Pain under the shoulder blade

24 April 2022

pain under the left shoulder blade from the back

Pain under the shoulder blade is a clinical sign of many pathological conditions, which may include gastrointestinal, cardiac, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology, etc.

The symptom of pain can be different in intensity and localization - under the right or left shoulder blade, and sometimes limits a person's motor activity. Pain under the shoulder blade is most often associated with spasms of skeletal muscles due to tension or with the reflection of pain that comes out of the internal organs that are located in the area of the scapula.

Causes of pain under the shoulder blades

Regio scapularis - this is the name of the scapular region, which is limited by lines - in the upper part of the body between the unpaired spinous process of the most protruding VII cervical vertebra and collarbones, below - the medial-vertical line along the lower edge of the scapula and the line from armpit to deltoid muscle. The diagnosis of pain under the scapula depends on the nature of the symptoms, its localization and accompanying clinical signs, since the region of the scapula itself can hurt only in case of injury - blow, bruise.

Causes of pain under the shoulder blades can be as follows:

LSRS - scapular-scapular, scapular-costal syndrome or scapular-raising muscle syndrome. If the muscle that attaches to the transverse extensions of the upper cervical vertebrae is hypothermic, injured, inflamed or overloaded, it is unable to perform its function normally - tilting the neck and lifting the shoulder blade. Symptomatically, PRS - scapular-rib syndrome is manifested in the form of painful, sometimes intense pain in the shoulder girdle, at the top of the shoulder blade and below it. Often the feeling of pain spreads to the shoulder, the side of the sternum. The most painful point is the point of muscle attachment, if you press on it, the pain becomes acute, it spreads to the neck. In addition, a characteristic sign of LS is the sound of crunching when moving the shoulders and arms. Dynamic constant loads, as well as static stress, can create a state in which the pain under the shoulder blade becomes constant, intensified by exposure to cold, drafts.
YABZH - stomach ulcer, as the most common cause of radiating pain under the shoulder blades. The symptom begins with dull, aching pains that intensify or decrease after taking the medication, vomiting. The pain is directly related to food intake, seasonal weather and most often radiates to the left - from the epigastrium to the left shoulder blade, to the chest and back. The symptom of pain in a stomach ulcer is usually 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 or as they are often called psychosomatic pains are also included in the causes of pain under the shoulder blade. These feelings are similar to the signs of angina pectoris, cardiac pain, because they cause a feeling of tightness, tingling in the chest, which intensifies and radiates to the arm, below the shoulder blade, below the collarbone, more often on the left, to the heart region. The symptom of pain can be both intense and painful, of an indeterminate nature. The main differential sign of vegetative pain is the lack of effect after taking cardio medications - they do not relieve pain or pressure. As a rule, relaxants and sedatives help with vegetative-vascular attack.
Osteochondrosis of the thoracic or cervical spine can cause unilateral dull, long-lasting, aching pain, which most commonly begins at the nape of the neck and spreads below the scapula. Pain can occur in the early morning hours, intensified by static load (sitting work), with sudden body movements. This condition is accompanied by radiating pain in the arm, under the shoulder blade, paraesthesia of the extremities, dizziness, visual disturbances. The symptom is removed by warming massages, ointments, warm bath.
Intercostal neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and is expressed by paroxysmal, unilateral pain that surrounds the intense nature. The feeling of pain spreads along the intercostal muscles, space and intensifies with deep breathing, coughing, sneezing, prolonged physical exertion, walking. In the clinical sense, intercostal syndrome is manifested by palpation of the innervating area, which is not typical for cardiac pathologies, osteochondrosis. Due to the constant tension of the muscles, the pain can spread lower - to the lower back, but it is most often manifested by a sting, burning under the shoulder blade.
An attack of angina pectoris begins with pain in the middle of the chest (retrosternal space), which spreads rapidly, spreads to the left and gives below the collarbone, in the back, under the left shoulder blade. Pain is not always relieved by taking nitroglycerin, a vasodilator, which can serve as a signal of myocardial infarction. In addition, there is a difference between the causes of angina pectoris: Severe, acute pain in the left side of the chest, below the shoulder blade, is characteristic of angina pectoris when a person is subjected to physical or psycho-emotional stress. Traction, excruciating pain may indicate an attack of angina at rest, when there are no external provoking causes of pain symptoms.
Causes of pain under the shoulder blade can be associated with a severe, life-threatening condition - perforation of a stomach ulcer, which is accompanied by strong, sharp pain radiating below the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, holding the patient with folded arms, knees to the abdomen (fetal position). This symptom requires urgent medical attention as well as cardialgia.
Yuert's symptom or sign of an inflammatory process in the pericardium, followed by the release of exudates. The main manifestations of exudative pericarditis are retrosternal pain, shortness of breath, fever and fever. The pain intensifies due to the accumulation of effusions and stretching of the pericardium when coughing, changes in posture, sensations can be painful, but most often "shoot" in the neck, under the left shoulder blade. Worsening of the inflammatory process often causes the clinical picture of "acute abdomen".
Aortic dissection - dissection of the aortic wall (aneurysm). A life-threatening condition, accompanied by intense back pain, between the shoulder blades or with a shift below one of them. Most often the pain moves 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 stroke (if the blood flow in the carotid arteries is disturbed), heart attack (if the blood flow in the coronary arteries is disturbed), mesenteric thrombosis, paralysis of the legs (if the blood flow in the coronary arteries is disturbed). blood flow in the iliac arteries is disturbed), spinal cord injury (if blood flow in the vertebral arteries is disturbed).
Thoracic spine hernia. The disease is rarely diagnosed because the thoracic region is quite stable in this regard. Constant, aching and growing pain in the area of the procedure and pathological focus gradually becomes intense, often similar to the symptoms of diseases of the broncho-pulmonary or cardiovascular system. The main characteristic sign of a hernia can be the tension of the muscles between the shoulder blades and the visible curvature of the spine. The diagnosis is confirmed by X-ray examinations, MR.
GSD is cholelithiasis, which can manifest as paroxysmal, unbearable pain, radiating to the right, below the shoulder blade and above.
Causes of pain under the shoulder blade can be the result of respiratory diseases - pneumonia or pleurisy. In pneumonia, the pain is localized in accordance with the pathological focus in the tissue, if the process develops in the posterior parts, there is pain in the back, between the shoulder blades or below them. Inflammation of the pleura is accompanied by suturing pain between the shoulder blades, often under one of them. The pain is intensified 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. The pain occurs suddenly in the acute course, or develops gradually, has a withdrawing, painful 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

