What does back pain between the shoulder blades mean? The most common causes

What does back pain between the shoulder blades mean? The most common causes
Zdroj foto: Canva

Pain is a symptom that tells us that something unnatural is happening in the body. It alerts us to it. Pain between the shoulder blades is a symptom of various diseases. It can be a problem with the thoracic spine, cardiovascular, respiratory or digestive system.

Pain between the shoulder blades may or may not indicate a more serious problem.

What could be causing this problem, you ask?

Pain (dolor in Latin) is caused by the effect of damaging mechanisms on our body. For example, it indicates a threat to the integrity, as in the case of skin damage.

Pain is a frequent symptom of various diseases. It is a subjective unpleasant sensation. And it is the most common reason for seeking professional help, i.e. examination.

The table shows the types of pain and a brief description of them

Name Description
Acute Its duration ranges from seconds to three months. It causes stress, stress hormones are released, heart activity increases (tachycardia), breathing increases, sweating is associated
Chronic Lasts more than three months, impairs quality of life
Superficial It is sharp and can be well localised
Deep It is dull, harder to localize, does not have sharp borders, radiates to different parts of the body (referred pain)
Root It arises from irritation of the spinal roots and runs along the entire nerve
Phantom Pain that arises after amputation of a part of the body

Do you have spinal pain between your shoulder blades and don't know what is causing it?

Back pain between the shoulder blades can indicate a variety of difficulties. The organs of the cardiovascular, respiratory and digestive systems are located in the chest. Often the cause of this pain is a musculoskeletal problem.

Pain between the shoulder blades from the spine and for musculoskeletal disorders

And just the most common reason for the difficulty is pain originating from the back area. In this part are located muscles, bones, tendons, ligaments, joints and neurovascular bundles. Ribs, thoracic spine, brachial plexus, part of which is the scapula.

The shoulder blades and ribs protect important organs of the chest, such as the heart, large blood vessels, lungs. The organs of the abdominal cavity extend below the ribs. The liver, stomach, pancreas or spleen. The spine protects the spinal cord and, of course, has an important role in movement.

The spine has cervical, thoracic, lumbar, sacral and coccygeal parts. Pain can radiate to the area between the shoulder blades from the cervical, thoracic and lumbar regions.

A man has pain in his cervical and thoracic spine
The most common cause is musculoskeletal problems. Photo source: Getty Images

The origin of the trouble can be overloading of the spine, ribs, muscles, intervertebral spaces. It occurs after strenuous physical activity, for prolonged loading, but also after poor movement and sudden change of position.

A good example of this is when a person tries to lift a heavy object using poor technique. Muscles, tendons, but also vertebrae and intervertebral discs are loaded unevenly and unnaturally. As a result, overloading of individual parts can occur.

Pain is also caused by colds, especially during windy weather. A big problem is sweaty skin on the back and subsequent blowing or draughts. The result is acute block. Intense pain, which is aggravated by movement, change of position.

The problem also arises because of an inappropriate position during prolonged sitting, but also during sleep. A great burden on the spine is precisely a long sedentary work and sedentary lifestyle.

Long-term sedentary work and a sedentary lifestyle negatively affect the spine's fitness = a possible cause of the problem.

An example of a disease that causes the spine to sag is Bechterew's disease. It is actually an autoimmune disease that causes inflammation of the tissue, affecting the joints and ligaments of the spine.

