Cough accompanies many diseases, sometimes occurring together with other unpleasant symptoms. It is not uncommon for the back under the shoulder blades to start to hurt when you cough - this signals that there are various diseases in the body that have not yet been identified. Therefore, if you notice this disorder, you should seek medical advice as soon as possible.
Timely seeking help from a doctor often helps prevent quite complex painful conditions with serious consequences. As for pain when coughing that radiates to the back, it should be noted that it can be a sign of several diseases at once. The doctor will order an examination, as a result of which it will be possible to collect a complete picture of the disease. After the examination, a more accurate diagnosis can be made.
Why does pain occur?
Coughing is a natural reflex of the body, which is aimed at clearing the airways of foreign objects, dust, and mucus. In itself, it is not an alarming sign and is treated in combination with other symptoms. But if your back starts to hurt during the process of coughing, this should be a warning sign. In most cases, this is normal, since the chest thrust is carried out by a group of muscles, some of which are located in the back. Their frequent contraction provokes discomfort, which leads to pain.
But it is not always the norm, since in most cases it is a sign of the development of pathology in the spine. The nature of the pain can be aching, constant, diffuse, pulsating, cutting. A clear definition helps in making a diagnosis. If there are other symptoms besides pain, you should immediately consult a doctor.
Causes of pain
The main cause of back pain when coughing is the inflammatory process, which leads to excessive tension in the intercostal muscles and the accumulation of lactic acid in them. In addition, the following reasons can provoke discomfort:
- Intervertebral hernia.
- Pathologies of the bronchopulmonary system.
- Kidney diseases.
- Damage to the heart muscle.
- Tuberculosis.
- Frequent hypothermia.
- Neoplasms in the spine.
- Rib injury or displacement
- Curvature or deformation of the ridge.
If when coughing it goes to the back, then the doctor needs to examine first of all the respiratory system, heart muscle, excretory system, to make sure that there are no visible signs of pathology of the circulatory system or disruption of the central nervous system. The cause of unpleasant symptoms is often hidden there too.
Important! If your back hurts when you cough from the very beginning of coughing, then you can assume pathology of the musculoskeletal system; if the cause lies in the respiratory system, then it does not appear immediately and goes away some time after the muscle contraction stops.
Back pain in the area of the shoulder blades when coughing often indicates inflammatory processes in the respiratory tract
Complex therapy
The treatment method is characterized by an established diagnosis. Pain under the shoulder blade in the back and its therapy are aimed at removing the root causes:
- If there is pain between the shoulder blades when coughing due to inflammation in the lungs, then antibiotics, antiviral, and anti-inflammatory drugs are prescribed. Doctors prescribe bronchodilators and mucolytics as auxiliary agents.
- If the shoulder blades hurt when coughing due to diseases of the spine, then painkillers are used for therapy, as well as medications that relieve inflammation.
- If there are symptoms of an acute infarction, the patient is urgently hospitalized for complex therapy in an intensive care unit.
- For tumors of various kinds, doctors relieve pain, diagnose the tumor, and then select treatment tactics.
- If a vertebra or thoracic area is injured, urgent surgery is possible.
- To treat heart disease, painkillers, drugs to protect the heart muscles, and bed rest are prescribed. Therapy is carried out in a hospital setting under the guidance of a doctor.
Pain between the shoulder blades and in the back can lead to serious consequences and death. Symptoms cannot be underestimated; self-relief of discomfort is also prohibited. As soon as coughing and discomfort in the back begin, you should immediately seek medical help. The sooner the causes are identified and treated, the better the prognosis.
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If it hurts under your shoulder blades when you cough
If severe pain when coughing appears between the shoulder blades, then the main cause is pathology of the respiratory system. Which one exactly is determined by the doctor during the examination process. Most often they provoke discomfort in the ribs or the same part of the back:
- bronchitis;
- tracheitis;
- inflammatory process in the lungs;
- pleurisy;
- heart failure.
To suspect a severe pathology of the respiratory system is the presence of difficulty breathing during coughing, lethargy, chills, hypothermia, and not just pain between the ribs. If such signs appear, you should immediately seek medical help. Doctors will help determine the exact cause of back pain under the shoulder blades and take the necessary measures for competent treatment.
