Pain under the shoulder blade

24 April 2022

pain under the left shoulder blade from the back

Pain under the scapula is a clinical sign of many pathological conditions, which may include gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology and others.

The symptom of pain can be different in intensity and localization: under the right or left shoulder blade, and sometimes limits the motor activity of a person. Pain under the scapula is most often associated with spasms of the skeletal muscles due to tension or with a reflex of pain emanating from the internal organs located in the scapular region.

Causes of pain under the shoulder blades

Regio scapularis - this is the name of the scapular region, which is bounded by lines, in the upper part of the body between the impar spinous process of the seventh most protruding cervical vertebra and the clavicles, below - a medial-vertical line along from the lower edge of the shoulder blades, as well as a line from the armpits to the edge of the deltoid muscle. The diagnosis of pain under the scapula depends on the nature of the symptom, its localization and accompanying clinical signs, since the scapular region itself can only hurt in case of injury: a blow, a bruise.

The causes of pain under the shoulder blades can be the following:

LSRS - scapulocostal syndrome, scapulo-costal or syndrome of the muscle that lifts the scapula. If the muscle that attaches to the transverse processes of the upper neck vertebrae is hypothermic, injured, inflamed or overloaded, it cannot perform its function normally - tilt the neck and lift the scapula. Symptomatically, PRS - shoulder rib syndrome manifests itself in the form of pain, sometimes severe, in the shoulder girdle, above the shoulder blade and below it. Often the sensation of pain extends to the shoulder, the lateral part of the sternum. The most painful point is the point of attachment of the muscle, if you press on it, the pain becomes sharp and radiates to the neck. Also, a characteristic sign of LS is a cracking sound when moving the shoulders and arms. Constant dynamic loads, as well as static stress, can create a condition in which pain under the shoulder blade becomes constant, aggravated by exposure to cold and drafts.
YABZH - gastric ulcer, as the most common cause of pain radiating below the shoulder blades. The symptom begins with dull aching pains that increase or decrease after taking medications, vomiting. The pain is directly related to food intake, seasonality, and most often radiates to the left - from the epigastrium to the left shoulder blade, chest and back. The symptom of pain in gastric ulcer is generally divided into hungry, late or early pain. In addition, PU is usually accompanied by nausea at the peak of pain, vomiting in 75-80% of cases, and heartburn.
Vegetative pains or as they are often called psychosomatic are also included in the causes of pain under the scapula. Such sensations are similar to signs of angina pectoris, cardiological pain, as they provoke a feeling of tightness, burning in the chest, intensifying and radiating to the arm, under the shoulder blade, under the clavicle, more often to the left, to the region of the heart. The symptom of pain can be both intense and painful, indefinite in nature. The main differential sign of vegetative pain is the lack of effect after taking cardiodrugs: they do not relieve pain and pressure. As a rule, relaxants and sedatives help with a vegetative-vascular attack.
Osteochondrosis of the thoracic or cervical spine can cause dull, prolonged, unilateral aching pain, which most often begins in the back of the head and extends down below the shoulder blade. The pain can occur in the early hours of the morning, intensify with static load (sedentary work), with sudden movements of the body. This condition is accompanied by radiating pain in the arm, under the shoulder blade, paresthesia of the limb, dizziness, visual disturbances. The symptom is eliminated by warming massages, ointments, a warm bath.
Intercostal neuralgia is the most common cause of pain below the shoulder blades. The symptom develops rapidly and is expressed in paroxysmal, one-sided pain, surrounding intense nature. The sensation of pain spreads along the intercostal muscles, spaces, and intensifies with deep breathing, coughing, sneezing, with prolonged physical exertion, walking. In the clinical sense, intercostal syndrome is manifested by palpation of the innervation area, which is not typical for cardiac pathologies, osteochondrosis. Due to constant muscle tension, the pain can extend down to the lower back, but more often it is manifested by stabbing, burning sensations under the shoulder blade.