The symptoms of scapular pain are so diverse that there is still no single standard algorithm for differential diagnosis in clinical practice. Each medical specialization has its own history, examination, testing, and examination schemes, however, there are frequent cases where the pain symptom is "masked" and does not indicate the true cause. In addition, chronic pain, to which a person is "accustomed", often blurs the diagnostic picture, resulting in wasted time, and the therapeutic effect is much more difficult to achieve.

What symptoms of pain under the shoulder blade require urgent medical attention?

Drawing, constant back pain with radiation under the shoulder blade, which does not subside within 2-3 days.
Pain under the shoulder blade in static stress (sitting work) in people over 50 years of age.
The pain radiating under the shoulder blades increases at night or in a horizontal position.
Pain with fever.
Pain followed by numbness of the arms, shoulders.
The pain that causes pressure, tingling, begins in the middle of the chest.
Pain that is not relieved by heart medications, sedatives.
Pain in the waistband radiating below the shoulder blade.
Sharp, severe pain with vomiting.

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

A sharp pain in the middle of the back, which spreads below the left shoulder blade. The pain started in the morning and intensified with movement.
Sharp, severe pain under the shoulder blades.
Dull pain under the shoulder blades, intensified by raising the arms.
Drawing, aching pain under the shoulder blade, spreading to the waist.
Pain under the left shoulder blade and a feeling of tightness in the chest.
Pain under the shoulder blades in the form of a localized area, burning.
The pain intensifies when a cough occurs.
Pain under the shoulder blade replaces the burning sensation, numbness of the hand.
Intense pain that disappears after vomiting.

Despite the various causes that cause the symptom of pain under the shoulder blades, there are different signs - danger signals that allow an experienced doctor to rule out relatively benign diseases associated with dorsalgia. Alarming symptoms that may accompany shoulder pain are the following signs:

Hyperthermia - 38-40 degrees.
Spontaneous pain, which grows and causes a state of "acute abdomen".
Shortness of breath, cyanosis of the skin.
Swelling of the hands.
Pain that does not subside at rest.
Vomiting.
Drop in blood pressure. pulse.
Unconsciousness.

Back pain under the shoulder blades

Pain in the back, in the area of the shoulder blade can be associated with many diseases, but it is most often a consequence of a deformity of the spinal column, especially if it is accompanied by a feeling of numbness of the extremities, tingling in the fingers.