If your chest hurts
When the chest hurts during coughing, intercostal neuralgia should be suspected. It manifests itself as characteristic reflex sensations, since the pathology develops due to severe irritation of the nerve endings located between the ribs. It appears for the following reasons:
Why does my back hurt so much?
- complication of osteochondrosis;
- pathology in the vertebrae;
- excessive load on the musculoskeletal system;
- constant stress;
- infectious or inflammatory processes;
- cold or ARVI.
A dry cough radiates into the chest, the discomfort does not go away for some time after the cessation of muscle contraction and is difficult to relieve with painkillers. In addition to discomfort, other signs appear. For example, numbness of a small area of skin, sleep disturbance, tearfulness. But the appearance of pain in the sternum can be a sign of myocardial infarction, lung disease, tumor or herpes zoster.
A cough that causes back pain is a reason to consult a doctor for a full examination.
Severe stages of the disease
With bronchitis, the chest hurts not from the first day. As a rule, this symptom occurs with a moderate or severe degree of the disease and increases in proportion to the severity of the underlying disease.
The average degree of bronchitis is characterized by:
- Moderate weakness.
- Shortness of breath on exertion.
- Attacks of dry cough, which are replaced by productive cough.
- Impurities of pus and blood in the sputum.
For severe cases:
- The weakness is so strong that the patient cannot perform simple physical activity or move for a long time.
- The temperature is low-grade or febrile.
- Severe shortness of breath even at rest.
- Copious purulent sputum.
- Hard breathing and multiple dry wheezing.
The disease at this stage takes a long time to treat and can be complicated by pneumonia or become chronic.
If you have lower back pain when coughing
When the cough radiates to the lower back and there are no other signs of health problems, experts suspect pathologies of the musculoskeletal system. Degenerative processes develop as a result of inflammation or displacement of the vertebrae. Discomfort is felt due to compression of the nerve endings. The main causes of lower back pain, even with the slightest cough, are:
- osteochondrosis;
- spinal disc disorder;
- scoliosis;
- bone tuberculosis;
- myositis;
- severe hypothermia of the zone;
- excessive stress on the back.
Spinal problems are most often suspected when pain occurs without fever. If the thermometer rises upward, then there is a risk of developing kidney pathology, which radiates to the lower back.
Which doctor should I contact?
You shouldn’t wonder while sitting at home why your back hurts when you cough, since delaying the process of seeing a doctor only aggravates the situation. The first thing you need to do is make an appointment with your family doctor. After assessing the general history, checking vaccination records and conducting an examination, he will prescribe a series of tests. If a CNS pathology is suspected, an additional referral to a neurologist will be given. When discomfort is accompanied by fever, you will need to visit a pulmonologist.
If pneumonia or other serious life-threatening diseases are detected, the patient is admitted to a hospital. In this case, systematic medical supervision will be required.
The appearance of pain when coughing should especially alert older patients.
Preventive measures
Preventive measures are limited to preventing the development of pain and disease:
- See a doctor to prevent the severe stage of bronchitis itself, its transition to a chronic form or the development of complications.
- Take care of your health during seasonal epidemics. You should take restorative and antiviral medications, get vaccinated against influenza, and treat ARVI in a timely manner. Refusal to visit public places during periods of increased incidence or careful treatment of mucous membranes if staying in a crowd cannot be avoided will reduce the risk of contracting colds and bronchitis.
- Strengthening the immune system, hardening, to protect yourself from colds or easily endure them.
- See a doctor and follow his recommendations for treatment, including when pain increases.
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Tests and diagnostics
The doctor cannot determine “by eye” why a patient’s cough is painful, even after conducting an initial examination and asking about all the symptoms. The situation almost always requires a comprehensive study to accurately determine the cause. Depending on the preliminary diagnosis, the following studies are prescribed:
- study of urine and feces;
- blood sampling for biochemistry;
- urine assessment using two methods: Zimnitsky’s test and Nechiporenko’s test;
- bacterioscopic examination of sputum;
- Ultrasound of the heart and kidneys;
- X-ray of the spine;
- MRI or CT.
If the pain is localized in the area of the shoulder blades, then an ECG is required to exclude pathological processes in the heart. Based on the data obtained, an accurate diagnosis is made and tactics to combat the problem are prescribed.
Diagnostics
When diagnosing a condition, interviewing the patient is of considerable importance. This helps clarify the specifics of back discomfort. When diagnosing, the localization of pain, its duration, frequency, intensity, and nature of occurrence are taken into account.
Information about such characteristics of cough as the time of onset, the presence of sputum, and the connection with discomfort in the back area is of considerable importance. Additional symptoms are no less important in order to more accurately determine the diagnosis.
Physical examinations, which are performed using different methods, provide the doctor with some information based on which he can suggest the cause of spinal pain. This could be the following information:
- During palpation, the doctor can determine the most painful area.
- During a visual examination, sometimes bruises are found on the skin, suggesting a contusion of the chest.
- Percussion allows you to determine the dullness of sound over the affected area of the lung, inflamed as a result of pneumonia.
- During auscultation, cardiac arrhythmia is sometimes detected, which indicates myocardial infarction. You may also hear a noise indicating problems with the pleura.
To clarify the diagnosis, additional research options are certainly prescribed. Their type and volume depend on the disease that the doctor suspects. The results of such studies may be enough to understand why coughing causes such unpleasant sensations. Once the diagnosis is established, the doctor prescribes treatment. Depending on how severe the patient’s condition is, as well as on the prognosis, it will be decided where it is more appropriate to carry out treatment - at home or in a hospital setting. Some types of treatment can be carried out at home, without constant medical supervision.
Features of treatment
Until the cause of the unpleasant symptoms is clarified, general therapy is prescribed, aimed at relieving pain and improving sputum discharge. First, a conservative approach is recommended; if it is not effective enough, the doctor recommends a radical approach, for example, surgery. This is necessary, for example, when the respiratory organs are damaged as a result of injury and air gets into the pleura. It all depends on the exact diagnosis and the cause of pain during coughing.
Conservative therapy
Unpleasant sensations can appear not only during coughing, but also when sneezing. The mechanism of pain formation in this case will be identical. When contacting a therapist, the doctor first determines the location of the pain, namely on which side the pain is felt more, the left or the right. This will allow you to accurately determine the diagnosis and prescribe the correct treatment.
If your back hurts all the time when you cough, therapy to relieve the condition should be comprehensive. The following groups of drugs are usually prescribed:
- Syrups or tablets for dry cough (Stoptusin, Omnitus, Gerbion). They make phlegm thinner and easier to remove from the body. Some substances affect the cough center in the brain and reduce the number of coughs.
- Tablets for wet cough (“Bronchobos”, “Lazolvan”, “Ambrobene”). They speed up the expectoration process and stimulate the epithelial cilia in the bronchi, which only improves the removal of sputum.
- Ointments to relieve back pain (“Doctor Mom”, “Voltaren”, “Ben-gay”). Sold in the form of creams and ointments, they perfectly warm up the muscles, help cope with pain, and have a complex effect. Mustard plasters help relieve discomfort, but they only have a distracting effect.
For pathological processes in the stomach, drugs with bifidobacteria are prescribed, which help restore the intestinal microflora. Therapy is carried out for six months for complete treatment.
Acupuncture is one of the effective methods of combating back pain
Folk remedies
Some patients wonder if back pain from coughing can be treated at home. But there is no clear answer to this question, since in some cases staying at home and self-medicating is simply dangerous and often leads to dire consequences. But, if the general condition is not disturbed, you can try to cure the discomfort using traditional methods. The most popular of them are:
- Banks. They are used only if there are no contraindications. They are placed on their backs so that a vacuum is formed inside. With their help, the inflammatory process is suppressed. But the procedure itself is painful, and bruises remain after it.
- Acupuncture. It is carried out using special needles with rounded tips. You cannot do it yourself, as you need to know the acupuncture points on the body. A specialist is hired for these purposes.
- Massage. It is recommended to lightly massage the back to relieve pain only if it appears as a result of excessive tension in the muscle frame. In this case, after a small impact, relief comes.
- Decoctions and infusions. For treatment, you need to drink restorative teas, which will alleviate the condition, relieve an obsessive cough, and improve the condition in general. Chamomile, rose hips, mint and other beneficial herbs have proven themselves well.
Pain in the back when coughing can be a symptom of a variety of pathologies, so there is no universal traditional medicine recipe against this condition. If it gradually becomes more intense, the patient’s condition worsens, and self-medication is simply dangerous.
Treatment methods
Once your doctor determines why you have back pain in the shoulder blade area, he will develop an appropriate treatment plan. In the case of diseases of the spine, in order to completely eliminate discomfort, it is necessary to correct all pathological changes that are caused by the disease. This:
- compression of the nerve roots;
- excessive muscle tension;
- circulatory disorders;
- thinning of intervertebral discs;
- spinal deformity;
- and other violations.
Treatment of such pathologies requires an integrated approach and is usually not very quick. In the early stages of spinal diseases, conservative treatment is used:
- taking medications;
- physiotherapy;
- manual therapy;
- reflexology (acupuncture);
- massage;
- exercise therapy;
- wearing orthopedic devices;
- therapeutic diet.
A combination of drug therapy and physical therapy can eliminate pain. To regenerate damaged tissues, a healthy diet, taking chondroprotectors and procedures that help restore normal blood circulation are necessary. Physical therapy and physiotherapy will help improve the condition of blood vessels and tissue nutrition. To relieve muscle tension, manual therapy, acupuncture, physiotherapy and exercise therapy are used. All procedures and medications can be prescribed exclusively by the attending physician after examination. Self-medication can worsen the condition and lead to irreversible dangerous consequences: constant pain, impaired mobility, paralysis. Doctors from the network of clinics “Hello!” specialize in the treatment of diseases of the joints and spine. The use of modern equipment and significant experience help them accurately determine the causes of pain and develop the most effective individual treatment plan for each patient. The clinics are located in different areas of the capital and are located near metro stations, making them easy to reach even for patients with mobility impairments.
Prevention
Treating coughs and back pain is much more difficult than preventing their occurrence. To do this, experts recommend following simple preventive measures:
- Treat viral diseases or infections in a timely manner. Contact specialized doctors for advice in case of complications, and fully comply with these instructions.
- Maintain personal hygiene and clean the place of residence, ventilate the room, avoid drafts.
- Constantly strengthen the body's defenses, consume vitamin complexes on a schedule.
- Play sports and keep your body in good shape.
- Undergo regular preventive examinations to exclude the development of chronic pathologies.
- Watch your diet, include healthy foods, more vegetables and fruits in your diet.
It is important to monitor the position of your back and not stay in a draft for a long time in order to prevent the occurrence of pain as a result of hypothermia. A healthy body tolerates all diseases more easily, and the risk of exacerbation or complications of pathology is lower.
If you cough for a long time, a person may experience pain in the back. She most often talks about overstrain of the muscle frame due to frequent muscle contractions. But in some situations there is a risk of developing serious pathology. In this case, it is better not to hesitate to contact a specialist to receive comprehensive medical care.
Causes of back pain between the shoulder blades
Respiratory diseases
Pain between the shoulder blades occurs with acute tracheitis or bronchitis, when unpleasant sensations radiate from the chest to the back. At rest, the discomfort in the back is insignificant, but it increases sharply when coughing, laughing, or when trying to talk loudly. The pain is dull in nature; burning and rawness in the interscapular area are less common. Symptoms last 3-7 days, disappearing without a trace after the inflammatory process subsides.
Postural disorders
Often the causes of pain between the shoulder blades are scoliosis, kyphosis or lordosis. Symptoms develop when sitting for a long time in an uncomfortable position, after sleeping on a too soft or, conversely, very hard mattress. Dull or aching pain appears, which intensifies when bending over or making sharp turns. Unpleasant sensations are observed already at a young age, which is associated with the prevalence of postural disorders among children.
Similar signs are found in patients suffering from a specific juvenile pathology - Scheuermann-Mau disease. In such cases, thoracic kyphosis intensifies, which is manifested by intense back pain and discomfort when staying in one position for a long time. As the disease progresses, adolescents feel a sharp pain between the shoulder blades, which occurs in the evening.
Thoracic osteochondrosis
Patients with degenerative spinal disease suffer from dull pain in the back between the shoulder blades, which is caused by constant muscle tension and compression of the nerve structures. Discomfort becomes stronger when turning and bending the body, standing or sitting for long periods of time. With severe pain, a person’s daily physical activity is limited.
Severe interscapular pain is observed with a herniated thoracic spine. If the upper thoracic segments are affected, the clinical picture is complemented by numbness and tingling in the hands, and difficulty swallowing. The pathology of the mid-thoracic region is characterized by intercostal neuralgia, and when the lower thoracic vertebrae are damaged, sharp pain is felt in the epigastrium and under the ribs.