An attack of angina pectoris begins with pain in the center of the chest (retrosternal space), which spreads rapidly, spreads to the left, and spreads below the collarbone, in the back, below the left shoulder blade. Pain is not always relieved by taking nitroglycerin, vasodilators, which can serve as a signal of myocardial infarction. In addition, there is a distinction between the causes of angina pectoris: severe, sharp pain in the left side of the chest, below the shoulder blade, is characteristic of angina when a person is subjected to physical or psycho-emotional stress. Drawing and aching pain may indicate an angina attack at rest, when there are no external causes causing the pain symptom.
The causes of pain under the shoulder blade may be associated with a serious and life-threatening condition - perforation of a stomach ulcer, which is accompanied by strong, sharp pains radiating under the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, the patient's posture is hands together, knees to the stomach (fetal position). This symptom requires immediate medical attention, as well as cardialgia.
Yuert's symptom or sign of an inflammatory process in the pericardium, accompanied by release of exudate. The main manifestations of exudative pericarditis are chest pain, shortness of breath, high body temperature, and fever. The pain intensifies due to the accumulation of effusion and stretching of the pericardium when coughing, changing the posture of the body, the sensations can be of a painful nature, but more often they "shoot" in the neck, below the left shoulder blade. Exacerbation of the inflammatory process often provokes the clinical picture of "acute abdomen".
Aortic dissection: Dissection of the wall (aneurysm) of the aorta. A life-threatening condition, accompanied by severe pain in the back, between the shoulder blades, or with a change below one of them. Most often, the pain shifts to the left, radiating to the arm and below the left shoulder blade, spreading along the dissecting aorta. The most dangerous consequences of this symptom can be a cerebrovascular accident (if the blood flow in the carotid arteries is disturbed), a heart attack (if the blood flow in the coronary arteries is disturbed), mesenteric thrombosis, paralysis of the legs (if blood flow to the iliac arteries is impaired), spinal cord injury (if blood flow to the vertebral arteries is impaired).
Disc herniation of the thoracic spine. The disease is rarely diagnosed, since the thoracic region is quite stable in this regard. Constant, aching, increasing pain in the area of the infringement and the pathological focus gradually becomes intense, often similar to symptoms of diseases of the bronchopulmonary or cardiovascular systems. The main characteristic sign of a hernia may be muscle tension between the shoulder blades and a visible curvature of the spine. The diagnosis is confirmed by X-ray examinations, MRI.
GSD is a cholelithiasis, colic can also manifest as paroxysmal, excruciating pain, radiating to the right, below the shoulder blade and above.
The causes of pain under the shoulder blade may be due to respiratory diseases - pneumonia or pleurisy. With inflammation of the lungs, the pain is localized according to the pathological focus in the tissue, if the process develops in the posterior sections, there is pain in the back, between the shoulder blades or under them. Inflammation of the pleura is also accompanied by shooting pains between the shoulder blades, often under one of them. The pain is aggravated by the cough reflex, breathing.
Myositis is an inflammatory process in the muscles as a result of hypothermia, SARS or overexertion, less often due to bruising. Pain comes on suddenly in an acute course, or develops gradually, has an aching, aching character in chronic inflammation. The symptom of pain is associated with movements, physical activity, change of posture and inclinations.

Symptoms of pain under the shoulder blades.

Symptoms of pain under the shoulder blades are so diverse that in clinical practice there is still no single standard algorithm for differential diagnosis. Each medical specialization has its own schemes for collecting anamnesis, examination, tests and examinations, however, there are often cases when the symptom of pain is "masked" and does not indicate the true cause. That is why the patient is required to describe as accurately as possible the nature of the pain, all the circumstances in which it occurs. In addition, chronic pain, which a person has "got used to", often lubricates the diagnostic picture, as a result of which time is lost, and the therapeutic effect is much more difficult to achieve.

What symptoms of pain under the scapula require immediate medical attention?

