Back pain in the shoulder blades area: causes of the disease, treatment

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

Back pain in the area of ​​the shoulder blade


The spine is the main part of the human musculoskeletal system. The lion's share of the pressure in statics or dynamics falls on the spine. It is therefore not surprising that shoulder blade pain is a common reason to see a doctor.

The pain syndrome, however, is very changeable: Often pain is not caused by the spine itself, but by a violation of the functions of the internal organs. This fact makes it difficult to diagnose the cause of the pain syndrome and leads to treatment errors.

Among the main causes of pain, pathologies of the musculoskeletal system and internal system are distinguished.

The first group includes:

  1. Osteochondrosis;
  2. Spinal deformities;
  3. Trauma and spondylolisthesis;
  4. Spondylosis;
  5. Osteoporosis;
  6. Ankylosing spondylitis.

Among the non-vertebral causes, diseases of the internal organs are the most common (pneumonia, myocardial infarction, intercostal neuralgia, gastric ulcer, cholecystitis). Tumor processes or mental instability (fibromyalgia, psychogenic pain) can also cause pain.

Pain variations

Why does the back hurt in the shoulder blades area? In general, the pain syndrome can be localized both directly in the area of the shoulder blades and between them. Pain is bilateral (in scoliosis) or predominantly unilateral (gastric ulcer, cholecystitis).

Because of the nature of the pain in the back between the shoulder blades, it can be acute (occurs suddenly with a rapid increase in strength) or chronic (weak and persistent). The main difference in practice is that the patient can accurately name the time of the onset of the acute pain syndrome. It will be difficult to remember the circumstances surrounding the occurrence of chronic pain.

Pathology options

A number of diseases can cause back pain in the shoulder blades area, but we will focus on the most common of them.

  • Osteochondrosis.Osteochondrosis is a disease in which the intervertebral disc "ages". In advanced cases, such pathological changes lead to a herniated disc. When the thoracic spine is affected by osteochondrosis, patients fear severe back pain between the shoulder blades, which occurs when bending over or in uncomfortable positions for long periods of timeThere are also noticeable weaknesses in the back muscles, disturbances in temperature perception and pain.
  • Spinal deformities.One of the causes of pain between and around the shoulder blades is the curvature of the spine. Pain usually provokes kyphosis (stooping, hunching) or scoliosis (C-, S-, or Z-shaped spine). With significant deformities of the spine, painful pain occurs, which is aggravated by physical activity. There are frequent episodes of respiratory failure (shortness of breath, inability to "breathe deeply"). The clinic is also accompanied by increased fatigue and headaches. In rare cases, the chest is curved.
  • Injuries.Sharp pain often occurs with direct trauma to the spine or the shoulder blades themselves. Similar injuries occur from falls from a great height, blows with a blunt object, transport or work-related accidents. Spinal injuries are associated with palpable pain, reflex contraction of the back muscles, and bruising. In some cases, it is possible to attach a neurological pathology. When the shoulder blade is traumatized, the pain is acute and is aggravated by swinging the arms. Sometimes it is combined with bleeding in the shoulder joint cavity - hemarthrosis.
  • Spondylosis.Spondylosis is known as senile destructive processes in the spine. Normally, bone tissue grows in the area of the intervertebral joints - osteophytes form, which can be complicated by the increase in the number of vertebrae. In such cases, there are severe pain, neurological and vascular disorders.
  • Osteoporosis.Osteoporosis is a condition that is associated with a decrease in the density of the bone system. Usually, when a fracture of the thinned thoracic vertebrae occurs, pain in the back in the shoulder blade area occurs. There is a curvature of posture - the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (disappearance of motor activity and sensitivity).
  • Ankylosing spondylitis. . . Ankylosing spondylitis is a condition that affects the intervertebral joints. Usually the clinic starts with pain between the shoulder blades or lower back. Pain is accompanied by a stiff movement, which increases after a night's rest. With the development of pathology, the spine becomes deformed, arched, which leads to a curvature of the chest and respiratory failure. In such a pathological position, ankylosis (immobilization) of the intervertebral joints occurs, as a result of which the patient can no longer bend. In this case, the disease can also affect the cardiovascular and urinary systems.
  • Diseases of the internal organs.With pneumonia (pneumonia) a detailed clinical picture is characterized by fever, sputum and unilateral pain in the chest or back area in the area of the shoulder blades. With a heart attack, the pain is sharp (stabbing, burning), felt in the chest, and radiating to the left shoulder blade and upper extremity. The pain syndrome with intercostal neuralgia is acute and stabbing, manifests itself in the form of attacks that disrupt the patient's breathing. The pain occurs along the ribs, spreading under the shoulder blades, collarbone and lower back. With a gastric ulcer, the pain is dull, localized in the upper abdomen, often accompanied by "hungry" pain (with long breaks between meals). In this case, the disease is characterized by indigestion, nausea, vomiting, and acid regurgitation. Sometimes there is bleeding from the ulcer: patients experience dagger pain, which disappears at the peak of the bleeding. Vomiting and stools turn dark (almost black) from blood contamination. Cholecystitis (inflammation of the gallbladder) is characterized by the appearance of a characteristic paroxysmal pain syndrome in the right hypochondrium, which spreads to the right side and scapula. The clinic of the disease includes digestive disorders, the provoking factor of which is the consumption of fatty and fried foods. Sometimes vomiting occurs with biliary contamination.
  • Tumors.Pain in the shoulder blades area can occur in neoplastic diseases of the vertebrae or the nerve sheath (neuroma). Metastases (daughter tumors) of the affected prostate or mammary glands can spread to the vertebral region. In this case, the tumor process is characterized by an asymptomatic course, and the appearance of pain is associated with an increase in the neoplasm and its pressure on the neurovascular bundle. Cancer can be suspected by "watchdog symptoms": pain, weight loss, fever, and constant weakness for no apparent reason.
  • Mental instability.The instability of the psyche towards stress and emotional outbursts can manifest itself as psychogenic pain. It arises against the background of complete health: patients can experience sensations of varying strengths that cannot be treated even with pain relievers. Stressful situations also provoke another idiopathic (baseless) pain - fibromyalgia. The disease runs against the background of persistent painful sensations and intensifies at certain (trigger) points.


