Acute or chronic pain between the shoulder blades is a very common complaint of people of different ages and professions. It can be a symptom of the usual overwork of the muscles of the back, and also testify to certain diseases of the spine and internal organs.
It's important to remember! Pain in the area of the scapula should in no case be ignored. In most cases this symptom is associated with non-dangerous diseases of the spine, but sometimes it is the only symptom of a life-threatening illness, for example, myocardial infarction, stratification of the thoracic aortic aneurysm, perforated stomach ulcer. And if you do not provide immediate medical care to a person, everything can end in a fatal outcome.
A bit of anatomy
To understand what exactly can hurt in the area of the shoulder blades, you need to understand the peculiarities of the anatomical structure of this part of the body.
Shoulder blade refers to the flat bones of our body. It performs a protective function, and also takes part in the formation of the skeleton of the hand and provides it with motor activity. A powerful muscular skeleton is located around the scapula. A large number of muscles of the shoulder and back begin or are attached to the scapula.
In the space behind the scapula there are ribs and intercostal spaces, in which there are vascular-neural bundles beginning at the spine. Between the scapula passes the thoracic spine.
scapula design The vital components of the thoracic and abdominal cavity are located in the projection of the scapula: the heart, thoracic aorta, lungs and pleura, lymph nodes, thoracic lymphatic duct, upper hollow vein, stomach, spleen, pancreas, liver and gallbladder. Pathologies of all these organs can be manifested by pain between the shoulder blades.
Given all of the above, back pain near the scapula can be associated with 2 groups of causes:
- Diseases and pathological conditions of the musculoskeletal system: spine, back muscles, intercostal nerves and ligaments.
- Diseases of internal organs of the abdominal and thoracic cavity( cardiac, gastroenterological and pulmonological diseases).
Causes related to the pathology of the spine
If you have wondered why it hurts between the shoulder blades, first of all it is necessary to exclude diseases of the musculoskeletal system, since they are found in most cases.
Pathology of the thoracic spine of the
The pain syndrome( acute and chronic) in the back manifests such diseases of the spine:
- intervertebral hernia,
- scoliosis, thoracic pathological kyphosis, kyphoscoliosis,
- vertebral trauma,for example, compression fractures,
- congenital defects of thoracic vertebrae.
In these diseases, pain in the spine may be associated with abnormal muscle tension that occurs as a result of changes in the tissues of the spine or in connection with compression, irritation, edema of the spinal nerve roots.
Degenerative and dystrophic lesions of the thoracic spine often occur with pain in the interdiagnosed area of the
. As a rule, vertebrogenic pains under the scapula have 2 options:
- Chronic and aching pain that arises or intensifies when moving, inclines to the sore side, in an uncomfortable position.
- Acute and sudden, very intense pain, which can be described as an electric shock. The patient is so badly hurt that he can not breathe or move. This pain lasts for several minutes, then it changes to chronic and less intense.
This disease has another name - ankylosing spondylitis. By its nature, it refers to autoimmune systemic inflammation of connective tissue, but with a predominant lesion of the articulations of the spine and its ligaments.
Pathology progresses slowly. Pain in the back is a constant worry, intensified at night. With time, deformities of the spine develop, limitations of its mobility, which cause disability of a person. In later stages, internal organs are involved in the pathological process.
Deformity of the spine in Bechterew's disease
As a rule, this disease develops in people whose activity is associated with increased load on the shoulder joint. For your information: the acromial process of the scapula is involved in the construction of the shoulder joint. The head of the humerus is attached to it.
Pleuralopathy periarthritis develops for several months or even years, has 3 stages:
- Acute stage of - patients complain of pain in the shoulder during movements. Pain sensations often spread into the scapula and the interlobar space. The function of the hand is not broken at this stage.
- The stage of imaginary well-being of is characterized by the abatement of the pain syndrome, but the limitation of motor activity in the shoulder is gradually beginning to develop.
- The final stage of - the pain is absent, but the volume of movements in the shoulder joint is significantly limited and sometimes does not exceed 10-15º.
A symptom that helps to recognize the disease at an early stage is the inability to get a hand on the head due to pain, and also crunching in the area of the scapula when trying to do this.
This condition can be congenital or acquired. In the second variant the pterygoid scapula may be the result of damage to some muscles near it, the nerves that innervate them. Such a disease is not only a cosmetic problem, but also accompanied by chronic aching pain at the level of the thoracic spine segment.
To detect pathology is simple. For this, a routine inspection is sufficient. In some cases, to examine the pterygoid scapula, you need to ask the patient to lean against the wall with his arms straight.
