Is interscapular muscle pain really dangerous

Painful sensations in the muscles, myalgia, as a symptomatic phenomenon are not well understood, especially pain in the scapula muscles. Until now, the symptom of muscle pain is either due to vertebral disease or neurological, that is, it is associated with radiculopathy, spondylarthrosis, osteochondrosis and so on.

Relatively recently in the classification of diseases appeared separate nosological units - fibromyalgia and myalgia, which are directly related to muscle tissue. Despite the fact that soft tissue pathologies, including pain in the shoulder blade muscles, have been studied since the 19th century, there is no unity in the terminology and systematization of syndromes. This is obviously due to the close anatomical relationship of the soft (periarticular) tissues and bone structures in the back and in the human body. Pathology of the back can include several nearby anatomical zones, such pain is usually called dorsalgia, but painful manifestations in the area of ​​the scapularis (scapularis zone) are more correctly and accurately called scapular.

[1]

Causes of pain in the shoulder blade muscles

In contrast to other muscle syndromes, the causes of muscle pain in the shoulder blade are usually not due to the "culprit" of all back pain - osteochondrosis. This is due to a lack of mobility and a fairly strong structure of the thoracic spine. As a result, almost all painful sensations in the area of ​​the shoulder blade are associated with muscle tissue, as well as damage to the tendons, bony links.

The main reason for pressing pain in the middle of the back is due to prolonged muscle tension which is usually due to the specific job. First of all, this applies to those who sit for a long time, often, holding the same posture - drivers, office workers, seamstresses, students, and so on. Accumulation, tension in the shoulders and shoulder blades in the area leads to a compensatory shortening, reduction of the chest muscles, aggravating the condition and habit of stooping, pulling the head, neck forward. As a result, triangular the muscles around the blade, lifting part of the trapezius muscle, sterno-clavicularly, overexerted, while others in the middle of the back - the lower part of the trapezius, the flexors of the neck, the anterior gait equalization experience stretching or weakening these abnormal, non-physiological phenomena Cause pain.

Also in clinical practice, the causes of muscle pain in the shoulder blade are classified according to the types of muscular-tonic syndromes:

  1. Chest muscle (small pectoralis) or stairwell syndrome. The pain in the scapular zone is manifested on the line of the 3-5. Rib, feels like burning, bursting. The symptom may be worse at night, in the movement of the body, with the distraction of the hands (hyperabduction). Often such manifestations resemble angina attacks, which makes the diagnosis much more difficult. Chronic hypertonicity pectoralis minor additionally leads to damage to the nerves and vascular plexus, the ray is located around the scapular coracoid, as a result - the loss of sensitivity of the hands, fingers. Pain in the pectoral syndrome anterior deltoid area is localized between the blades, radiating on the ulna (elbow) surface of the shoulder and forearm.
  2. Serratus posterior superior syndrome - the upper posterior tooth muscle is often provoked by a degenerative process in the upper thoracic discs. The pain is localized under the shoulder blade, feels deep in the muscles, is painful, dull, painful.
  3. Serratus posterior inferior syndrome - The lower posterior muscle is felt as a chronic, exhausting dull pain in the lower back (at chest level). Syndrome restricts body movements when tilting, turning.
  4. Interbloping syndrome is felt as a lumpy, aching pain between the shoulder blades. The symptom increases with a longer horizontal body position, with tilting the pain when driving over uneven terrain (vibration) can become quite severe. The pain is localized at the point of attachment of the rhomboid, trapezius and latissimus muscles of the back (zone of the shoulder blade), it can spread to the shoulder, the forearm, along the ulnar nerve.
  5. Syndrome of the acquired scapula, causing paralysis of the anterior dentate, trapezius muscle, or rhombus. Paralysis can be caused by both an infectious disease and trauma, bruising, including professional (athletes, circus performers).

In addition, pain in the muscles of the shoulder blades can be caused by an inflammatory process in muscle tissue - myositis. In turn, myositis is provoked by such factors:

  1. Hypothermia.
  2. Infections, including viral infections.
  3. Occupational diseases related to high blood pressure of the muscles.
  4. Back injuries.

