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Pain between the shoulder blades, also called interscapular pain can be caused by many conditions, some of which are benign while the others can be serious. It is a very common complaint, especially among persons who have sedentary lifestyle. In most cases this symptom is not a sign of a serious disease, but nevertheless, it requires detailed examination.

Projected Pain

During the embryonic development, internal organs of chest and abdominal cavity are changing their position, but their nerves still originate from the same parts of spinal cord. That is the reason why sometimes pain can be felt in interscapular area even if the pathological process is located somewhere else in the chest or abdominal cavity. This kind of pain is called projected pain. For example, diseases of pancreas, stomach, and gallbladder can produce pain in scapular or interscapular region.

Spine Disorders

Damage of intervertebral discs due to degenerative process in the neck or thoracic region can cause interscapular pain in some persons. If some of the intervertebral discs are dislocated, than some of the sensitive nerves can be compressed and that condition is called discus hernia. Discus hernia is the most common cause of back pain, and in some cases it can be very serious. This pain has different quality in different positions of the body. If suspected, an MRI scan of particular region of the spine is indicated in order to confirm the diagnosis. This condition can be treated surgically or with medications depending on severity. For pain relief, Non-steroidal anti-inflammatory Drugs (NSAIDs) are most commonly used.

Myocardial Infarction/Heart Attack

Sometimes, the clinical presentation of myocardial infarction or heart attack can be very unusual and can include pains in different parts of thorax and abdomen. Therefore, in patients experiencing interscapular pain of unknown origin, ECG recording is needed in order to exclude heart attack. This is especially recommended in persons with increased risk for cardiovascular disease (obesity, diabetes mellitus, hypercholesterolemia, older age, etc.).

Other causes

Congenital as well as acquired abnormalities of the spine and ribs can cause interscapular pain.

The main cause of acquired abnormalities is a bad posture experienced by persons who sit most of the day or have non-physiological posture in the workplace.

Back pain in thoracic region can occur due to chronic pulmonary diseases that induce chronic cough (Chronic Obstructive Pulmonary Disease - COPD).

NSAIDs are often used to lower or eliminate the pain originating from skeletal causes. If the pain is more severe, steroids and even opioid analgesics can be included. However, surgical procedure is sometimes needed in order to remove the main cause of pain. As vital organs are located in thoracic region, the cause of interscapular pain should always be fully investigated.

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