X-rays are the gold standard for examining the spine. Computed tomography can be used to determine the cause of vertebral pain. To examine other organs and systems, ultrasound diagnostics or MRI are used. To exclude an accompanying pathology, laboratory or other instrumental methods of examination may be necessary.


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

  • Osteochondrosis.Non-steroidal anti-inflammatory drugs and analgesics are used as drug therapy for pain relief. Physiotherapy, remedial gymnastics, and massage are also effective. In later stages of the disease, surgery to remove the hernial sac is recommended.
  • Spinal deformities.Conservative therapy for curvature of the spine consists in the use of supporting devices (corsets, bandages). You also need sufficient exercise, massage and physiotherapy (paraffin applications, electrical stimulation). In the case of significant deformities, surgical treatment methods are indicated in order to fix the spine in the anatomically correct position.
  • Injuries.Minor injuries are treated with rest, warmth, and massage; more severe injuries may require traction. If conservative methods are ineffective, the spine is surgically reconstructed.
  • Spondylosis. Treatment of this pathology is aimed at slowing the progression of the disease. Hyaluronic acid injections, chondroprotectors, physiotherapy (shock wave therapy) and physiotherapy exercises are prescribed. In severe pain syndrome, the blockade is carried out with painkillers.
  • Osteoporosis.Osteoporosis treatment includes high-dose 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 modify the immune response, an antimetabolite from the group of structural analogues of folic acid is prescribed. Physiotherapy, breathing exercises, and therapeutic massages are performed during remission.
  • Diseases of the internal organs.Pneumonia therapy includes antibacterial agents, as well as drugs that relieve bronchospasm. During the rehabilitation period, vibration massage and therapeutic exercises are prescribed. Intercostal neuralgia is treated with warming and anti-inflammatory ointments. Distraction therapy with topical agents containing paprika extract or bee venom is often used. The treatment of gastric ulcers consists of a combined antibiotic therapy, as well as drugs that reduce the acidity of the stomach contents. Help with cholecystitis includes the use of antispasmodics and drugs that affect the bile. Antibiotic therapy may be required in some cases. If there are large stones in the gallbladder, it is recommended to remove it - cholecystectomy.
  • Tumors.Treatment of tumor processes consists of chemotherapy with antineoplastic agents and surgical removal (if possible) of the neoplasm.
  • Mental instability.The psychological instability requires intensive psychotherapy and the use of antidepressants or anxiolytics. Limiting psycho-emotional stress is an important part of treatment.
The man is worried about the pain in the shoulder blade

How do you prevent something?

To prevent back pain in the shoulder blades area, lifestyle changes are required: increasing the nutritional value of the diet, playing sports, quitting smoking and drinking. It is important to identify and treat chronic diseases in a timely manner to avoid stress.

Remember that pain is not a disease in its own right, but a manifestation of a much more serious pathology that requires diagnosis and adequate treatment!