Patients rarely pay attention to recurrent pain in the scapula area. However, this symptom is not only a "wake-up call" for serious changes in the internal organ complex as well as the musculoskeletal system. This condition may threaten the disability and death of the patient. How to not miss the disease and heal the back pain in the scapula area, please read on.
Cause
The spine is the main component of the human musculoskeletal system. Therefore, in statics or dynamics, most of the pressure falls on the spine. Therefore, it is not surprising that a common reason for consulting a doctor is pain in the scapula area.
However, the pain syndrome is variable: usually the pain is not caused by the spine itself, but by the violation of the function of the internal organs. This fact makes it difficult to diagnose the underlying cause of the pain syndrome and leads to treatment errors.
Among the main causes of pain, there is a difference between the pathology of the musculoskeletal and internal systems.
The first group includes:
- Osteochondrosis;
- Spinal deformity;
- Trauma and spondylolisthesis;
- Spondylosis;
- Osteoporosis;
- Ankylosing spondylitis.
Among non-vertebral causes, visceral diseases are the most common (pneumonia, heart disease, intercostal neuralgia, gastric ulcer, cholecystitis). In addition, the tumor process or mental instability (fibromyalgia, psychogenic soreness) can cause soreness.
Pain changes
Why does the back pain in the shoulder blade area? Generally speaking, pain syndrome can be located directly in the scapula area or between the shoulder blades. The soreness is bilateral (with scoliosis) or mainly on one side (gastric ulcer, cholecystitis).
Depending on the nature of the back pain between the shoulder blades, it can be acute (occurs suddenly with a rapid increase in strength) or chronic (weak and continuous). The main difference in practice is that patients can accurately name the onset of acute pain syndrome. Although it can be difficult to remember chronic pain episodes.
Pathology options
Many diseases can cause back pain in the scapula area, but we will focus on the most common diseases.
- Osteochondrosis.Osteochondrosis is a disease during which the intervertebral disc "ages". In advanced cases, this pathological change can lead to a herniated disc. When the thoracic spine is affected by osteochondrosis, patients worry about severe back pain between the shoulder blades, which can occur when bending for a long time or maintaining an uncomfortable posture. May increase the apparent weakness of the back muscles, temperature and pain perception disorders.
- Spinal deformity.One of the causes of pain between the shoulder blades and in the shoulder blade area is the curvature of the spine. Usually, soreness causes kyphosis (bending over, kyphosis) or scoliosis (C, S, or Z-shaped spine). When the spine is obviously deformed, soreness will appear, and it will be aggravated by physical activity. Respiratory failure (shortness of breath, inability to "deep breath") occurs frequently. The clinic is also accompanied by increased fatigue and headaches. In rare cases, the chest will bend.
- Hurt.Severe pain is usually accompanied by direct trauma to the spine or scapula itself. Similar injuries occur when falling from a height, being hit by a blunt object, transportation or industrial accidents. Spinal injuries are related to palpable pain, reflexive contractions of back muscles, and bruising. In some cases, neuropathological attachment is possible. When the scapula is traumatized, the pain is severe, and swinging the arm will aggravate it. Sometimes it is combined with shoulder joint cavity bleeding-arthrodesis.
- Spondylopathy.Spondylosis is known as the destructive process of old age in the spine. Usually, in the intervertebral joint area, bone tissue grows-osteophyte formation, which may be complicated by the mutual increase of vertebrae. In this case, severe pain, neurological and vascular diseases can occur.
- Osteoporosis.Osteoporosis is a disease related to the decrease of bone density. Usually, when a thinned thoracic spine fractures, back pain in the scapula area occurs. Postural curvature-the formation of scoliosis and/or kyphosis. In some cases, the disease can be complicated by nerve root syndrome (loss of motor activity and sensitivity).
- Ankylosing spondylitis. . . Ankylosing spondylitis is a disease that affects intervertebral joints. Usually, the clinic starts with pain between the shoulder blades or in the lower back. Soreness is accompanied by exercise stiffness, which will increase after a night's rest. With the development of pathology, the spine deforms and arches, leading to chest curvature and respiratory failure. In this pathological position, the intervertebral joints are rigid (fixed), so the patient cannot bend any more. In this case, the disease also affects the cardiovascular and urinary systems.
