Back pain in the region of the blades. Causes, treatment, medications, exercises, to what doctor to address

Back pain with osteochondrosis of the spine are caused more often. In the area of ​​the blades may also occur in some diseases of the internal organs. Many symptoms are not specific and require instrumentation and laboratory studies. For pain used NSAIDs and muscle relaxants. So that the process is not passed in the chronic stage, it is necessary the timely detection of the underlying cause.

Pain in the shoulder blades - what can it be?

Back pain in the area of ​​the blades may have a different character.

According to subjective feelings:

• Sharp. They may be the cause of potentially dangerous pathology (vertebral compression fracture, tumor, etc.).
• Dull, aching. They are usually seen in lesions of bone or muscle tissue and amplified during movement. Their difference is that the patient can pinpoint the location of the source of sensations.

By Location:

• localWhich are caused by irritation of local pain receptors located in the skin or muscle. The pain is usually permanent. Its intensity depends on the position of the body.
• reflectedArising pathologies other organs and systems (stomach, retroperitoneal space, etc.), and transmitted within the nerve plexus skin segments. They are not related to physical activity.
• irradiatingCharacterized by high intensity. They may be accompanied by sensory and motor disorders. Their appearance is associated with stretching, or compression of irritation (edema, inflammation, ischemia) nerve roots of the spine or major nerves that provide the connection of muscle tissue, joints and skin brain. When coughing, physical exertion, sneezing pain increases. Often it pays well in hand, the occipital region, and its character can be shooting, cutting and burning.

Pain in the shoulder blades as a cause of disease. additional symptoms

Pain can be due to both tension and overload the back muscles, and be a sign of a more serious pathologies.

Dangerous symptoms are the following:

• numbness;
• nausea or vomiting;
• high intensity of pain;
• fever;
• pain in the heart, feeling short of breath, arrhythmia.

Many accompanying symptoms are nonspecific, so an accurate diagnosis requires laboratory and instrumental diagnostics.

Stomach ulcer

Back pain in the area of ​​the blades at a stomach ulcer can give to the left side and resemble angina, which often leads to an erroneous diagnosis.

Atypical localization of sensations is observed in many patients, but common symptoms, characteristic of this disease are as follows:

• the occurrence of stomach ache after 0.5-1 hours after eating, a gradual increase in its intensity, and then fainting during 1.5-2 h as gastric emptying;
• some patients - a short paroxysmal pain several times during the day;
• lack of appetite, nausea, vomiting and related weight loss;
• weak expression of pain intensity in the defeat of the upper portion of the stomach, as well as the absence of seasonal exacerbations in the elderly.

If a gastric ulcer is combined with inflammation of the duodenum 12, most often abdominal pain lasts a long time and is strong. Discomfort may also appear behind the xiphoid process and the sternum.

Psychological problems

Back pain in the shoulder blades associated with only psychogenic causes are rare, since the presence of such abnormalities in patients often there are other neurological pathology and skeletnomyshechnye violations.

This diagnosis can be put only in the event that severe pain that is present more than six months can not be explained by the presence of other physical ailments.

Despite the complexity of identifying the reasons for this, medical studies show that There is a clear correlation between pain and psychological factors as follows:

• severe emotional stress, grief;
• increased anxiety;
• depression;
• fears, including those due to the possible appearance of pain.

As additional features are the following:

• centered on the patient's own health;
• fear of pain and spinal cord injury;
• Social dissatisfaction with work or living conditions, and other factors;
• pain in other places;
• skeletnomyshechnye disorders often associated with low physical activity and lead to increased discomfort;
• reduced pain threshold.

myocardial infarction

Myocardial infarction, or necrosis of the heart muscle, accompanied by the following symptoms:

• pain in the heart of the high-intensity;
• appearance cold sweat, cold extremities;
• pallor, earthy or bluish coloration of the skin;
• feeling short of breath;
• arrhythmia, acceleration or slowing of the heartbeat;
• fever.

The distinctive feature in this case is the short term, intermittent pain, independent of body motions, and the possibility of its suppression using nitroglycerin.

