Low back pain in the shoulder blades: causes, treatment

Patients rarely notice recurrent pain in the shoulder blades. However, this symptom is the "awakening" of serious changes not only in the musculoskeletal system, but also in the internal organ-complex. Such conditions can threaten the patient with disability and death. Read how to avoid the disease and treat back pain in the shoulder blades.

Low back pain in the scapula


The spine is a key component of the human musculoskeletal system. Thus, during static or dynamic, the lion's share of pressure falls on the spine. Therefore, it is not surprising that the most common reason for seeing a doctor is pain in the shoulder blades.

However, the pain syndrome is very variable: often the pain is triggered not by the spine itself, but by dysfunction of internal organs. This fact complicates the diagnosis of the underlying cause of pain syndrome and leads to errors in treatment.

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

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 (pneumonia, heart attack, intercostal neuralgia, gastric ulcer, cholecystitis) are the most common. Also, tumor processes or mental lability (fibromyalgia, psychogenic pain) can cause pain.

Pain changes

Why does the back hurt in the area of the shoulder blades? In general, the pain syndrome can be localized both directly in the area of the shoulder blades and between them. The pain 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 sharply with a rapid increase in strength) or chronic (weak and long-lasting). The main difference in practice is that the patient can accurately name the time of onset of acute pain syndrome. It will be difficult to remember the initial conditions of chronic pain.

Pathological options

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

  • Osteochondrosis.Osteochondrosis is a disease caused by "aging" of the intervertebral disc. In advanced cases, such pathological changes lead to disc herniation. When the thoracic spine is affected by osteochondrosis, patients are concerned about the acute back pain between the shoulder blades that occurs when they bend over or remain in uncomfortable positions for long periods of time. Significant weakening of the back muscles, temperature and pain may be accompanied by disturbances in perception.
  • Deformities of the spine.One of the causes of pain between the shoulder blades and in the area is the curvature of the spine. As a rule, the pain is triggered by kyphosis (bending, humping) or scoliosis (C, S or Z-shaped spine). Significant deformities of the spine are accompanied by excruciating pain aggravated by physical activity. There are often episodes of respiratory failure (shortness of breath, "inability to breathe deeply"). The clinic is also accompanied by increased fatigue and headaches. Rarely the chest bends.
  • Injuries.Acute pain is often seen with direct trauma to the spine or shoulder blades. Similar injuries occur when falling from a height, being hit by a blunt object, or in a traffic or industrial accident. Spinal cord injuries are associated with palpable pain, reflexive contraction of the back muscles, and bruising. In some cases, it is possible to add neurological pathology. When the scapula is damaged, the pain is sharp, intensified by shaking the arms. Sometimes associated with bleeding in the shoulder joint - hemarthrosis.
  • Spondylosis.Spondylosis is a destructive process of aging in the spine. Usually, bone tissue grows in the area of the intervertebral joints - osteophytes are formed, which can be complicated by the growth of vertebrae. In such cases, severe pain, neurological and vascular diseases appear.
  • Osteoporosis.Osteoporosis is a disease associated with a decrease in the density of the bone system. As a rule, back pain in the shoulder blades occurs when a fracture of the thin thoracic vertebra occurs. The curvature of posture is visible - the formation of scoliosis and / or kyphosis. In some cases, the disease is complicated by radicular syndrome (loss of motor activity and sensitivity).
  • Ankylosing spondylitis. . . Ankylosing spondylitis is a disease that affects the intervertebral joints. Usually, the clinic begins with pain between the shoulder blades or in the lumbar region. The pain is accompanied by stiffness of movements, which intensifies after a night's rest. With the development of pathology, the spine is deformed, arched, which leads to chest curvature and respiratory failure. In such a pathological condition, ankylosis (immobilization) of the intervertebral joints occurs, so the patient can no longer bend. In this case, the disease can additionally affect the cardiovascular and urinary systems.
  • Diseases of the internal organs.The detailed clinical picture with pneumonia (inflammation of the lungs) is characterized by fever, sputum production and unilateral pain in the area of the chest or shoulder blades. During a heart attack, the pain is sharp (stabbing, burning), is detected in the chest and spreads to the left back and upper back. Pain syndrome with intercostal neuralgia is acute and piercing, manifesting itself in the form of attacks that prevent the patient from breathing. The pain occurs along the ribs, distributed under the shoulder blades, clavicle and lower back. Pain with peptic ulcer is dull, localized in the upper abdomen, often accompanied by "hungry" pain (with long intervals between meals). In this case, the disease is characterized by indigestion, nausea, vomiting and sour belching. Occasionally there is bleeding from the ulcer: patients feel dagger pain that disappears at the height of the bleeding. Vomiting and feces turn dark (almost black) due to blood impurities. Cholecystitis (inflammation of the gallbladder) is characterized by the development of a characteristic paroxysmal pain syndrome in the right hypochondrium, spreading to the right side and back. The clinic of the disease includes digestive disorders, the provoking factor of which is the consumption of fatty and fried foods. Sometimes vomiting appears with bile impurities.
  • Tumors.Pain in the area of the shoulder blades can be seen with neoplastic diseases of the vertebrae or nervous system (neuroma). Metastases (girl tumors) from 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 with "guard symptoms": pain, weight loss, fever and constant weakness for no apparent reason.
  • Mental lability.The instability of the psyche against stress and emotional outbursts can manifest itself as psychogenic pain. It occurs against the background of complete health: patients may experience a variety of strong feelings that can not be treated even with painkillers. Stressful situations cause another idiopathic (unexplained) pain - fibromyalgia. The disease persists against the background of long-term pain, which intensifies at certain (trigger) points.


