Back pain comes in many forms and types. Location and nature of pain, duration, presence or absence of irradiation to other parts of the body, stimulating factors - all this can be combined in many ways. different cases.Back pain in shoulder area- a common type of pain in various diseases.
The main cause of pain in the shoulders and back
Why does my back hurt in the shoulder blade area?Such symptoms can be observed in diseases of the spine, neurological disorders, pathologies of muscles and other organs. These include referred pain in diseases of the lungs and heart, and diseases of the gastrointestinal tract, as well as pain in nerve root syndromes, trauma and osteoarthritis. Let's take a closer look at the common causes of pain in the back and shoulder blades.
Injury
Injuries to the shoulder blades occur in two ways - from direct impact (collision, fall) and indirect, with loads along the axis of the upper limb (fall on the elbow, strong twitching of the muscles of the shoulder girdle). In the first case, a spinal injury and a rib fracture can occur simultaneously. Such injuries occur in 50% of serious traffic accidents. Severe pain, limited movement, and severe swelling of the tissues surrounding the shoulder blade may also be observed with severe bruising.
Osteoarthritis
Osteonecrosis is a common causeback-acheAndbackboneany localization, and also inshoulder area. Degenerative-dystrophic processes in the joints and intervertebral discs, due to malnutrition and cartilage regeneration, lead to the formation of protrusions and herniations, spasm of the back muscles and reduction in the height of the intervertebral disc. Spinal nerves can become compressed; Pain may be caused by nerve root syndrome.
The pain is stimulated when bending or turning or lifting weights. Due to concurrent inflammation of the back muscles, pain may increase when lifting and extending the arms. There may be stiffness of the spine, stooping of the back, forcing the patient to bend slightly forward, pain may ache, shoot out, wrap around the chest. Some patients describe it by saying they feel like something is stuck between their shoulder blades.
Scoliosis
Scoliosis is a disease in which the spine has a pathological S-shaped curvature, primarily in the coronal plane. As a result, the normal distribution of loads and biomechanics are disrupted. Risk factors for scoliosis are poor posture, weak back muscles, childhood and improper workplace organization. Back pain due to scoliosis is often caused by spasm, inflammation and tension in the muscles that are unable to support and stabilize the weakened spine.
Scoliosis is characterized by pain that decreases when lying down and increases when standing for long periods of time.
Kyphosis of the spine
Kyphosis is a pathological curvature of the spine in the sagittal plane, most often occurring in the thoracic region. As a result of kyphosis, the spine begins to look like a question mark "? ", and may begin to form humps. Risk factors for kyphosis are vitamin D deficiency, osteoporosis and poor posture. Kyphosis can be caused by injury or tuberculosis of the spine. Ankylosing spondylitis causes severe kyphosis in the thoracic region.
The pain from kyphosis, like scoliosis, is caused by tension and muscle spasm as they are subjected to excessive pressure. At the same time it is feltback muscle painand in the regionshoulder
Spondylitis, inflammation of the spine
Osteoarthritis is a degenerative-dystrophic change in the intervertebral joints, due to malnutrition of the articular cartilage, leading to the gradual destruction of the spinal joints. Ankylosing spondylitis is an inflammation of the intervertebral joints that occurs in response to an autoimmune or reactive process (rheumatoid arthritis, ankylosing spondylitis, reactive arthritis). The result of both processes is stiffness or fusion between the vertebral joints, leading to impaired mobility of the spine. The difference is that in the first case the inflammation is of a secondary nature and occurs in response to the destruction of the joints, and in the second case the primary inflammation leads to degenerative changes-dystrophy.
The pain in ankylosing spondylitis and osteoarthritis is aching and increases at night. A characteristic symptom is stiffness and stiffness of the spine in the morning, which disappears after exercise or physical activity. The course of the disease is chronic, undulating, with periods of exacerbation and improvement. The pain can be localized not only between the shoulder blades but also throughout the entire spine.
Protrusion and hernia
Protrusion and herniation of the intervertebral disc are a consequence of progressive osteonecrosis of the spine. The intervertebral disc has lost its elasticity and elasticity, or rather its peripheral part, called the annulus fibrosus, protrudes under the influence of load and forms a protrusion. If the annulus fibrosus breaks, the contents of the disc will fall out, forming a herniated disc. Both bulging and herniated discs can cause spinal root entrapment through the intervertebral foramen. Acute pain, protective tension, and muscle spasm occur. The pain can spread to the shoulder, elbow, forearm and is often localized in the shoulder blade area (with hernia or protrusion in the thoracic spine).
Inflammation of the nerve root
Acute pain that begins in the interscapular region and continues along the intercostal spaces is the most common sign of radiculitis. The cause is due to compression of the disc or compression of the spinal nerves. Less commonly, sciatica can be caused by a tumor, spinal degeneration, or vertebral displacement. Typical signs of the disease are pain caused by movements in the thoracic spine and lifting heavy objects.
Inflammation around the shoulder joint
Periarthritis of the shoulder is a disease accompanied by pain in the shoulder and scapula, caused by inflammation of the shoulder joint and inflammation of the surrounding soft tissues. Risk factors include trauma and microtrauma of the shoulder joint, intense physical activity in athletes and workers, and cartilage degeneration of the cervicothoracic spine. Periarthritis of the shoulder is the most common cause of acute pain in the shoulder blade and joint.
The pain occurs gradually, intensifying due to intermittent pain during physical activity, with a large range of motion in the shoulder joint (swinging the arm, throwing, when placing the arm behind the back). Then the pain becomes constant and painful even when resting. Therefore, the patient cannot sleep on the affected side.Painfulshoulder andreturn the shoulder blade. There may be pain when moving. Characterized by a marked limitation of mobility in the shoulder joint, the patient is unable to lift or abduct his arm.
Nerve pain
Pain in the shoulder blades, spreading along the intercostal nerves, is a sign of neuralgia, a chronic neurological disease. A characteristic symptom is increased pain when coughing, sneezing or moving - the pain becomes intense, aching. The cause of the disease is stimulation of the spinal roots due to spinal diseases, ankylosing spondylitis and spondylosis, and myositis. Aggravation of the condition can be provoked by drafts, hypothermia and physical activity.
Heart disease
Heart diseases are often accompanied by severe pain in the left shoulder area. The cause of pain syndrome can be angina, coronary heart disease, coronary atherosclerosis. Severe acute pain under the left shoulder blade that does not go away for a long time is a sign of myocardial ischemia or myocardial infarction. The nature of the pain is very diverse - from aching, constant to acute, with sharp pain in the left shoulder and forearm, left neck. A characteristic symptom is pain relief with nitrates (drugs for heart failure) - nitroglycerin, isoket, nitrosorbide.
Problems with the digestive tract
Gastrointestinal diseases are a common cause of back pain in the shoulder blade area. Pain is reflective in nature and occurs because part of the pain impulse from the solar plexus and receptors in the gastrointestinal tract returns to the spinal cord. Pain in the shoulder blade area can occur with hiatal hernia, chronic or acute pancreatitis, gastric ulcer and duodenal ulcer. For cholecystitis and gallstonespainlocalizedat the back between the shoulder blades, thanright.
Lung disease
Pain in the shoulder blades can occur with some lung and bronchial diseases. Usually these are pneumonia, acute bronchitis, asthma and other pathologies. Lung cancer patients oftenback pain in shoulder area.
Back pain areas in the shoulder area
Pain in the shoulder blade area when inhaling or exhaling is a typical sign of intercostal neuralgia, spinal spondylosis with bulging or herniated disc, back myositis, and radiculitis. The cause of pain is that breathing is ensured by the coordinated contraction of a large number of muscles, and movements of even this magnitude can cause increased pain in the above diseases.
Pain in the sternum and shoulder blades
Pain in the sternum and shoulder blades is common in glenohumeral periarticular disease. Inflammatory and degenerative-dystrophic changes in the shoulder joint disrupt the normal distribution of loads, which is why pathological changes begin at the site of attachment of the clavicle and ribs to the sternum(Tietze syndrome).
Pain in the sternum and shoulder blades also occurs with lung and heart diseases.
Pain in the right or left shoulder blade
Pain in the left shoulder blade can manifest as heart disease, as mentioned above. Right shoulder pain is characteristic of acute or chronic cholecystitis and gallstones.
Pain in the shoulder blades and neck
Back-ache,in the shoulder and neck areascan occur with osteonecrosis of the cervical and thoracic spine. This symptom is also characteristic of a hernia or protrusion. Radiating pain in the neck and shoulder blades is observed in some diseases of the heart and lungs (angina, lung cancer, pneumonia).
Types of pain in the shoulder blade
Pain in shoulder blades
Pain in the left shoulder blade is due to heart disease, on the right side is due to biliary tract diseases and gallstones. Pain accompanies glenoid periarticular disease, neuralgia, and radiculitis. Pain in the back and shoulder area can also occur with ankylosing spondylitis and spondyloarthritis.
Pressing pain in the shoulder blade
Pressing pain in the shoulder blade is characteristic of myositis or inflammatory myopathies. The shoulder blade is surrounded by a series of muscles, inflammation of which not only leads to pain but also limits the mobility of the shoulder girdle. Severe inflammation of the soft tissues and ligaments of the shoulder joint may also be accompanied by pain.
Dull pain when inhaling
Dull pain in the back and shoulder blades, aggravated by inhalation, can manifest in pneumonia, lung cancer, neuromuscular disease and myositis. This symptom is also a sign of trauma, back bruising and soft tissue hematomas. Dull pain in the back and shoulder blades accompanies some diseases of the spinal cord, such as multiple sclerosis.
Sharp pain in shoulder blade
Sharp pain in the shoulder blade, increasing with movement, sneezing and coughing, is a sign of back injury, fractures and fractures of the shoulder blade. The mechanism of injury is usually a direct physical impact or an indirect impact transmitted along the axis of the upper extremity, such as a fall on the elbow.
When moving (walking) there is pain in the shoulder blades
Shoulder pain when walking can occur with herniation and protrusion of the thoracic spine. The axial load on the spine that occurs when moving and hitting the ground with the heel is transmitted to the diseased disc and causes pain.
Burning in the shoulder blade area
A burning sensation in the shoulder blade area can be a sign of acute myocardial infarction. Ischemia (circulatory failure and lack of oxygen in the myocardium) of the myocardium is accompanied by severe pain, painful shock and hypotension. However, if the posterior wall of the left ventricle and the septum of the heart are damaged, the pain can mimic spinal osteonecrosis, poor quality food poisoning, acute surgical pathology and many other diseases.
Burning and tingling on the skin in the intervertebral area can be symptoms of herniated or protruding discs of the thoracic and cervical spine. This symptom occurs in multiple sclerosis and other diseases of the spinal cord.
Shoulder pain and nausea
Pain in the left shoulder blade accompanied by nausea and vomiting can also be a sign of acute myocardial infarction. Similar symptoms are characteristic of acute cholecystitis, gallstones, obstructive jaundice (obstruction of the bile duct lumen due to stones) - pain is more localized on the right side, nausea is due to intoxication.
How to relieve pain in the shoulder
For spinal diseases and many other conditions, pain relief is easier by rest and bed rest. An effective way to combat pain is to prescribe pain relievers, mainly non-steroidal anti-inflammatory drugs. In some cases, dry heat, bothersome medications, and anti-inflammatory agents in the form of ointments and gels on the skin will help. Patches containing anti-inflammatory drugs are widely used, their effects are limited to the area of application and are not accompanied by significant side effects.
It is important to remember that any pain is a sign to consult a doctor. The reason is that long-term use of painkillers increases the risk of serious and dangerous complications. Therefore, their use as a medical care is aimed at relieving pain before seeing a doctor. After determining the cause, treatment is adjusted taking into account the diagnosis and individual characteristics of the patient.
How is pain in the shoulder blade diagnosed?
To diagnose the cause of pain in the shoulder blades, a doctor's clinical examination is used, which allows to identify mild symptoms and characteristic signs of a particular disease. A study of skin sensitivity, testing of reflexes, assessment of range of motion in the shoulder joints and spine, etc. v. be done. To confirm the diagnosis, instrumental methods such as ECG, ultrasound, CT or MRI are used.
Magnetic resonance imaging is a popular method to diagnose the cause of back pain related to diseases of the spine, spinal cord, joints and soft tissues. The procedure is safe, highly accurate, and allows you to get detailed images of the area of concern. This method is based on the physical phenomenon of magnetic resonance, created only with magnetic fields and radio waves that are safe for human health.
Treatment of shoulder pain
Treatment of pain in the back and shoulder blades is aimed at the cause of the disease (etiotropic treatment), the mechanism of its occurrence (pathological treatment) and the symptoms (symptomatic treatment). The treatment plan depends on the patient's diagnosis and condition. For example, consider a treatment plan for spondylosis.
To eliminate degenerative-dystrophic phenomena and improve nutrition of the soft tissues of the spine, chondroprotective drugs, vitamin therapy, drugs that improve blood microcirculation, therapeutic exercises and physiotherapyprescribed. To relieve tension in the back muscles, massage is performed and muscle relaxants are prescribed. When spinal nerves are compressed, physical manipulation is used - underwater traction, manual therapy. To combat pain, painkillers are prescribed.
Treat shoulder pain at home
Home treatment is possible only if the patient has consulted a doctor, undergone an examination and an accurate diagnosis has been determined. In most cases, the cause of pain in the shoulder blades and back does not require urgent hospitalization, treatment is carried out at home, as prescribed by the doctor. However, the opposite happens more often - patients try to treat it at home, self-diagnose and use painkillers uncontrollably. The result of self-diagnosis and self-medication is chronic pain and side effects of painkillers. Patients often come to the doctor late when the disease causes many complications. In severe cases, late treatment significantly worsens the prognosis and reduces the possibility of complete recovery. That's why any back pain requires careful diagnosis and consultation with a doctor.
Which doctor should I consult for pain in my shoulder blade?
By way of clarificationCauses and treatments of shoulder and back paintreated by a neurologist, since in most cases the pain syndrome is of neurological origin. These are almost all diseases of the spine, spinal cord and peripheral nerves. Spinal injuries are treated by a traumatologist, but even in this case, if neurological symptoms are present, consultation with a neurologist is required. In severe cases, if you have back pain, you should at least contact a therapist who can make a preliminary diagnosis and refer the patient for consultation with another specialist. The worst thing is if the patient does not go to the doctor and self-medicate - the consequences of such "treatment" lead to complications, chronic diseases and in some cases even threaten health and life. human.