Pain in the neck, between the shoulder blades - Causes, symptoms and treatment. MF.

Neck pain and interblade area is a nonspecific muscular reaction to any pathology in the region.

Possible causes of pain in the neck and between the shoulder blades

In the neck, the seven vertebrae( cervical vertebrae) that surround the spinal cord are part of your spine. Between the disks of these vertebrae and the nerves of the neck pass alongside. The structure of the neck includes neck muscles, arteries, veins, lymph glands, thyroid gland, parathyroid gland, esophagus, larynx, trachea. Pain in the neck can be associated with damage to various structures of the neck( muscles, nerves, vertebrae, intervertebral discs) or can spread from a number of located areas of the body.

In addition to pain, patients are often concerned about decreased mobility of the neck( stiffness), nerve damage can also indicate a change in sensitivity, muscle weakness, tingling sensation and other symptoms.

Diseases accompanied by pain in the neck or between the shoulder blades

Pain in the neck and between the shoulder blades may bother

with degenerative - dystrophic spine pathology - vertebrogenic cervicalgia and thoracology, cervicotoracology.

In this case, the pain can be of varying degrees of severity - from acute, firing to aching, twisting, but always associated with movement. Turning the head, tilting, raising hands, putting hands back will intensify the pain. If the head is tilted forward, the pain will appear in the cervical or thoracic spine( Neri symptom).Pain can intensify at night.

There are such painful sensations after loads, hypothermia, with long forced poses - in front of the computer, with crane operators, seamstresses, drivers, with a sedentary lifestyle. .. The body temperature does not increase, blood tests are normal.

Pain is more often due to muscle hypertension - muscle pain. When examined, the soreness of the spinous processes, the paravertebral points, the muscles of the neck and the thoracic region-the interscapular region, the subscapular, in the course of the intercostal spaces, the limitation and pain of movements, muscle tension, scoliosis is determined. One-sided and bilateral pain syndromes are possible. The diagnosis is made clinically.

On the roentgenograms of the spine, signs of osteochondrosis, cervical spine and thoracic spondylarthrosis, instability of the vertebrae of the cervical spine, and scoliosis of the thoracic spine are possible. If necessary, individually, you may need a CT scan and / or magnetic resonance imaging.

In the treatment use non-steroidal anti-inflammatory drugs, muscle relaxants, B vitamins, gabbatin( with severe pain syndrome), locally rubbing, dry heat, Kuznetsov or Lyapko's implants. After relief of acute pain syndrome - massage, exercise therapy, swimming, acupuncture, sanatorium treatment. Prophylaxis requires daily charging, swimming. Biting, baking sensations in the interscapular area pass during movements. The better the muscles - the less worried the pain.

Pains in the neck and thoracic spine may be a symptom of of osteoporosis .

In this case, the pain blunt, aching persistent, without a clear connection with the movement, combined with pain in other bones and joints in older people. The diagnosis is confirmed radiologically and by conducting densitometry. The treatment uses bisphosphonates, calcium, chondroprotectors.

Neck and shoulder pain can be caused by the atypical course of the myocardial infarction .

Pain is more often localized in the left half of the chest, but can be irradiated to the left shoulder blade and left arm, can disturb only in the neck, scapula. It is possible to increase blood pressure, shortness of breath, palpitation, arrhythmia.

The diagnosis is made only by electrocardiogram. Therefore, all patients with pain in the neck or between the shoulder blades are ECG to exclude myocardial infarction.

With the diagnosis "Myocardial infarction", urgent hospitalization is required in a specialized infarction department and all subsequent rehabilitation courses.

Pains in the neck and the interscapular area can be with pneumothorax .

Pneumothorax is the ingress of air into the pleural cavity. More often pneumothorax occurs with chest injuries, fracture of ribs, knife and gunshot wound, it is possible for chronic obstructive pulmonary diseases, tuberculosis, emphysema, cystic fibrosis, bronchial asthma, pneumonia, systemic connective tissue diseases, lung tumor. Can be open and closed.
Spontaneous development of pneumothorax is possible.

Acute, dagger, shooting pain in the chest, shoulder blade during inspiration, can be irradiated to the shoulder combined with varying degrees of dyspnea. The amplitude of respiratory movements of the chest is reduced, breathing is weakened, it is rapid, there may be tachycardia, lowering of arterial pressure, swelling of the veins of the neck( with intense pneumothorax).

Emergency hospitalization is indicated.

Pain in the neck and shoulder blades can occur with inflammatory diseases of ENT - angina, pharyngitis, laryngitis, tracheitis, zaglugal abscess .

Angina

Pharyngitis

Tonsillitis

Temperature, sore throat, pain when swallowing, changing the voice, "stuffiness" of the throat should lead the patient to an ENT doctor. Acute otitis can be accompanied by unilateral pain in the neck.

Neck and interscapular pain may occur with lung disease - pneumonia , pleurisy, obstructive diseases , bronchial asthma , lung tumors .

Increased fever, cough, shortness of breath, impaired general health, weakness should lead the patient to the therapist. Common clinical tests, lung radiography and treatment of the detected disease will be required.

A strong cough can cause myositis of intercostal muscles .Pain in the intercostal spaces during palpation, deep sigh will require consultation of a neurologist. Perhaps non-steroidal anti-inflammatory drugs, muscle relaxants, gabantine, B vitamins and local triturates, mustard plasters, pepper plaster in addition to the therapeutic treatment of the underlying disease will be prescribed.

Pain in the neck, shoulder blade, intercostal space of one-sided localization can be with acute herpetic infection .

Bubble rashes, surrounding, along the course of intercostal spaces, accompanied by pain syndrome of varying severity, an increase in temperature requires treatment with a dermatologist or infectious disease specialist with antiviral drugs. From anesthetics, you can take gabapentins, non-steroidal anti-inflammatory drugs, vitamins of group B. It is possible to develop postherpetic neuralgia - prolonged severe pain that persists after the disappearance of the rash and lasts up to six months.
Pains in the neck, thoracic spine may be caused by metastases of tumors in the spine. The diagnosis is made only by the results of an x-ray examination( computed tomography) and magnetic resonance imaging.

Neck pain can be in skin formations, including of malignant .

Neck pain can be for thyroid disorders .Thyroiditis, goiter, thyroid tumor will be accompanied by pain in the neck, not acute, dull, aching. US of a thyroid gland, its hormones and treatment at the endocrinologist and if necessary the oncologist.

Neck pain can be with cervical lymphadenitis - palpated enlarged painful formation on the neck, soft, "rolling" under the fingers, accompanied by an increase in temperature. More often occurs as a complication of inflammatory diseases of the oral cavity, ENT - organs. A careful examination and treatment of the focus of infection is required. Lymphadenitis, with progression develops periadenitis, abscess, with a breakthrough abscess of phlegmon. .. sepsis.

Cervical lymphadenitis in infectious mononucleosis

Suppuration of the lymph node

Pain in the scapula zone can irradiate with gastrointestinal diseases - gastritis , gastroduodenitis , peptic ulcer , cholecystitis , pancreatitis .The pain in this case is not associated with movement and occurs when the existing disease is exacerbated.

Among the reasons that are more common in the elderly, include the formation of herniated mesenteric discs and arthritis( inflammation of small joints between the vertebrae).Severe pain and stiff neck are noted with meningitis.

Which doctors can help if there is pain in the neck?

• Therapist
• Rheumatologist
• Neurologist
• Traumatologist
• Orthopedist
• Physiotherapist
• Masseur or manual therapist

Neurologist doctor SV Kobzeva.