Radiography is the gold standard for spinal examination. Computed tomography can be used to determine the cause of back pain. Ultrasound or MRI is used to study other organs and systems. Laboratory or other instrumental examination methods may be needed to rule out concomitant pathologies.


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

  • Osteochondrosis.Non-steroidal anti-inflammatory drugs and analgesics are used as medications to relieve pain. Physical therapy, therapeutic gymnastics and massage are also effective. In the later stages of the disease, surgery is recommended to remove the hernia sac.
  • Deformities of the spine.Conservative therapy for curvature of the spine involves the use of supportive devices (corsets, bandages). You also need enough activity, massage and physiotherapy (paraffin applications, electrical stimulation). In case of significant deformity, surgical treatment is indicated to correct the anatomical position of the spine.
  • Injuries.Minor injuries are treated with rest, heat and massage, while more serious injuries may require traction. If conservative methods are ineffective, the spine is reconstructed surgically.
  • Spondylosis.Treatment of this pathology aims to slow the progression of the disease. Thus, hyaluronic acid injections, chondroprotectors, physiotherapy (shock wave therapy), as well as physiotherapy exercises are prescribed. Blockade with severe pain syndrome is carried out with analgesics.
  • Osteoporosis.Treatment of osteoporosis includes high doses of calcium and vitamin D. Hormone therapy with female sex hormones, thyroid and other hormones is also possible.
  • Ankylosing spondylitis.Inflammation and pain are managed with anti-inflammatory therapy. To modify the immune response, an antimetabolite of the group of structural analogues of folic acid is prescribed. During remission, physiotherapy, breathing exercises, therapeutic massage are performed.
  • Diseases of the internal organs.Therapy for pneumonia includes antibacterial agents, as well as drugs that relieve bronchospasm. Vibration massage and therapeutic exercises are prescribed during rehabilitation. Intercostal neuralgia is treated with warming and anti-inflammatory ointments. Distraction therapy with local remedies with red pepper extract or bee venom is often used. Treatment of gastric ulcers consists of combined antibiotic therapy, as well as drugs that reduce the acidity of the stomach. Help with cholecystitis includes the use of antispasmodics and drugs that affect the bile. In some cases, antibiotic therapy may be required. If there are large stones in the gallbladder, it is recommended to remove the latter - cholecystectomy.
  • Tumors.Treatment of tumor processes consists of chemotherapy with antineoplastic agents and surgical removal of the neoplasm (if possible).
  • Mental lability.Mental lability requires intensive psychotherapy, as well as 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 scapula

How can this be prevented?

Lifestyle changes are required to prevent back pain in the shoulder blades: increase the nutritional value of the diet, play sports, quit smoking and drinking. It is important to detect and treat chronic diseases in a timely manner, to prevent stress overload.

Remember that pain is not an independent disease, but a manifestation of a more serious pathology that requires diagnosis and proper treatment!