Cervical osteochondrosis

Back pain in the region of the blades, due to the cervical spine osteochondrosis, accompanied by such symptoms as:

• numbness, pain or ache in your hands, fingers, shoulders, or chest;
• increase in the intensity of discomfort during exercise, coughing, sneezing;
• numbness of the tongue;
• pain in the neck with clamping nerve root at the top of the neck;
• tinnitus, hearing loss, dizziness, "spot", darkening of the eyes;
• frequent headache, which is throbbing in nature;
• high blood pressure;
• exacerbation of pain at night.

This disease most often occurs in those who are engaged in "sedentary" work - engineers, office workers, drivers, accountants. Increased pain when turning head, deep breathing, sneezing and coughing.

Intercostal neuralgia

Intercostal neuralgia occurs due to compression of the intercostal nerves, resulting in the formation of edema. A distinctive feature of this disease is severe pain that arises in the intervals between the ribs. It is amplified by coughing, sneezing, and other movements of the chest, can be felt encircling or only on one side (usually the left).

Depending on how much disadvantaged nerve, pain is of an obtuse or acute. Other signs include numbness or tingling sensation, returns to the heart and loins.

Perforation of the stomach ulcer

Back pain in the region of the perforation blades at gastric ulcers, as in myocardial infarction, are paroxysmal, sharp, "dagger" character. When this disease is the destruction of the walls of the stomach and its contents out into the abdominal cavity.

Depending on the stage of development of the state observed the following additional features:

1. "Shock" period lasting up to 6 hours after perforation. During this period, there is an acute pain as a result of peritoneal irritation by stomach acid. Can also be observed: decreased heart rate, increased blood pressure, the tension of the abdominal muscles, cold sweat. The patient tends to take a position on the right side with his legs pulled up.
2. In the second stage the pain subsides. Such temporary improvement may last up to 2 hours.
3. Later develop signs of inflammation of the peritoneum: bloating, abdominal pain and right upper quadrant, the tension of his muscles, tachycardia, thirst, dry skin, a failure in bowel habits.

Muscle spasm of the gall bladder

The following symptoms may be present at a spasm of the gall bladder:

• pain under the ribs on the right and in the navel;
• nausea, appetite deterioration;
• belching;
• sense of bitterness in the mouth;
• flatulence;
• constipation or diarrhea;
• autonomic disorders - headaches, fatigue, increased sweating, increased or decreased heart rate, blood pressure change.

The nature of pain there may be short-lived, and paroxysmal or persistent and nagging.

subdiaphragmatic abscess

Subdiaphragmatic abscess occurs as a complication of inflammatory diseases - appendicitis, cholecystitis or peritonitis. In this case, there is an accumulation of pus under the diaphragm.

For such a condition characterized by the following features:

• fever, heat to 40 ° C;
• a nagging pain in the left or right upper quadrant, extending under the shoulder blades or shoulders;
• nausea, vomiting;
• weakness, sweating, chills.

Most often, an abscess is formed on the right side of the body.

kidney disease

Back pain in kidney diseases appear in the lumbar spine and give in the area of ​​the shoulder blades.

Other features are the following:

• swelling of limbs, face;
• change urine (reddish brown color, increase in turbidity, an increase in sediment, foam appearance);
• headache;
• appetite loss, nausea;
• itchy skin;
• frequent urination or difficulty;
• dyspnea;
• tachycardia, arrhythmias;
• fever;
• chest pain;
• an increased amount of urine;
• constant feeling of thirst;
• general weakness;
• hypertension.

When the cause of the pain lie in the very blade

Pain in the shoulder blade may also be caused by reasons related directly to this part of the skeletal system.