Often times, the pain symptoms are felt in poorly differentiated blade, making it difficult to determine - which really hurts - muscles, bones, tendons, or this function of pain reflected the possibility of a disease such as the following:

  • IHD is an ischemic heart disease.
  • Angina pectoris.
  • Myocardial infarction.
  • Protrusion or hernia of the intervertebral discs of the thoracic spine.
  • Kifoscoliosis.
  • Mejrebernaya neuralgia.
  • Spondylarthrosis.
  • YABZH - gastric ulcer of the stomach.
  • Respiratory diseases - pneumonia, pleurisy.

In order to correctly determine the causes of pain in the shoulder blade muscles, it is necessary to describe the features of the symptom as accurately as possible.

[2], [3], [4]

How is the pain manifested in the shoulder muscles?

The symptomatology of muscle pain is characterized by sensations of tension and stretching. In contrast to the articular lomiaschih pain, the pain symptoms in the shoulder blade muscles often have no character. The interscapular muscles between the spinous processes, like the joints, can be very painful. If the patient does not complain of temporary pain in the shoulder blades, radiating to the left, does not subside with a change in body position, accompanied by a feeling of cold in the back, it is likely evidence of destruction not only muscle tissue, but also tendons, ligaments.

The type of pain in the area of ​​the shoulder blade can be different, depending on the source of the pain signal and the cause that provokes it: the parameters by which the pain symptoms in the shoulder blade muscles differ:

  • Description of sensation - acute, aching, stabbing, squeezing, bursting pain.
  • Localization of pain - between the shoulder blades, under them, under the right or left, at the top of the shoulder blade.
  • The duration of the pain is temporary, prolonged, chronic.
  • Dependence on the position of the body - decreases with change in position, increases with certain movements.
  • Distribution by type - visceral (reflected), neuropathic, or just muscle pain.

How to distinguish the types of muscle pain in the shoulder blade

symptom

Muscular

Reflex, visceral

Neuropathic

description

Exact characteristics, including where it is located

The description is vague, the pain diffuse, coming from within, from the depths to the muscles

The pain spreads towards the nerve roots, irradiated

Are there movement restrictions?

Often restricts motor activity

The movements are unlimited

The movements of the limbs are little restricted, the restrictions affect the volume of movement of the chest and back

Effect of Movement on Pain

The pain is aggravated by movement

Will not be rendered

Has only axial load, as well as reflex movements - coughing, sneezing

Definition with palpation

Touch areas are well palpated. Palpation makes the pain worse

The source of the symptom with palpation cannot be determined

Possible definition

Pain in the muscles under the shoulder blade

Pain in the muscles under the shoulder blade can be both a sign of real myalgia and a signal of more dangerous diseases, such as:

  • Gastric ulcer, which is most often localized in the epigastric zone, but can irradiate on the left side - in the chest area, under the left shoulder blade. The pain is no different in structural form, it is difficult to determine what exactly it hurts - muscles, ribs. Therefore, if the pain under the shoulder blade is related to food intake, then most likely it is due to a gastrointestinal tract disease.
  • An angina attack often resembles the signs of pain in the muscles under the shoulder blade. It is difficult to distinguish these two symptoms independently, however, with angina pectoris pain subsiding after taking vasodilator drugs, muscle pain cannot be neutralized by these drugs.
  • Intercostal neuralgia can also manifest as paroxysmal shingles in the lower part of the scapula. The pain is worse when coughing, sneezing, painful areas are well defined by palpation.
  • Muscle spasticity gallbladder, bile duct occlusion often manifest as colic, the pain can be sharp, cut signs radiate in the right upper part of the body below the shoulder and right shoulder cut.

In any case, a simple pain symptom that a person thinks is muscular must persist for a maximum of 1-2 days without specific treatment. There is enough rest and relaxation to relax the muscles; if the pain under the shoulder blades does not subside, urgent medical attention is required.

Diagnosis of pain in the shoulder muscles

The diagnostic measure for determining the cause of muscle pain in the shoulder blade is primarily the elimination of possible life-threatening diseases - angina, myocardial infarction, perforation of the gastric ulcer and such diseases:

  • Oncological processes in the spine.
  • Onkoprotsessy in internal organs.
  • Neurological pathologies that require urgent therapy.
  • Psychogenic factors, diseases, including psychopathology.

This is due to the fact that the diagnosis of pain in the muscles of the blades is difficult due to nonspecific symptoms, the clinical picture rarely shows a specific diagnostic area, in addition to almost all dorsalgia rarely correlates with the results of instrumental examinations. Quite often there are cases when it is a painful symptom, but the survey did not reveal a significant pathological source of the pain, and it happens that studies determine the pathology that is not accompanied by pronounced clinical symptoms.