Tightness, constant pain in the back radiating below the shoulder blade, which does not go away in 2-3 days.
Pain under the scapula with static stress (sedentary work) in people over 50 years of age.
Pain radiating under the shoulder blades, increasing at night or in a horizontal position.
pain with fever
Pain accompanied by numbness of the arm, shoulder.
Pain that causes pressure, burning, starting in the middle of the chest.
Pain not relieved by heart medications, sedatives.
Waist pain radiating below the shoulder blade.
Acute and severe pain with vomiting.

Symptoms of pain under the shoulder blades are most often described as follows:

Sharp pain in the middle of the back, which extends below the left shoulder blade. The pain started in the morning and is aggravated by movement.
Sharp and severe pain under the shoulder blades.
Dull pain under the shoulder blades, which is aggravated by raising the arms.
Drawing, aching pain under the scapula, extending down to the waist.
Pain under the left scapula and a feeling of constriction in the chest.
Pain under the shoulder blades in the form of a localized area, burning.
The pain worsens when the cough appears.
The pain under the shoulder blade is replaced by a burning sensation, numbness of the arm.
Severe pain that goes away after vomiting.

Despite the variety of causes that provoke a symptom of pain under the shoulder blades, there are differential signs - danger signs that allow an experienced doctor to exclude relatively benign diseases associated with back pain. Alarming symptoms that may accompany pain in the shoulder blades are the following signs:

Hyperthermia - 38-40 degrees.
Spontaneous pain, increasing and causing the state of "acute abdomen".
Difficulty breathing, cyanosis of the skin.
Swelling of the hands.
Pain that does not subside at rest.
Threw up.
Drop in blood pressure. vegetables.
Fainting.

Back pain below the shoulder blades

Pain in the back, in the scapular region, can be associated with many diseases, but most often it is due to deformation of the spine, especially if it is accompanied by a feeling of numbness in the extremities, tingling in the fingers.

Also, back pain under the shoulder blades is provoked by such diseases, conditions:

Curvature of the spine - kyphosis.
Disc herniation in the thoracic region.
Lateral curvature of the spine - kyphoscoliosis.
Coronary artery disease.
Shoulder periarthritis.
Intercostal neuralgia.
Frontal curvature of the spine - scoliosis.
Angina - exertion or rest.
Protrusion (degeneration) of the thoracic spinal disc without rupture.
YABZH - peptic ulcer of the stomach.
Cholecystitis.
Hepatic colic with concomitant dyskinesia of the gallbladder.
Dry pleurisy.
Pneumonia.
Inflammation of the interscapular muscles, tendons, supraspinous ligaments.

Pain under the shoulder blade on the left.

The symptom of pain under the left shoulder blade may be associated with such diseases:

Periodic pain under the left shoulder blade may indicate a developing stomach ulcer. The pain increases rapidly, is accompanied by nausea, and then vomiting, the symptom is associated with food intake or its absence - hunger pangs. The pain begins in the epigastrium and spreads to the sides, right, or left, most often radiating below the left breast and below the left shoulder blade.
Vegetative crises are also characterized by pains on the left side, massaging under heart disease. Pain under the shoulder blade on the left, pulling, aching, often causing a feeling of fear, not stopping with nitroglycerin and other heart drugs - this is a typical sign of psychogenic conditions.
Myocardial infarction most often has clinically pronounced symptoms: burning in the middle of the chest, pain radiating to the left side of the jaw, down the arm, under the left shoulder blade, numbness of the limb, nausea.
Angina pectoris - pain attacks can develop with tension, stress (angina pectoris) or as an exacerbation of a chronic form (angina pectoris at rest).
Intercostal neuralgia is accompanied by sharp pain, often in the waist, radiating to the right or left below the shoulder blade. The symptom can be intensified by a change in body posture, physical activity. The pain is relieved by warming up and relaxing the muscles.
Osteochondrosis, both cervical and thoracic, is also one of the reasons that causes pain under the left shoulder blade. The symptom of pain is accompanied by dizziness, nausea, numbness of the hands or one hand.
Ulcer perforation is an acute condition, which is expressed in very intense pain radiating to the area of the clavicle, below the shoulder blade. In addition to severe pain, the patient is characterized by a knee-to-stomach posture, cold sweat, cyanosis, and a drop in blood pressure and pulse.