Among them are the following:

• Fracture of scapula. This is a rare type of injury, which occurs when falling on the back or shoulder. In this case, there is deterioration in the motor activity of the deltoid muscle, shoulder hanging, and in the armpit can be a broken edge of the blade. The injury zone formed subcutaneous swelling and hemorrhage.
• wing-bladeOr Sprengel's disease. This rare congenital disease, consisting in incorrect development blade (high distance up to 10 cm), spine and ribs. Deviation often one-sided. Diagnosis of the disease is carried out already in early childhood and is not difficult.
• Bursitis subscapularis muscle (Scapular crunch). The disease is an inflammation of the joint capsule. Symptoms of the disease include: swelling in the area of ​​the blade, when pressed on which there is a sharp pain, fever, numbness in the forearms, clicking on the move.
• Osteomyelitis blade. bone marrow inflammation in a given location - a rare phenomenon. The main reasons for its development are trauma and sepsis. Externally, it is reflected in the fact that the blade moves backwards and there is difficulty in its motion. Clarify the diagnosis based on ultrasound, CT, rentgenobsledovaniya.

The causes of pain in the back between the shoulder blades

The most common reasons that cause pain in this localization are:

• long neck muscle tension resulting uniform physical exertion or the use of furniture inconvenient, improper working position;
• low back pain and other pathologies of the spine;
• sudden movement as a result of which there is hyperextension of the muscles;
• squeezing muscles backpack or tight clothing;
• metabolic degradation;
• psychogenic disorders;
• diseases of the internal organs;
• injury, improper healing of fractures;
• tumor.

Risk factors for the development of this condition are:

• hypothermia;
• infectious diseases;
• poor diet, vitamin deficiency;
• stress;
• increased physical activity;
• obesity;
• abuse of alcohol and cigarettes;
• diabetes;
• elderly age;
• spinal osteoporosis, especially among women.

How to ease the twinge. First aid

The following methods are used to reduce pain intensity:

• analgesics and NSAIDs (some of the drugs listed in the table below);
• local use of ointments with NSAIDs;
• anesthetic injection.

Such treatment may be carried out only after the determination of an accurate diagnosis, as self-management of pain may hamper the identification of the true cause of the disease.

Table - NSAIDs for the treatment of pain between the shoulder blades:

Tradename	Active substance	Average price, RR.
Tablets, capsules
Voltaren	diclofenac	200
diclofenac	65
Naklofen	100
ketonal	ketoprofen	50
ketoprofen	100
Flamaks Forte	130
Ibuklin	ibuprofen	120
Nurofen	140
ibuprofen	30
Local products (gels, creams)
gel Diklovit	diclofenac	100
gel Ortofen	100
Diclofenac gel	70
Ibuprofen gel	ibuprofen	70
Ketoprofen gel	ketoprofen	90
Cream, gel Ketonal	400

Pathology Methods of treatment

In cases where the pain is not related to the internal organs of illness or injury, the state is benign. The goal of treatment is to eliminate the pain using analgesics and NSAIDs listed above. The specific treatment depends on the cause of such a condition. Complex classes and physiotherapy should be agreed with your chiropractor.

Physiotherapy. Terms of employment and a set of exercises

Back pain in the area of ​​the blades are often caused by uneven muscle tension, which leads to their shortening, spasm and unpleasant symptoms.

some exercises recommended to maintain a balance:

• The standing arms bend in shoulder joints at 90 °, to bring the blade together. The same is repeated in a sitting position. Perform 10 times 2-3 times a day.
• The fingers hook the back of the head. Bringing together the blade, exhaled air. Try to bend over backwards in his chest. Exercise can be done sitting or lying on his stomach. The amount of information is the same as for the previous exercise.
• Standing in the door frame to lift the arm so that the elbow was above the shoulder joint, lean forearm or hand. The pectoral muscle area should be a feeling of tension. Hold for 15-30 seconds. Perform 1 set of 3-4 times a day.
• Lie on your side, legs should be straight, in line with the torso. Raise your legs together and try to keep them to 20, perform 2 sets 3 times a day.
• Lie on your side, as in the previous case, to sit up straight on her hand while holding the position 15-30 seconds. Then sit down, rotate the torso to the opposite side, hold the position for 15-20 seconds. These exercises are repeated 2-3 times a day.

Such training will help strengthen your back muscles and relieve unnecessary stress.

