulder-scapular periarthritis

It is characterized by inflammation of the shoulder joint and surrounding tissues. It is accompanied by reduced mobility, which can only be eliminated after warming up the muscles.

With humeroscapular periarthrosis, discomfort is observed in the shoulder blades and below. At the initial stage, it occurs after intense physical activity, as the disease progresses - at rest. Other symptoms of the pathology:

  • numbness of the upper limbs;
  • headache;
  • decreased mobility of the spine.

Cardiac pathology

Pain under the shoulder blades may indicate heart disease. This is due to the fact that the branches of the parasympathetic trunk connected with the spinal cord and nerve roots go to the organ. If there is pain under the left shoulder blade of the back of the back, the symptom may indicate a mild form of myocardial infarction. It can persist for several days, increase with movement and decrease at rest.

Pain under the scapula and pressing pain behind the breastbone with heart disease

Other signs of pathology:

  • burning, pressing pain behind the breastbone;
  • heart rhythm disturbances;
  • Heart palpitations;
  • dyspnea;
  • dizziness;
  • nausea Vomiting;
  • increased blood pressure.

Diseases of the digestive system

The mechanism of the onset of pain is similar to the previous reason - spreads along the nerve fibers. The localization of the symptom depends on the affected organ, less often the discomfort is bilateral.

Diseases of the digestive system - the cause of pain under the shoulder blades

If the back hurts on the left under the scapula, development is possible:

  • inflammation of the gastric mucosa;
  • pancreatitis (inflammation of the pancreas);
  • stomach ulcer.

In addition, with such pathologies there is nausea, vomiting, heartburn, belching, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, there is pallor of the skin, a decrease in blood pressure, weakness, darkening of the stool.

A feeling of discomfort under the right shoulder blade may indicate such conditions:

  • duodenal ulcer;
  • hepatitis;
  • liver cirrhosis;
  • gallstones.

Other causes of the symptom

The following factors can also cause shoulder blade pain:

  1. Inconvenient sleeping place. In particular, a collapsed mattress and sleeping on the left side can cause pain on the opposite side, as the spine bends and the roots are pinched.
  2. Vegetovascular dystonia. It is accompanied by drops in blood pressure, shortness of breath, impaired cardiac activity and sometimes back pain in the shoulder blades.
  3. Polio. An infectious disease in which the pain in the shoulder blades is neurogenic.
  4. Pleurisy. With inflammation of the pleura, the symptom occurs due to the friction of its leaves against each other. The pain peak occurs with deep breathing.
  5. Renal pathology. Characterized by a stabbing, aching pain under the right shoulder blade. In addition, there is a change in the color of urine, urine output.
  6. Poisoning. Discomfort occurs when an excess of toxins or decomposition products build up in the body against the background of a cold or severe poisoning. It is accompanied by chills, muscle pain, fever.
  7. Subphrenic abscess. Pain under the shoulder blades is observed when inhaling and results from the accumulation of pus in the upper abdominal cavity.
  8. Mental disorders. Sometimes mental disorders are accompanied by discomfort in the back, but the mechanism of its development has not yet been studied.

Types of pain

The nature of the pain in the shoulder blades may differ. Based on this criterion, it is possible to assume a possible disease and determine the cause of the discomfort:

  1. Shooting, sharp, occurring by turning the body or moving. Typical for pinched nerves. This feature allows to distinguish it from pain in gallstone disease - with this diagnosis, discomfort is constant and does not depend on movements.
  2. Cutting and annoying pain of varying intensity. May indicate neuralgia, joint inflammation.
  3. Throbbing, pain or burning. Such pain in the shoulder blades indicates diseases of internal organs. The symptom develops as a result of compression of the nerve roots, with movement it may become more pronounced.
  4. Stifling pain in the shoulder blades or below. Typical for a hernia of the spine. Often accompanied by numbness in the arms or legs, lumbago.

Which doctor should I contact?

If painful sensations appear in the shoulder blades, you need to make an appointment with a neurologist. The doctor will conduct an examination, make a diagnosis and determine treatment tactics. In case of detection of pathologies of internal organs, he will turn to a specialist with a narrow profile - gastroenterologist, cardiologist, orthopedist (depending on the alleged diagnosis).

Investigation

To establish the cause of the appearance of pain in the region of the shoulder blades, the following diagnostic procedures are assigned to patients:

  1. Clinical studies of blood, urine. They show inflammatory changes, help in the diagnosis of somatic diseases.
  2. X-ray examination, CT. They make it possible to detect the curvature of the spine, injuries and their consequences, osteochondrosis.
  3. Ultrasound. It is used to identify pathologies of internal organs.
  4. ECG. Informative in case of suspected heart disease.
  5. MRI. Reflects the condition of the spine, shoulder girdle, internal organs. The area of investigation is determined by the doctor based on the proposed diagnosis.

To note!Pain under the shoulder blades is often indicative of neurological abnormalities. Therefore, CT and MRI scans are the "gold standard" for determining the cause of a symptom.

Processing characteristics

The aim of treatment is not only to eliminate pain, but also to eliminate the factor that leads to its appearance. When seeking medical help, the pain syndrome is relieved in parallel, as well as the appointment of etiological treatment aimed at eliminating the underlying disease.
The therapeutic program may include the following methods:

  1. Medical treatment. To relieve pain, drugs based on a number of analgesics and anti-inflammatory drugs are used. Depending on the cause of the symptom, antibacterial, diuretic, gastroprotective agents, etc. can be used.
  2. Physiotherapy. Helps to accelerate the recovery of somatic pathologies, to strengthen the spine. To eliminate pain in the shoulder blades, electrophoresis, UHT and heating procedures are used.
  3. Massage. Help to eliminate muscle spasms, improve posture, relieve painful sensations. It is prescribed for spinal problems. Sometimes the intervention of an osteopath or a chiropractor is necessary.
  4. Gymnastic. Shown during the recovery period. A set of exercises is selected for each patient individually, depending on the established diagnosis.

How to prevent discomfort in the shoulder blades?

It is then recommended to each patient having followed a treatment, to follow a certain number of preventive measures. They are necessary to prevent the recurrence of the disease.
It is important to follow these rules:

  • create favorable conditions for sleep - choose an orthopedic pillow and a mattress of moderate firmness to support the physiological position of the spine;
  • watch your posture;
  • follow the principles of good nutrition;
  • try to prevent exacerbation of chronic pathologies;
  • give up addictions (smoking, alcohol consumption);
  • Visit your doctor regularly for preventive examinations.

Pain in the shoulder blades can be caused by somatic and neurological causes. In the latter case, the symptom appears suddenly and is pronounced. Of somatic origin, the pain gradually increases and persists for a long time, does not depend on the movements of the body.
Pain relievers can be used to relieve an unpleasant symptom. However, in order to completely eliminate painful sensations, it is important to undergo comprehensive treatment aimed at getting rid of the underlying pathology. Only a doctor can develop the correct therapeutic course after a comprehensive examination.