We know the following causes arising from the musculoskeletal system:

  • Osteochondrosis is an inflammation of the intervertebral disc. Later it spreads and causes problems in its surroundings.
  • Spondylarthrosis or even spondylarthritis is a chronic and rheumatic disease. If neglected, it can cause lifelong problems.
  • Spondylosis is a degenerative disease that affects the intervertebral discs. These do not perform their full function. As a result, the vertebrae are damaged.
  • Spondylolisthesis is the displacement of a vertebra relative to its adjacent vertebra.
  • Intervertebral disc herniation can cause oppression of the spinal cord, nerve and spinal roots.
  • Pseudoradiculopathy
  • Scoliosis, abnormal kyphosis, kyphoscoliosis is a spinal deformity
  • Congenital defects of the vertebrae
  • Osteoporosis
  • Frozen shoulder syndrome
  • Intercostal neuralgia
  • Injuries, fractures
  • Injuries during violent movements, e.g. golf, football, hockey, are common
  • Myositis is inflammation of the muscle
  • Tuberculosis of the spine
  • Spinal tumour

In addition to the pain between the shoulder blades, there is also pain shooting to the anterior chest area. The sufferer often reports chest tightness, chest pain, pain on inspiration, feeling of inadequate breathing, lung pain.

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These discomforts are partly influenced by movement and position. That is, a certain position aggravates or triggers the pain. On the other hand, when there is relief, we talk about the relief position.

Mental strain and stress

Increased workload, overwork, chronic fatigue syndrome, prolonged stress. They have a negative effect on the whole body and the spine.

Problems are exacerbated by sedentary work, inappropriate posture and poor posture when working at an office desk, computer. Often they also arise in the factory at the belt during monotonous work and strain on the musculoskeletal system.

Psychological stress, stress, neurotic personality, genetic predisposition, physical stress are common factors in the development of problems such as acute spinal blockage.

Pain in the spine and between the shoulder blades in pregnancy

Pregnant woman, wearing a dress and a hat
A significant load on the spine occurs during pregnancy. Photo source: Getty Images

From the beginning of pregnancy until delivery, the body adapts to its current state. As the weeks pass, body weight increases and the distribution of organs adapts to the enlarging uterus and fetus.

The body's centre of gravity changes.

The body weight increases, at least by 7 kilograms. At optimal condition, the natural weight increase is from 10 to about 16 kilograms. The mammary glands also increase, preparing for the role of breastfeeding.

These are the main reasons that plague pregnant women during the joyful months. Spinal pain, even between the shoulder blades, is aggravated by already present risk factors. These are, for example, overweight, obesity, congenital or other musculoskeletal diseases that were already present before pregnancy.

In general, pain during pregnancy is a problem.

Therefore, it is important to inform the gynaecologist about the difficulties. The doctor can then determine the appropriate course of action and treatment for spinal problems according to the severity. The spontaneous use of analgesics (painkillers) could be harmful for the development of the fetus.

The table shows the distribution of approximate weight gain before the end of pregnancy

Name Approximate weight
Fetus 3-4 kg
Uterus 1-1,5 kg
Fetal packaging and water 1,5 kg
Increased blood volume 1,5 kg
Increase in mammary glands 0.5 kg
Water retention in the body 2 kg
Body fat gain 2-3 kg

Spinal pain for internal organ disease

Of course, it is not only musculoskeletal problems that cause thoracic spine pain and pain between the shoulder blades. It is necessary to think about diseases of the cardiovascular, respiratory, but also digestive system.

Cardiovascular disease as a cause of pain between the shoulder blades

Pulmonary embolism is a blockage of the blood vessels of the pulmonary circulation. The blockage can be caused by a blood clot, fat particles, amniotic fluid, a foreign body, but also air. In addition to thrombosis, it can occur as a result of surgery, with fractures of the lower limbs, when immobilizing them, but also when traveling for a long time.

Its symptoms are:

  • shortness of breath, sudden shortness of breath at rest
  • chest pain, which may radiate between the shoulder blades
  • heart failure
  • coughing up blood
  • fatigue
  • swelling of the lower limbs
  • sudden death with massive embolization

Acute MI can also present with pain between the shoulder blades. There may be chest pain that moves (radiates) to the back and between the shoulder blades, as well as pain between the shoulder blades themselves.

In addition to heart attacks, pain in coronary heart disease can also spread to the area between the shoulder blades, especially in its painful form (angina pectoris, which is a constricting chest pain). This is divided into stable and unstable pain.