Since exercise can lead to increased pain, an increase in the load must be carried out gradually. Useful as walking, exercises on an exercise bike and swimming on the first 5-10 minutes. per day, then the duration of the training is adjusted to half an hour.

Improving patients occurs after 1-2 months of daily sessions. Exercise therapy is contraindicated in trauma in postoperative period, in the acute stage of osteoarthritis, as well as expressed pain syndrome.

Medications. The treatment regimen, names of drugs

To relieve pain and muscle relaxants are used to relax the muscles. Some of them are listed in the table below.

Title	The active substance, the release form	Dosage, mg / day.	Average price, RR.
tizanidine	Tizanidine tablets	6-12	140
sirdalud	Tizanidine, capsules	6-12	300
tolperisone	Tolperisone tablets	300-450	280
Mydocalm	100-450	350
baclofen	Baclofen Tablets	30	250

In gastric ulcer prescribe the following medications:

• Antacids, enveloping and healing gastric mucosa: Almagel, Maalox, Fosfalyugel, gastrofarm;
• histamine receptor blockers which reduce stomach acidity of the medium: cimetidine, ranitidine, gastrosidin;
• antibiotics in the defeat Helicobacter pylori infection: De Nol, Trykhopol, Metronidazole;
• reparative agents that promote the healing of damaged tissue: Aktovegin, Solkoseril.

The operation is performed in the case of failure of medical treatment of ulcers and in its perforation. With adequate therapy benign defect grows within 1-2 months. Stubborn course of the disease may indicate the presence of malignancy.

If the pain in the shoulder blades is caused by psychological reasons, it is prescribed as an NSAID, or antidepressants:

• paroxetine;
• bupropion;
• trazodone;
• mirtazapine;
• Moclobemide and others.

The effective as cognitive-behavioral therapy and exercise therapy, with a gradual increase in physical activity.

Myocardial infarction apply the following groups of drugs:

• Non-narcotic analgesics for pain relief;
• antithrombotic agents (aspirin, heparin);
• beta blockers to reduce pain and restriction of necrosis zone (metoprolol, atenolol, Vazokordin);
• Antianginal preparations reducing the oxygen consumption of cardiac muscle (Nitroglycerin Sustak, verapamil).

When administered NSAIDs intercostal neuralgia and muscle relaxants, as defined above. After calming down aggravation performed exercise therapy, massage the back and neck and neck area. When subdiaphragmatic abscess used antibiotics, detoxification therapy is performed (dropper) and the purpose of treatment is to eliminate the primary cause of the suppuration.

When the spasm of the gall bladder using the following medicines:

• antispasmodic drugs - No-spa, Drotaverinum, papaverine, Platifillin, Tifen;
• sedatives: sodium bromide, valerian tincture;
• cholagogue: holosas, Allohol, Holenzim.

From food exclude fatty, spicy, fried and canned foods.

Mud treatment. Indications, especially procedures

Mud treatment is applied only at the stage of rehabilitation. Processes in the acute phase are contraindicated for this procedure.

The following indications for pelotherapy for back pain:

• spinal injury;
• surgery to remove the intervertebral hernia;
• low back pain;
• bursitis;
• muscle pain;
• neuralgia.

Contraindications include:

• fever;
• tumors, including benign;
• 4 degree angina, arrhythmia, hypertension higher degree II, circulatory failure, expressed atherosclerosis, thrombophlebitis;
• hyperthyroidism;
• bleeding tendency;
• pregnancy.

Mud procedure can be done at home by yourself. In commercially available therapeutic mud, packed in plastic containers. When heated to a low temperature 23-25 ​​° they have a pronounced analgesic and anti-edematous effect.

Technique of the treatment is as follows:

1. Blanket laid on the couch, and then oil-cloth, c / b, and the sheet on it - the mud layer (4-5 cm and 6-8 for interstitial peat).
2. The patient lies back on the couch and wrapped.
3. Withstand the interval 15-20 minutes. The total duration of treatment is 5-18 procedures daily or every other day.
4. Patient unwrap, remove the dirt from the back, its remains wash off with warm shower.

