Back pain in the shoulder area: causes and treatment

Patients rarely pay enough attention to recurrent pain in the shoulder area. However, this symptom is a "wake-up call" about serious changes not only in the musculoskeletal system but also in the internal organ complex. Such conditions can threaten patients with disability and death. How not to miss the disease and cure back pain in the shoulder area, read on.

Etiology

The spine is the main component of the human musculoskeletal system. So the part of the lion's pressure during static or dynamic falls on the spine. So it's no surprise that a common reason to consult a doctor is pain in the shoulder blade area.

However, the pain syndrome is very variable: often the pain is caused not by the spine, but by a violation of the functions of internal organs. This fact makes it difficult to diagnose the root cause of the pain syndrome and leads to treatment errors.

Among the main causes of pain, pathologies of the musculoskeletal and visceral systems are distinguished.

The first group includes:

1. bone necrosis;
2. spinal deformities;
3. injuries and spondylolisthesis;
4. spondylolisthesis;
5. Osteoporosis;
6. ankylosing spondylitis.

Among extravertebral causes, diseases of internal organs are most common (pneumonia, heart attack, intercostal neuralgia, peptic ulcer, cholecystitis). In addition, tumorigenic or unstable mental processes (fibromyalgia, psychosomatic pain) can cause soreness.

Pain Variations

Why does my back hurt in the shoulder area? In general, the pain syndrome can be localized directly to the shoulder blades and between them. Pain is bilateral (with scoliosis) or localized mainly on one side (gastric ulcer, cholecystitis).

In essence, back pain between the shoulder blades can be acute (occurs suddenly with rapidly increasing intensity) or chronic (weak and persistent). The main difference in practice is that patients can accurately name the onset of the acute pain syndrome. While remembering the onset of chronic pain will be very difficult.

Pathology option

Several conditions can cause back pain in the shoulder blade area, but we will focus on the most common ones.

• Bone tumor.Osteochondrosis is a disease in which the discs occur "aging". In severe cases, such pathological changes lead to disc protrusion. When the thoracic spine is affected by degenerative bone conditions, patients worry about sharp back pain between the shoulder blades, which occurs when bending over or in an uncomfortable position for a long time. It can add visible weakness of the back muscles, disturbances in temperature perception, and pain.
• Spine deformity.One of the causes of pain between and in the area of the shoulder blades is the curvature of the spine. As a rule, pain causes kyphosis (stooping, hunchback) or scoliosis (C, S, or Z-shaped spine). With significant deformities of the spine, pain appears, which is aggravated by physical activity. Frequent episodes of respiratory distress (difficulty breathing, inability to "breathe deeply"). The clinic was also accompanied by increased fatigue and headaches. In rare cases, the breasts are curved.
• Injured.Sharp pain often occurs when there is a direct injury to the spine or the shoulder blade itself. Similar injuries occur from falls from a height, being hit by a blunt object, and in traffic or industrial accidents. Spinal cord injury is associated with pain to palpation, reflex contraction of the back muscles, and bruising. In some cases, the association of neuropathy is possible. When the shoulder blade is injured, the pain is acute, aggravated by swinging the arm. Sometimes it is combined with hemorrhage in the shoulder joint cavity - hemarthrosis.
• Spondylolisthesis.Spondylolisthesis are called senile destructive processes in the spine. Usually, in the area of the intervertebral disc joints, bone tissue grows - bone cells are formed, this can be complicated by the proliferation of the vertebrae together. In such cases, severe pain, neurological and vascular disturbances appear.
• Osteoporosis.Osteoporosis is a disease associated with a decrease in the density of the skeletal system. Usually, back pain in the shoulder blades occurs when the thin thoracic vertebrae are broken. Postural curvature appears - the formation of scoliosis and / or scoliosis. In some cases, the disease is complicated by lens syndrome (loss of motor activity and sensitivity).
• Ankylosing spondylitis. . . Ankylosing spondylitis is a disease that affects the disc joints. Usually, the clinic begins with pain between the shoulder blades or in the lower back. Aching sensations accompanied by stiff movements, worse after a night of rest. With the development of the pathology, the spine is deformed, crooked, leading to thoracic curvature and respiratory failure. In such a pathological position, ankylosing (immobilization) of the disc joints occurs, so that the patient can no longer bend over. In this case, the disease can further affect the cardiovascular and urinary systems.
• Diseases of internal organs.With pneumonia (pneumonia), the detailed clinical picture is characterized by fever, sputum production, and unilateral chest or back pain in the shoulder region. During a heart attack, a sharp pain (such as stabbing, burning), is identified in the chest and spreads to the left collarbone and upper extremities. Acute and penetrating intercostal neuralgia, manifesting as episodes that interfere with the patient's breathing. The pain is felt along the ribs, distributed under the shoulder blades, collarbone and lower back. With peptic ulcer, the pain is dull, localized in the upper abdomen, often accompanied by "hungry" pains (with prolonged breaks between meals). In this case, the disease is characterized by digestive disturbances, nausea, vomiting and heartburn. Sometimes there is bleeding from the ulcer: the patient feels a stabbing pain, which disappears with high bleeding. Vomiting and stools are dark (almost black) due to impurities in the blood. Cholecystitis (cholecystitis) is characterized by the appearance of a characteristic paroxysmal pain syndrome in the right hypochondrium, extending to the right side and fibula. Clinic of the disease includes digestive disorders, the predisposing factor is the consumption of fatty and fried foods. Sometimes vomiting appears with impurities of bile.
• Tumors.Shoulder pain may be associated with vertebral or nerve tumors (neuromas). Metastasis (daughter tumor) from the affected prostate or mammary gland may spread to the vertebral region. In this case, the tumor process is characterized by an asymptomatic process, and the occurrence of pain is associated with the proliferation of the tumor and its pressure on the neurovascular bundle. Cancer can be suspected by "watchdog symptoms": pain, weight loss, fever, and persistent weakness for no apparent reason.
• Mentally unstable.Psychological instability in the face of stress and emotional outbursts can manifest as psychological pain. It arises in the context of complete health: the patient can experience sensations of varying degrees that cannot be treated even with painkillers. Stressful situations also trigger another idiopathic (uncaused) pain - fibromyalgia. The disease progresses against the background of persistent, intensifying pain sensations at certain points (triggers).

