Back pain between the shoulder blades occurs with pathologies of the spine (posture disorders, osteochondrosis, Bechterew's disease), diseases of the esophagus (gastroesophageal reflux disease, achalasia of the cardia, strictures), mediastinitis. Less often, the symptom develops against the background of aortitis, aortic dissection, malignant tumors of the mediastinum. The diagnostic complex includes radiography of the spinal column, OGK, CT and MRI, EFGDS. The condition of the vessels is assessed using ultrasound, aortography. Pain is relieved by the appointment of NSAIDs or narcotic analgesics. Treatment of the underlying disease is represented by medical, physiotherapeutic and surgical methods.