After the procedure is necessary to rest for an hour. In sanatorium conditions carried mud baths, for which a large amount of raw material required - to 300 kg. After 1-3 sessions can occur exacerbation of pain, it is normal balneoreaktsiey.

In this case, make a break for 1-2 days, reduce the area of ​​skin onto which dirt or shorten the duration of its exposure. With a sharp deterioration in the mud completely overturned.

Physiotherapy. Effective methods, duration of therapy

The following treatments are used as a physiotherapeutic methods on area between the back vanes:

• Electrophoresis of the spine and cervical department. This technique allows you to create a skin depot of drug which has a lasting effect on the pathological focus (No-Spa, papaverine and other drugs). Duration of treatment - 10 procedures for 15-20 minutes.
• The impact of ultrasonic waves. They contribute to the enhancement of metabolic processes, in the result is anti-inflammatory and analgesic effect. A similar effect has laser. Duration of treatment - 10 procedures.
• therapeutic baths (Contrast, hydrogen sulfide, turpentine, radon, coniferous). They have by several effects: chemical, thermal and mechanical (hydro). This improves blood microcirculation, accelerate metabolism and regenerative processes. The number of procedures - 12-15 to 1 course. Coniferous bath can be taken at home with the help of concentrates available on the market. Keep in mind that this type of physical therapy is contraindicated in cardiovascular diseases and other pathologies.
• AcupunctureProvider reflex effect on the muscles of the back. Treatment is carried out for 10-15 sessions.

When osteochondrosis will be useful as treatments such as:

• "Dry" or underwater spine traction (traction). This reduces the compression of the nerve roots or blood vessels. therapy - 10 procedures for 25-30 minutes.
• Massage (Only subsided after acute stage). It allows you to eliminate the asymmetry of the load of the back muscles and improve blood circulation in the tissues. The course of treatment - 12-15 20-25 minute procedure. The combination of massage with spinal traction gives good effect on cervical osteochondrosis.
• Postisometric muscle relaxation (FEAST). It is a kind of manual therapy and is based on the smooth muscle relaxation and stretching in a given direction. This makes it possible to eliminate muscle spasm and pain.

Sanatorium rest. Where to go, how much is a ticket

Sanatorium, in which the treatment of disorders of the musculoskeletal system, there are in almost all regions of Russia. The following table lists some of the destinations and prices.

Title	location	Minimum prices for accommodation with a standard set of procedures and power, rub. / Day.
Moscow region
"Pushkin"	city Pushkino	2100
"Buran"	city Sergiev Posad	2150
"Raven"	from. raven	4000
"Pine"	Ramenskoye district, pos. Bykovo	2200
The Black Sea coast
"Black Sea"	city Sochi	5400
"Mountain"	Yalta, smt. Livadia-1	2900
"Little Bay"	city Anapa	1450
"Aquamarine"	city Anapa	2200
Volga and Ural Federal District
"Ust-Kachka»	Perm, p. Ust-Kachka	3500
"Samara"	city Samara	2700
"Ai"	Bashkortostan p. Mesyagutovo	1400
"Gem"	Sverdlovsk region	2500
Siberian and Far Eastern District
"Arshan"	Buryatia, pos. Arshan	2300
"Nil Deserts"	Buryatia, pos. Nilovka	1600
"Belokurikha"	Altai region, pos. Belokurikha	3750
"Uchum"	Krasnoyarsk region, pos. lake Uchum	2750

As a precaution, back pain is recommended to do daily workout and before going to work in the garden or playing sports.

Always make sure your posture to avoid physiologically unnatural muscle tension in the shoulder blades. Smoking and alcohol contribute to reduce the level of oxygen in the blood and tissue nutrition deterioration of intervertebral discs, so by them should also be abandoned.

Helpful videos about the causes and treatments of back pain in the area of ​​the blades

Exercise for the management of pain in the area of ​​the blades:

The causes of pain between the shoulder blades: