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A feeling of heat, burning, burning in the spine is a clear sign that not everything is in order in the body. Although quite often a burning sensation in the spine is caused by simple hypothermia or muscle strain, it can also be the result of much more serious causes that require seeing a doctor and long-term and complex treatment.
I. Burning in the back in the area of the shoulder blades
Many people, both office workers and manual workers, have experienced burning back pain in the shoulder blade area throughout their lives. What does this symptom indicate and what diseases can be masked under it? Should I worry about this and what can be done to reduce the pain and prevent its reoccurrence? Pain in the shoulder blade area is one of the most common complaints when seen by a specialist and is often combined with other symptoms of damage to the human musculoskeletal system. Most studies conducted in the population regarding pain in the thoracic region and the scapular region show the following data: ● pain in the thoracic region, in particular in the interscapular region, is more common in females. ● Pain leads to difficulty performing daily tasks and decreased performance. (Important socio-economic factor) ● pain in the shoulder blades is often combined with psychological problems such as depression and anxiety disorders, especially against the background of stressful situations both at work and at home.
Which doctor should I contact?
If the origin of the burning sensation is in doubt, you should consult a physician. After diagnosis, the patient will be referred to a specialist doctor, who will begin treatment. Often the patient suspects what caused the burning sensation in the lower back. It is advisable to immediately make an appointment with a gynecologist, endocrinologist, gastroenterologist, nephrologist, or urologist.
II. What are the causes of pain in the shoulder blades?
The most common cause of a burning sensation in the area of the shoulder blades is an inflammatory process in the muscle and adjacent soft tissue. This inflammation can occur for a number of reasons: ● Long-term work at the computer. ● Weakness of the muscles of the cervical and thoracic spine. ● Stereotypical, i.e. long-term repeated movements of the upper limbs (in English literature this condition is called overexertion injury) ● structural changes in the cervical and thoracic spine, leading to narrowing of the spinal canal and intervertebral foramina through which the roots of the spinal nerves pass (intervertebral hernia, arthrosis of the intervertebral joints and their enlargement due to inflammatory changes, thickening of the ligamentum flavum, etc.) ● sudden sprain of muscles and ligaments, for example in a traffic accident or playing sports - whiplash injury. Less common causes: ● Osteoporosis. ● vertebral fractures. ● infectious process in the vertebral bodies (for example, damage to the vertebral bodies by tuberculosis). ● herpes zoster (especially in people with immunodeficiency and people over 60 years of age). ● tumors of the spine and metastases to the vertebral bodies (especially in people with a history of cancer). ● Scheuermann-Mau disease - changes in the bone tissue of the vertebral bodies, leading to curvature of the spine. ● Ankylosing spondylitis is a disease of an autoimmune nature that leads to fusion of vertebrae and, as a consequence, immobilization in this segment of the spine. IMPORTANT! Consultation with a specialist is necessary . Do not think that pain in the thoracic spine, in particular in the area of the shoulder blades, is associated only with the structural elements of the spine. Periodically, such pain occurs in various diseases, such as: myocardial infarction, coronary heart disease, pleurisy, diseases of the gastrointestinal tract (stomach and duodenal ulcers, hiatal hernia, reflux disease), etc. Is there any reason for concern ? In most cases the answer is no! With timely treatment and elimination of the cause that caused the burning sensation in the interscapular area, a fairly quick and lasting result can be achieved. But there are a number of warning signs (red flags) that you should pay attention to if you have chest pain. Red flags for a burning sensation in the area of the shoulder blades: ● recent serious injury (for example, an accident or a fall from a height) ● pain that first appeared before the age of 20 years and over 50 years ● a history of oncology ● pain arising from a minor injury, when lifting heavy objects or falling from your own height ● taking glucocorticosteroids (dexamethasone, prednisolone, etc.) for six months or more, which leads to the development of steroid osteoporosis ● HIV infection and conditions associated with immunosuppression ● morning stiffness in the spine and joints ● periodic rise in temperature and loss of body weight for no apparent reason ● pain increases in intensity and changes in character over time ● is accompanied by curvature of the spine and the appearance of local visible changes in the area of pain ● numbness, tingling, a crawling sensation and/or decreased muscle strength in the upper and lower extremities ● involuntary urination and defecation or difficulty with them
Diagnostics
The diagnostic program depends on the external examination of the patient, the characteristics of the symptoms, and the collected medical history. If a disease of the musculoskeletal system is suspected, radiography is performed in 2 projections. If the obtained images are not informative enough, then the patient is shown an MRI or CT scan. Instrumental studies help assess the condition of intervertebral discs, vertebrae, muscles, blood vessels, ligaments and tendons.