Diagnose

X-rays are 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, diagnosis by ultrasound or MRI is used. To rule out concomitant disease, other laboratory or instrumental tests may be needed.

Treatment

These medical conditions require a specific treatment plan, only a doctor can prescribe medication.

• Bone tumor.As a drug therapy for pain, non-steroidal anti-inflammatory drugs and analgesics are used. Physical therapy, gymnastics, and massage are also effective. In the later stages of the disease, surgery is recommended to remove the skull sac.
• Spine deformity.Conservative treatment for curvature of the spine includes the use of assistive devices (corsets, bandages). You also need full activity, massage and physical therapy (application of paraffin, electrical stimulation). In cases of significant deformity, surgical treatments are indicated to immobilize the spine to an anatomically correct position.
• Injured.Minor injuries are treated with rest, warmth, and massage; More severe injuries may require traction. If conservative methods don't work, the spine is reconstructed surgically.
• Spondylolisthesis.Treatment of this pathology is aimed at slowing the progression of the disease. So, injections of hyaluronic acid, chondroprotectors, physiotherapy (shock wave therapy), as well as physiotherapeutic exercises are indicated. With severe pain syndrome, blockade is carried out with analgesics.
• Osteoporosis.Osteoporosis care includes high doses of calcium and vitamin D supplements. Hormone therapy with female sex hormones, thyroid, and other hormones is also possible.
• Ankylosing spondylitis.Inflammation and pain are controlled with anti-inflammatory therapy. To modulate the immune response, an antimetabolite of the group of structural analogues of folic acid is prescribed. During remission, physical therapy, breathing exercises and therapeutic massage are performed.
• Diseases of internal organs.Therapy for pneumonia includes antibacterial agents, as well as drugs that reduce bronchospasm. During the rehabilitation period, vibration massage and therapeutic exercises are prescribed. Intercostal neuralgia is treated with hot compresses and anti-inflammatory ointments. Often used as distraction therapy with topical treatments of red pepper extract or bee venom. Treatment for peptic ulcers includes combination antibiotic therapy, as well as medications that reduce stomach acid levels. Help with cholecystitis includes the use of antispasmodics and drugs that affect the bile. In some cases, antibiotic therapy may be required. In the case of large stones in the gallbladder, the latter method should be removed - cholecystectomy.
• Tumors.Treatment of tumor processes includes chemotherapy with antineoplastic agents and surgical resection of the tumor (if possible).
• Mentally unstable.Mental instability requires intensive psychotherapy, as well as the use of antidepressants or anxiolytics. Managing psycho-emotional stress is an important part of treatment.

How to prevent?

To prevent back pain in the shoulder area, it is necessary to adjust the lifestyle: increase the nutritional value of the diet, play sports, quit smoking, drink alcohol. It is important to detect and treat chronic diseases in a timely manner, avoiding stress overload.

Remember, pain is not a standalone disease but a manifestation of a much more serious condition that needs proper diagnosis and treatment!