As a rule, the diagnosis of pain in the muscles of the shoulder blades includes such actions:

  • A brief anamnesis, a detailed description of the previous symptom is not required, since the muscular pain symptom is not considered to be pathogenic for a dangerous, threatening pathology.
  • Specification of the type and parameters of pain:
    • Localization, possible radiation.
    • At whatever position, the position of the body seems pain.
    • At what time of the day does the pain bother you?
    • Relationship symptom with motor activity, other factors.
    • The rate of symptom development is spontaneous or increasing pain.
  • Visual inspection of the patient:
    • Asymmetry of the humeral zone.
    • Identification of possible scolioses, abnormalities in the structure of the spine (test symptom Forestier).
    • Mobility of the spine in the thoracic area (Ott test symptom, Thomayer symptom).
    • Determination of the possible morbidity in the course of the spinous processes (Zatsepin symptom, Vershchakovsky test, bell symptom).
  • Instrumental examination is often not required as 95% of muscle pain is considered benign. Studies are needed only in cases of suspected such pathologies:
    • Signs of an acute infectious process.
    • Signs of oncology.
    • Explicit neurological symptoms.
    • Injury.
    • Ineffective treatment for a month.
    • Radiography is also necessary if the patient is dependent on manual therapy or physiotherapy procedures.
  • Electromyography can be used to identify the features of muscle structure.

It should be noted that the widespread practice of X-ray related muscle pain in a patient can significantly complicate the diagnosis as the vast majority of our contemporaries have some or other signs of degenerative disc disease and other diseases of the spine. The presence of a degenerative process in the spine does not exclude the myogenic factor that provokes pain in the muscles of the scapula and cannot be the basis for a correct diagnosis.

[5], [6], [7]

Treatment of pain in the shoulder blade muscles

Treatment of pain in the shoulder muscles can be divided into two phases: short-term, urgent measures, and long-term tactics.

Urgent action

Long term activities

Neutralizing the symptom of pain with analgesics or anti-inflammatory nonsteroidal drugs

Preventing Causes That Cause Muscle Pain

Purpose of the myeloraxants

Gentle pulling or dynamic exercises

Injection or acupuncture action on TT (trigger points)

Exercises to correct posture

Kupirovanie, neutralization of comorbid symptom complexes

Correction of the occupational load

Normalization and maintenance of weight

Psychological correction of pain symptoms

Adhering to the rules of a healthy lifestyle, including motor activity

In general, muscle pain is not difficult to manage; resting overworked muscles is usually enough to rule out any symptom-causing factors. A good result is also massage and training in relaxation techniques, including post-isometric relaxation.

How do you prevent muscle pain in the shoulder blade?

How can you prevent muscle pain, wherever it develops, in the back, in the area of ​​the shoulder blade, waist, neck? Obviously, there are no specific recommendations, since every human body is unique in its anatomical structure, physiological and other parameters. However, the prevention of pain in the shoulder blade muscles is the observance of known, but unfortunately rarely used in practice measures. These rules mainly relate to such points:

  1. When treating a person for a muscle or other pain, illness, it is necessary to strictly adhere and meet all medical appointments. Self-medication is a very common phenomenon, but the percentage of effectiveness that it gives is minimal, in contrast to the large number of complications.
  2. After the course of the treatment of muscle pain, it is necessary to observe a gentle motor regime, but this does not mean complete peace and inactivity. The muscles must be trained, otherwise there will be an opposing hypertonic effect - adynamia, atrophy and muscle weakness.
  3. Muscle tone is good for regular exercise, even if a person is not involved in professional sports, simple morning exercises can easily replace complex training.
  4. It is necessary to exclude all factors that lead to static loading. If a person's professional activity is associated with constant overexertion of the muscles of the scapula, then during the working day it is necessary to regularly change the position of the body. Perform workouts.
  5. In order to maintain muscle tone and relieve the spine, you need to monitor your posture and, if necessary, wear a corrective corset.

Pain in the shoulder blade muscles is a rather complex polyethological symptom and not an independent disease. Determine the exact cause of the pain, carry out all the necessary measures for this examination and appoint an effective treatment, only a doctor. From the person experiencing discomfort in the zone of the shoulder blades, it is only necessary to take care of his health and immediately seek help at the first alarming signs.

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