MRI of the lumbar region.
To detect diseases of internal organs, endoscopic examination of the gastrointestinal tract and ECG can be performed. An ultrasound of the abdominal cavity and genitourinary system is required, which allows identifying the inflammatory process.
The development of pathologies is also indicated by deviations from the norm in the parameters of general clinical, serological, and biochemical blood tests. Inoculation of biological samples in nutrient media helps to establish the type of infectious agents and their sensitivity to drugs.
III. Is it necessary to conduct additional research methods?
At the appointment, the doctor, after assessing your condition (clinical picture) and medical history, makes a conclusion about the need or lack thereof for additional research methods. In most cases, if the pain syndrome is benign, the diagnosis is made based on the patient’s clinical picture. If there are “red flags”, depending on the conditions that the doctor wants to exclude, additional research methods may be prescribed, such as a blood test for inflammatory markers, tumor markers, MRI, computed tomography, radiography, or referred for consultation to a specialized specialist.
Treatment
Help before diagnosis
If the burning sensation is caused by a slight burn of the skin (only redness, no blisters), it can be treated with dexpanthenol sprays. Medicines quickly relieve symptoms, soothe the skin and promote its healing. If you experience severe burns, rashes or other symptoms, consult a doctor. To quickly relieve burning sensations, experts prescribe gels and sprays with a soothing and cooling effect.
Conservative therapy
Therapy is determined by the underlying disease. Often, burning skin is caused by dermatological pathologies, to eliminate which an integrated approach is practiced. For mild cases of the disease, local remedies are sufficient: lotions and wet-dry dressings for weeping, ointments and rich creams for peeling. They use medications with antiseptics and antibiotics, topical steroids, and antimycotics.
For allergic dermatoses, systemic detoxification therapy is prescribed: antihistamines, sedatives, methods of extracorporeal hemocorrection. Antifungal drugs in tablets are recommended for the treatment of common mycoses. Herpes zoster requires intravenous or oral acyclovir.
Physiotherapy methods are effective in a comprehensive treatment regimen. To eliminate rashes, accelerate skin healing and stimulate immune defense, laser therapy, magnetic therapy, and ozone therapy are prescribed. In the remission phase of chronic dermatoses, skin irradiation with ultraviolet light and mud therapy are used. With senestopathies, patients require the help of a psychiatrist.
IV. Let's take a closer look at the most common cases of pain in the shoulder blades.
What do such causes of pain as long-term computer work, weakness of the cervical and thoracic muscles, and stereotypic movements of the upper limbs have in common?
As a rule, the basis is an increase in muscle tone, i.e. muscle-tonic syndrome and myofascial pain syndrome (MFPS). Myofascial syndrome is characterized by the presence of trigger points, which are a tangle of individual contracted muscle fibers, against the background of which the bulk of the muscle affected by the triggers becomes weaker. This occurs due to the reflex response of our central nervous system, which receives information that the muscle fibers in the trigger zones are in increased tone, and since an excessive increase in tone in the muscle is energy-consuming for the body, it gives the command to weaken the muscle. A logical question arises: how can such opposite conditions as hypertonicity and weakness be combined?
In this image we see the classic pose of a person working at a computer. With this position of the body, the following biomechanical changes are observed: 1. The shoulder blades and shoulders shift forward; the muscles of the interscapular region are weakened (middle and lower portions of the trapezius muscle, rhomboid muscles), but at the same time the pectoral muscles are shortened. 2. There is an increase in thoracic kyphosis (i.e., a stooped back) 3. Compensatory hyperextension of the cervical spine - weakness of the muscles of the anterior group of the neck, and hypertonicity of the extensors of the neck and head. That is, when any muscle group is weakened, the tone in the antagonist muscles reflexively increases. Such biomechanical changes are called upper cross syndrome. In the clinical picture, in addition to burning pain in the area of the shoulder blades, such patients may also experience a feeling of stiffness, discomfort in the cervical spine and headache. The pain caused by this condition responds very well to treatment using soft manual therapy techniques; a course of exercise therapy with further exercises at home is also a prerequisite for achieving a lasting result. The method of acupuncture has proven itself well; this method helps to cope with muscle strain in the cervical-collar area and relieve psycho-emotional stress.