The unstable form can also develop into a heart attack. It is important to note whether the pain lasts 15-20 minutes. In people treated for stable angina, it is important to observe a change in the long-term symptoms. In particular, a change in the nature, intensity, duration and the underlying cause of the chest pain.

You can also read about chest pain in the article on angina.

Dissection of a thoracic aortic aneurysm is a serious disease.

Its manifestation is intense, severe, excruciating chest pain, which may move to the area between the shoulder blades. During dissection, the vessel wall is damaged, where blood accumulates through the flow. Not only does the blood accumulate, but it progresses further. Depending on the location and extent of the blood progression in the false channel, complications occur.

The most serious complication of dissection of the ascending aorta (the part that moves away from the heart and toward its arch) is death.
And if left untreated, the risk of death is up to 95%.
Read more in the article: Aortic Dissection.

Diseases with this spread of pain also include pericarditis (inflammation of the pericardium). With cardiac problems, dyspnea, pallor, sweating, heaviness on the stomach, a feeling to vomit, that is, nausea, to vomiting are also associated.

Diseases of the respiratory system

The respiratory system can be affected by various inflammations. Pain between the shoulder blades is mainly caused by inflammation of the lower respiratory tract, but also by pneumonia and pleurisy.

Dyspnoea, increased body temperature and even fever are associated. Constipation and coughing are common. Similarly, pulmonary tuberculosis and oncological processes can manifest themselves in this type of interscapular pain.

Digestive tract and interscapular pain

Diseases of the digestive system include inflammation of the oesophagus. Similar to the respiratory system, the oesophagus can be affected by cancer. In this case, problematic swallowing and pain when swallowing are present at the same time.

In this case, diverticulum, ulcer and varices of the oesophagus should also be mentioned. Pain in gastroesophageal reflux disease and in oesophageal spasm is also unpleasant. This is also known as diffuse oesophageal spasm. It occurs when the oesophageal musculature contracts, especially when swallowing food that is too hot or too cold.

Model of the digestive system, oesophagus, stomach
The origin of the pain can also be in the esophagus or stomach. Source of the photo: Getty Images

Diseases of the stomach and duodenum can also present with pain that shoots up between the shoulder blades. These are mainly gastritis and gastric or duodenal ulcer disease.

Another example is diseases that typically present with pain under the right rib arch. These are gallbladder problems, particularly inflammation of the gallbladder and bile ducts. It is not uncommon for the pain to move from under the ribs to the shoulder blades.

Gallstones are another example. The trouble is provoked mainly by dietary error, i.e. fatty food. Pain on the opposite side, under the left rib arch, is typical of pancreatitis. Pancreatitis is inflammation of the pancreas. It has various causes, but alcoholism is a common reason.

Other causes of pain

In addition to the above diseases, pain with transfer or radiation between the shoulder blades can also provoke:

  • lung abscess
  • bronchiectasis
  • tumour metastasis in multiple myeloma
  • lymphoma
  • traumatic injury to the spleen
  • hepatitis
  • tumours of the liver, gallbladder, pancreas

What investigations are performed for pain between the shoulder blades?

Diagnosis of the cause of spinal pain with its localization between the shoulder blades relies on several examination methods. The patient's medical history is, of course, important, as well as family history. During this, the occurrence of various diseases in the family is examined.

Blood is taken for laboratory tests, X-ray, CT, MRI.

An ECG is important to rule out a coronary event, i.e. a heart attack, but also an ECHO, USG (SONO), or an endoscopic examination of the respiratory or digestive tract. A general practitioner, neurologist, orthopaedic surgeon, internist, cardiologist and ENT may be involved in the diagnosis.

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The aim of the portal and content is not to replace professional examination. The content is for informational and non-binding purposes only, not advisory. In case of health problems, we recommend seeking professional help, visiting or contacting a doctor or pharmacist.