Pterygoid scapula to know simply
Most often this disease has a vertebrogenic character, that is, the inflammation of the nerve during the intercostal space is due to changes in the spinal column with hernia, osteochondrosis, etc. But sometimes the pathology can have an infectious character, for example,virus with shingles.
With intercostal neuralgia, patients complain of:
- the pain that occurs between the scapula and spreads along the chest wall to the front of its surface, has an intense shooting character;
- pain sensations are localized, as a rule, only on one side, are strengthened with pressure on the affected area and tilt in the same direction;
- with herpes zoster along the course of the inflamed nerve, there is reddening and characteristic vesicular eruptions;
- on the course of the affected intercostal space, it is possible to observe a violation of skin sensitivity, tingling.
Important! Left-sided intercostal neuralgia is very similar in clinical picture with angina or myocardial infarction. Therefore, in order not to miss such a terrible disease, all patients are made ECG.
This inflammation of the muscles is of an infectious or aseptic nature. Pain under the scapula often disturbs patients with myositis. Pain can be either acute( complicates the course of any acute respiratory viral infection) or chronic.
In patients with myositis, patients complain of aching sensations, which are aggravated by movement, palpation and stretching of inflamed muscles. As a rule, with myositis, ointments based on NSAIDs, as well as local-irritants, are very effective.
Causes related to the pathology of internal organs
As already mentioned, pain in the region of the scapula and between them can be associated with the pathology of several internal organs of the abdominal and thoracic cavity. Let's consider the main ones.
Pain distribution in angina pectoris or myocardial infarction
Among the lesions of the internal organs, which may manifest pain syndrome in the zone of the scapula, heart disease and large vessels are in the first place in the spread and danger to life.
An attack of angina or myocardial infarction is often accompanied by pain under or between the left scapula. To distinguish these dangerous conditions from other causes of pain will help such symptoms:
- attack develops suddenly and is often associated with physical or emotional stress;
- pain does not have a shooting, stabbing character, but a pressing, compressive, burning;
- the pain appears, as a rule, behind the sternum bone and gives between the scapula, but there may be variants when it hurts only in the zone of the scapula;
- the patient has shortness of breath, pale skin, cold sweat, fear of death;
- the duration of pain does not exceed 15-20 minutes, if it hurts longer, then a heart attack may have developed;
- pain with angina occurs under the influence of nitroglycerin.
Another cardiological pathology that requires emergency care is the exfoliating aortic aneurysm. If you do not immediately operate on the patient, then the aneurysm may burst, there will be a deadly internal bleeding. The pain in this pathology is similar to an attack of angina, arises abruptly, but differs in characteristic migration: it begins in the chest and spreads into the interlopacial space, then descends downwards into the lumbar zone. You can also observe a sharp drop in blood pressure.
Pain between scapular bones can occur with such diseases of the bronchopulmonary apparatus:
- pleurisy( inflammation of the pleura);
- pulmonary tuberculosis;
- pulmonary tissue abscess;
- malignant tumors;
- bronchiectatic disease.
Symptoms such as coughing, shortness of breath, fever, wheezing with breathing will help suspected pulmonological pathology. For confirmation, X-rays of chest organs are carried out without fail.
Pleural pain often occurs between the blades
Diseases of the gastrointestinal tract
The pain between the shoulder blades and in their projection can manifest such ailments of the digestive tract:
- perforated ulcer of the stomach and duodenum;
- acute pancreatitis;
- acute cholecystitis;
- malignant tumors of the liver, stomach, pancreas.
Additional symptoms( abdominal pain, vomiting, nausea, etc.), as well as additional examination methods( ultrasound, fibrogastroduodenoscopy, radiography of abdominal organs, laboratory tests) will help to diagnose the diagnosis.
Other causes of
There are many more reasons that can lead to pain between the shoulder blades. It should be listed some of them:
- osteoporosis and its consequences( kyphotic deformity of the spine, compression fractures of the thoracic vertebrae);
- malignant lesions of the spine and the scapula itself( multiple myeloma, hemangiosarcoma, lymphomas, sarcomas, metastases of other tumors);
- osteomyelitis and tuberculosis of the scapular bone, vertebral column;
- traumatic spleen injuries.
Therefore, there are a lot of reasons for the pain between the shoulder blades. Most of them do not require urgent medical intervention and do not affect life expectancy, but only reduce its quality. But there are also those who require emergency medical intervention to save lives. Therefore, for any pain in the area of the scapula, you need to seek help from a doctor to find out the exact diagnosis.
- A bit of anatomy
- Reasons for backbone pathology
- Reasons for internal pathology
- Other causes