Consider another cause of burning pain in the area of the shoulder blades, namely degenerative-dystrophic changes in the cervical spine (osteochondrosis, spondyloarthrosis, spondylosis) and disc herniations. The muscles of the upper thoracic region receive innervation from the cervical roots of the spinal cord. Thus, the presence of dystrophic changes in this area leads to the development of myofascial syndrome in the rhomboid muscle, the levator scapulae muscle and the upper portion of the trapezius muscle.
Domestic authors have found that damage to the disc, joints and ligaments of the cervical spine at the level of C4-C5, sometimes C5-C6, leads to the development of MFPS in the rhomboid muscle (PRESENTED IN THE FIGURE). When the rhomboid muscle is affected, the pain is localized along the inner edge of the scapula, sometimes spreading to the shoulder girdle (the area of pain distribution is indicated in red), but never spreads to the cervical region, unlike the pain coming from the levator scapulae muscle and the upper portion of the trapezius muscle. In addition to pain, crunching and clicking sounds are often observed when moving the shoulder blade, but the movements themselves are not limited. The usual position for such patients is a slouched back.
Damage to internal organs, accompanied by referred pain in the shoulder blades. Heart. With ischemia (lack of blood supply) of the heart muscle, a symptom such as burning pain, localized in the area of the left shoulder blade, left arm, neck and lower jaw, is often observed. Most often, pain during myocardial ischemia occurs during physical activity, in contrast to myofascial pain syndrome, which manifests itself at rest and is less intense. Pain during myocardial ischemia is often accompanied by panic and fear of death. As you can see, pain in the thoracic region can be caused by a variety of pathological conditions that require careful collection of complaints and medical history, differential diagnosis and exclusion of the most dangerous diseases first. At the same time, you should not worry too much about it; in the vast majority of cases, the pain is benign in nature and, with the right tactics, responds well to treatment.
Symptoms
The nature and intensity of the symptoms accompanying burning depend on the type of developing pathology. If it is of infectious origin, then signs of general intoxication of the body appear: the body temperature rises, the person suffers from headaches, dizziness, lack of appetite, chills, fever.
Often the burning sensation is accompanied by a decrease in tactile, temperature and pain sensitivity. This indicates the development of radicular syndrome - a dangerous complication of pathologies of the musculoskeletal system. Subsequently, a gradual decrease in sensitivity continues, until its complete loss. The muscles located in the zone of innervation of the affected root weaken and then atrophy.
Radicular syndrome.
First aid to a patient
Constant burning in the lower back causes not only physical, but also psychological discomfort. It is possible to get rid of it only by eliminating the pathology that provoked it. But even during treatment, a burning sensation occurs from time to time. Cold compresses will help reduce the severity of discomfort. Apply a thick cloth soaked in cool water to your lower back for 15-20 minutes.
What is not recommended to do
It is strictly forbidden to try to get rid of the burning sensation on your own by rubbing ointments, gels, or alcoholic tinctures of herbs into the lower back. A slight improvement in well-being often becomes the reason for postponing a visit to the doctor. Many diseases of internal organs rapidly progress, spreading to healthy tissue.
Before visiting a doctor, it is not recommended to take any pills or rub in ointments. This will distort the clinical picture and significantly complicate diagnosis.
Surgical intervention
If a patient consults a doctor with complaints of severe symptoms, then he is likely to be diagnosed with a pathology of 2 or 3 degrees of severity. Conservative treatment may not be effective, so the patient is prepared for surgery. This is especially true for degenerative changes in the lumbar region, when there is a threat of human disability. The surgeon removes the herniated disc and sometimes replaces the disc with an implant.
Useful tips and prevention
The best prevention of any pathology is examination by a doctor 1-2 times a year. The disease will be detected at the initial stage of development, even before its first symptoms appear.
Doctors recommend giving up bad habits, doing physical therapy, swimming, yoga, and walking long distances.