- Visceral diseases.For pneumonia (inflammation of the lungs), the detailed clinical features are fever, expectoration of sputum, and pain on one side of the chest or back in the scapula area. During a heart attack, the soreness is severe (tingling, burning), identified in the chest and radiated to the left scapula and upper limbs. The pain syndrome of intercostal neuralgia is acute and stinging, manifesting in the form of episodes that interfere with the patient's breathing. The pain occurs along the ribs and is distributed under the shoulder blades, collarbone, and lower back. For gastric ulcers, soreness is dull pain, located in the upper abdomen, usually accompanied by "hunger" pain (long rest between meals). In this case, the disease is characterized by digestive disorders, nausea, vomiting, and acid belching. Sometimes the ulcer will bleed: the patient will feel tingling, which disappears at the peak of the bleeding. Due to impurities in the blood, vomiting and stool become darker (almost black). Cholecystitis (inflammation of the gallbladder) is characterized by a characteristic paroxysmal pain syndrome in the right side flank and spread to the right side and scapula. The clinical manifestations of the disease include digestive system diseases, and its predisposing factors are the consumption of fats and fried foods. Sometimes vomiting is accompanied by bile impurities.
- Tumor.Soreness in the scapula area may appear in neoplastic diseases of the vertebrae or nerve sheaths (neuroma). Metastases (child tumors) from the affected prostate or breast can spread to the vertebral area. In this case, the tumor process is characterized by an asymptomatic process, and the appearance of pain is related to the increase of the tumor and its pressure on the neurovascular bundle. Cancer can be suspected through "watchdog symptoms": pain, weight loss, fever, and persistent weakness for no apparent reason.
- Mentally unstable.Psychological instability to stress and emotional outbursts can be manifested as psychogenic pain. It appears in the context of complete health: patients can experience feelings of various intensities that cannot be treated even with painkillers. Stress situations can also trigger another type of idiopathic (no cause) pain-fibromyalgia. The disease occurs in the context of prolonged pain, which is exacerbated at certain (trigger) points.
diagnosis
Radiography is the gold standard for examining the spine. To determine the cause of vertebral pain, computed tomography can be used. To study other organs and systems, ultrasound diagnosis or MRI is used. In order to rule out accompanying pathology, laboratory or other instrumental inspection methods may be required.
treatment
These pathological conditions require a specific treatment plan; only a doctor can prescribe medication.
- Osteochondrosis.As medications for pain relief, non-steroidal anti-inflammatory drugs and analgesics are used. Physical therapy, therapeutic gymnastics and massage are also effective. In the later stages of the disease, surgical removal of the hernia sac is recommended.
- Spinal deformity.Conservative treatment of spinal curvature includes the use of support devices (corsets, bandages). You also need enough activities, massages and physical therapy (paraffin application, electrical stimulation). In the case of severe deformities, surgical treatment is required to fix the spine in the anatomically correct position.
- Hurt.Minor injuries can be treated with rest, warmth, and massage; more serious injuries may require traction. If conservative methods are not effective, surgical methods are used to reconstruct the spine.
- Spondylopathy.The treatment of this pathology is aimed at slowing the progression of the disease. Therefore, hyaluronic acid injections, chondroprotective agents, physical therapy (shock wave therapy), and physical therapy exercises are prescribed. For severe pain syndromes, use analgesics to block.
- Osteoporosis.Osteoporosis care includes high-dose calcium and vitamin D supplements. Hormone treatment of female sex hormones, thyroid and other hormones is also possible.
- Ankylosing spondylitis.Inflammation and pain are controlled by anti-inflammatory therapy. In order to change the immune response, antimetabolites of the structural analogue group of folic acid are prescribed. During the remission period, perform physical therapy, breathing exercises and therapeutic massage.
- Visceral diseases.The treatment of pneumonia includes antibacterial agents and drugs to relieve bronchospasm. During the rehabilitation period, vibration massage and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warm-up and anti-inflammatory ointments. Distraction therapy that uses red pepper extract or bee venom for topical treatment is often used. The treatment of gastric ulcer includes combined antibiotic therapy and drugs to reduce the acidity of the stomach contents. Treatment of cholecystitis involves the use of antispasmodics and drugs that affect bile. In some cases, antibiotic treatment may be required. In the case of large stones in the gallbladder, it is recommended to remove the latter-cholecystectomy.
- Tumor.Treatment of the tumor process includes chemotherapy with anti-tumor drugs and surgical removal (if possible) of the tumor.
- Mentally unstable.Mental instability requires intensive psychotherapy and the use of antidepressants or anti-anxiety drugs. Limiting psychological and emotional stress is an important part of treatment.
How to prevent it?
In order to prevent back pain in the scapula area, lifestyle changes are required: increase the nutritional value of the diet, exercise, quit smoking and alcohol. It is important to detect and treat chronic diseases in time to avoid excessive stress.
Remember, pain is not an independent disease, but a manifestation of a more serious pathology that requires diagnosis and proper treatment!