Pain under the shoulder blade on the right.

The symptom of pain that manifests itself under the right shoulder blade is associated with such diseases:

Biliary colic with spasm of the bladder, ducts due to obstruction with stones. The pain is sharp, cutting, located below the right rib and radiates to the back below the shoulder blade.
Pain under the right shoulder blade can be caused by a diaphragmatic abscess. The symptom is very acute, aggravated by inhalation, even not deep, more often radiates to the right.
Pyelonephritis in acute form begins with pain in the lumbar region, which subsequently spreads upwards and is given under the right shoulder blade. The purulent process in the right kidney is accompanied by pain during urination, elevated body temperature.
Myofascial syndrome is also the cause that leads to pain under the right scapula. These are chronic muscle pain associated with irritation of certain trigger points.
Among the factors that provoke a symptom of pain under the right shoulder blade, sometimes herpes is also found - shingles. This is a viral disease that is not considered life threatening, but it causes very intense and excruciating pain, burning sensation and numbness. Herpes is typical of a rash, itching and muscle pain that radiates below the shoulder blade.
Osteochondrosis is one of the reasons that often provokes radiating pain under the shoulder blades, including the right.
Right-sided pneumonia. Pain with inflammation of the lungs is most often manifested in the acute stage, there may be fever, a feverish state.

If the pain subsides below the shoulder blade.

Any symptom of pain that "reveals" is called irradiation. The visceral pain impulse can be so intense that irritation of the primary nerve branch is rapidly transmitted along the chain to the final branch, that is, far from the original source. Pain occurs under the scapula most often from the organ affected by inflammation and can be triggered by such reasons:

Increased pressure in the intestines with inflammation, ulcerative process. The postbulbar part of the duodenum with an ulcer radiates to the right under the scapula.
Biliary colic (gallbladder, liver).
Acute pain occurs under the left shoulder blade and during an attack of angina pectoris, when there are sensations of pressure, compression.
Pericarditis can also present with referred pain below the shoulder blades.
Aortic dissection (aneurysm) is manifested by severe chest pain radiating to the neck, left side, shoulder, below the shoulder blade.
Pneumothorax (spontaneous) - sharp pain in the chest with a reflex under the scapula, in the region of the scapula.
Exacerbation of pancreatitis.
Kidney colic.
Acute musculoskeletal back pain.
Myocardial infarction.
Osteochondrosis of the cervical spine.

Referred pain can be transient, but it can also indicate that an acute condition is developing that requires immediate medical attention. If the pain subsides under the shoulder blade and does not stop with antispasmodics, heart drugs, you should consult a doctor who will conduct an examination, differential diagnosis and prescribe the appropriate treatment.

Pain under the shoulder blades when inhaling

A symptom of pain under the scapula, aggravated by inhalation, is a characteristic sign of the following pathologies:

Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain can increase with bending, movements, decrease in a horizontal or lateral position. The accumulation of fluid in the pleural cavity causes swelling and pain under the scapula when inhaling.
Pericarditis is an inflammatory process in the pericardial sac, the disease is manifested by weakness, retrosternal pain, which are intensified by inhalation.
Pain under the shoulder blades with a deep breath may indicate intercostal neuralgia, which manifests itself in the form of pains in the waist that seem to squeeze the chest.
Gallbladder diseases, spasms, colic, can also be accompanied by a pain symptom associated with inhalation.
Renal colic (pyelonephritis, renal abscess) can also be accompanied by pain in the hypochondrium, so intense that it spreads throughout the epigastric region, gives way under the scapula, and increases with inspiration.