Back pain between the shoulder blades
Ankylosing spondylitis
An early sign of the disease is discomfort primarily in the lumbar spine, but as ankylosing spondylitis progresses, symptoms spread to the back between the shoulder blades. Unpleasant sensations develop in the evening or at night, intensify in the morning, and decrease or disappear completely during the day. The pain subsides after a hot shower or bath or physical activity.
The spread of the pathological process to the thoracic spine is accompanied by increased kyphosis and tonic tension of the spinal muscles. Therefore, pain in the interscapular region becomes constant and reduces the patient’s motor activity. Over time, a characteristic hump on the back forms. A typical symptom of ankylosing spondylitis is sacroiliitis, an inflammation of the sacroiliac joint.
Diseases of the esophagus
Most esophageal pathologies are characterized by irradiation of pain into the interscapular space. In this case, a clear connection is determined between discomfort and food intake, physical activity with the body bending forward. Symptoms are supplemented by a retrosternal burning sensation, heartburn, and sour belching. Most often, back pain between the shoulder blades is caused by:
- GERD.
For reflux esophagitis, a burning sensation behind the sternum and in the back area is typical 10-20 minutes after finishing a meal. Manifestations intensify if the patient takes a lying position, bends over a lot and performs physical work. Frequent heartburn and sour belching are observed. - Achalasia cardia.
If there is a violation of the opening of the lower esophageal sphincter, sharp retrosternal and interscapular pain occurs at the moment of swallowing. At first, symptoms appear sporadically - when eating in a hurry, chewing food poorly and swallowing large pieces at once. Dysphagia then becomes permanent. - Esophageal stenosis.
The narrowing of the lumen of the organ is accompanied by difficulties in the passage of the food bolus, which causes sharp pain in the chest, the space between the shoulder blades. The patient feels that food is stuck in the middle of the esophagus, and swallowing movements do not help move it further and only increase the discomfort felt in the back.
Diaphragmatic hernia
It is characterized by severe pain that spreads throughout the upper abdomen and moves to the interscapular area. Often, with hiatal hernia, there is also pain in the precordial region, which is mistaken for an attack of angina. Symptoms occur after eating, physical activity, and straining. To reduce discomfort, patients induce vomiting or belching and drink water.
Aortic pathologies
Back pain occurs with aortitis. Discomfortable sensations are localized between the shoulder blades, behind the sternum, sometimes they move to the neck or epigastric region. Less commonly, a painful burning sensation occurs in the chest and radiates to the back. Soreness is a constant concern and does not depend on the action of external factors. Typically, tachycardia, shortness of breath on exertion, at rest, and a dry hacking cough are detected.
Unbearable retrosternal pain, radiating to the interscapular area and spreading from top to bottom, is observed with dissecting aortic aneurysm. Sometimes the sensations are so strong that the patient loses consciousness from painful shock. Blood pressure drops, pulse quickens, oxygen starvation of the brain occurs. If a person is not given emergency medical care, there is a high risk of death.
Mediastinitis
Intense pain that begins suddenly and is felt in the area between the shoulder blades is characteristic of acute posterior mediastinitis. Discomfort increases with swallowing, throwing back the head, and coughing. To reduce back pain and ease breathing, the patient sits with his head tilted forward, slightly hunched over. Edema and cyanosis of the upper half of the body develop, and subcutaneous emphysema occurs occasionally.
Acute inflammation of the mediastinum is accompanied by massive intoxication, so the pain syndrome is accompanied by febrile fever, weakness, and cardiac dysfunction. In chronic mediastinitis, the symptoms are less pronounced: moderate dull pain in the back, behind the sternum, prolonged low-grade fever, and periodic swallowing disorders are observed.
Mediastinal cancer
Pain in the retrosternal region, which radiates to the area between the shoulder blades, is the main complaint of patients with malignant tumors of the mediastinum. The symptom occurs at a late stage of the disease and is caused by the growth of the tumor into neighboring structures and nerve endings. Excruciating pain syndrome is combined with shortness of breath and cough when the bronchi are involved in the process, dysphagia when the esophagus is affected, puffiness and cyanosis of the face when the superior vena cava is compressed.
Rare causes
- Injuries
: spinal fracture, spondylolisthesis, crack or fracture of the scapula. - Muscle diseases
: myalgia, myositis, muscular-tonic syndrome. - Pulmonary diseases
: pneumonia, dry or exudative pleurisy.