Severe pain below the shoulder blade

Severe and severe pain under the scapula, left or right, is a reason to seek medical help; Often this symptom of pain cannot stop on its own and can also indicate life-threatening conditions. Severe pain under the shoulder blade can be provoked by such diseases:

Sharp, stabbing, stabbing pain, increasing during inspiration, reflected in the shoulder, may be a sign of spontaneous pneumothorax. Additional clinical symptoms of pneumothorax are rapidly developing shortness of breath, tachycardia, drop in blood pressure, slow pulse, (compensatory) enlargement of neck veins.
Severe pain, radiating under the scapula and accompanied by arterial hypertension, indicates an exacerbation of osteochondrosis of the thoracic spine. Back pain under the scapula, headache and a simultaneous jump in blood pressure are a clear symptom of pinched nerve endings in the cervical or thoracic region. The pain can increase when turning the body, shooting when bending or moving, and is not stopped by heart drugs, sedatives.
Severe pain below the shoulder blade may be associated with perforation of the ulcer in the upper part of the stomach. If the perforation progresses rapidly, the pain increases literally every minute, the general clinical picture of the ulcer is typical: acute pain with irradiation, vomiting, cold sweat, cyanosis of the face, characteristic posture - knees bent to the chest.
Hepatic (biliary) colic is also manifested by severe pain radiating to the right, under the shoulder blade, in the neck and even in the region of the right eye. The pain symptom is associated with blockage of the bile ducts after eating fatty and fried foods.
A purulent process in the area between the diaphragm and the organs located below, subdiaphragmatic abscess is an acute condition that requires immediate medical attention. A developing bacterial infection in this form can lead to general intoxication, sepsis. In fact, this is a purulent peritonitis, limited by the diaphragm, manifested by severe pain in the hypochondrium, radiating to the right - the shoulder, under the shoulder blade. Also typical hyperthermia up to 40 degrees, fever, nausea.

A strong symptom of radiating pain is not recommended to last more than an hour, if it cannot be stopped by the available means, you should call emergency help.

Pain behind the shoulder blades

The pain behind the shoulder blades, between them, as a rule, is not intense, so the person does not pay attention to the symptom, considering it temporary, transient. Untimely determination of the cause, the factor provoking such pain, can lead to the development of chronic and difficult-to-treat diseases.

Persistent and nagging pain between the shoulder blades, below them, is often caused by muscle tension, which in turn is explained by professional details: sedentary work in the office, at a sewing machine, driving a car, etc. Usually, back pain below the shoulder blades is not associated with life-threatening pathologies and even dystrophic changes in the spine, since the thoracic region is not mobile, it is quite stable and stable. In most cases, violations, changes, and less often - inflammation, relate to the muscular system of the interscapular region, ligaments and tendons can also be stretched.

Pain of this type, associated with muscles, is characterized by a feeling of heaviness, tension, which quickly passes with active movements (exercises), massage or warm-up.

Pain, which is caused by damage, stretching of the tendons, is felt differently, it provokes a sensation of pain under the shoulder blades, often the pain symptom is reflected in the region of the heart. Also, a person complains of numbness of the hands, a tingling sensation, "goosebumps. "It is not possible to neutralize such pain with heart drugs, but you can get rid of it and do it quite simply:

Periodically change the position of the body, preferably every half hour. If the work is sedentary, you need to get up, walk, make circular movements with your hands, shoulders, bring your shoulder blades together and apart.
It is advisable to dedicate 20-30 minutes a day to stretching exercises for the muscles of the interscapular area, and for the general muscle tone of the body. Regular exercise will help prevent muscle spasms and pain behind the shoulder blades.
It is necessary to periodically massage the shoulder-scapular area, the neck area.
Periodically, you can perform the following exercise: put a small (tennis) ball on the floor, lie on it with your upper back and "roll" on the ball, passing it vertically and between the shoulder blades.

If a symptom of pain in the back under the shoulder blades is accompanied by cough, subfebrile temperature, pain increases with breathing, cough reflex, you should see a doctor, be examined to exclude diseases of the bronchopulmonary system.