In addition, back pain under the shoulder blades is caused by such diseases, conditions:

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

Pain under the shoulder blade on the left side

The symptom of pain under the left shoulder blade can be associated with the following diseases:

Periodic pain under the left shoulder blade may signal the development of a stomach ulcer. The pain increases rapidly, it is accompanied by nausea, and then vomiting, the symptom is associated with food intake or its absence - hunger pains. The pain begins in the epigastrium and spreads laterally - right or left, most often radiating under the left breast and under the left shoulder blade.
Vegetative crises are also characterized by pain on the left side, massage under cardiopathy. Pain under the shoulder blade on the left side, withdrawal, pain, often causes a feeling of fear, disturbance with nitroglycerin and other cardiac 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, in the arm, under the left shoulder blade, numbness of the extremities, nausea.
Angina pectoris - attacks of pain can develop with tension, stress (angina pectoris) or as an exacerbation of a chronic form (resting angina pectoris).
Intercostal neuralgia is accompanied by acute pain, often lumbar, radiating to the right or left below the scapula. The symptom can be intensified by a change in posture, physical activity. The pain is relieved by warming up, 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 arm.
Perforation of the ulcer is an acute condition that is expressed by very strong pain that radiates in the area of the collarbone, below the shoulder blade. In addition to intense pain, the patient is characterized by posture with knees pressed to the abdomen, cold sweat, cyanosis, drop in blood pressure and pulse.

Pain under the shoulder blade on the right side

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

Biliary colic with spasm of the bladder, ducts due to stone obstruction. The pain is sharp, cutting, localized under the right rib and radiates to the back under the shoulder blade.
Pain under the right shoulder blade can be caused by a diaphragmatic abscess. The symptom is very acute, intensified by inhalation, even if not deep, it usually radiates to the right.
Acute pyelonephritis begins with pain in the lumbar region, which later spreads to the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination, fever.
Myofascial syndrome is also a cause that causes pain under the shoulder blade on the right side. These are chronic muscle aches associated with irritation of certain trigger points.
Among the factors that cause the symptom of pain under the right shoulder blade, sometimes there is herpes - shingles. This is a viral disease that is not considered life-threatening, but causes very strong, unbearable pain, tingling and numbness. Herpes is typical for the rash, itching and pain in the muscles that radiate under the shoulder blade.
Osteochondrosis is one of the reasons that often causes radiating pain under the shoulder blades, including the right one.
Right-sided pneumonia. Pain with pneumonia is most often manifested in the acute phase, there may be fever, fever.

If the pain gives under the shoulder blade

Any symptom of pain that "emits" is called radiation. The impulse of visceral pain can be so intense that the irritation of the primary nerve branch is rapidly transmitted along the chain to the end branch, ie far from the original source. Pain under the shoulder blade usually occurs from the organ affected by inflammation and can be caused by the following reasons:

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

The recommended pain may be transient, but it can also signal the development of an acute condition that requires urgent medical attention. If the pain gives under the shoulder blade and does not stop with antispasmodics, heart medications, you should consult a doctor who will perform an examination, differential diagnosis and prescribe adequate treatment.

Pain under the shoulder blades when inhaling

The symptom of pain under the shoulder blade, which is aggravated by inhalation, the signal is characteristic of the following pathologies:

Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain may be intensified by bending, moving, relaxing in a horizontal position or on the side. Accumulation of fluid in the pleural cavity causes swelling and pain under the shoulder blade when inhaled.
Pericarditis is an inflammatory process in the pericardial sac, the disease is manifested by weakness, retrosternal pain, which becomes more intense when inhaled.
Pain under the shoulder blades with deep breathing may indicate intercostal neuralgia, which manifests itself in the form of lumbar pain that seems to tighten the chest.
Gallbladder diseases, cramps, colic, may also be accompanied by a symptom of pain associated with inhalation.
Renal colic (pyelonephritis, kidney abscess) can also be accompanied by pain in the hypochondrium, so intense that it spreads throughout the epigastric region, occurs under the shoulder blade and intensifies with inspiration.

Severe pain under the shoulder blade

Intense severe pain under the shoulder blade - left or right - is a reason to seek medical help, often such a painful symptom cannot be stopped on its own, and can indicate life-threatening conditions. Severe pain under the shoulder blade can be caused by such diseases:

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

It is not recommended to endure the symptom of strong radiating pain for more than an hour, if it cannot be stopped by available means, it is necessary to call an ambulance.

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 identification of the cause, the factor that causes such pain, can lead to the development of chronic, difficult to treat diseases.

Persistent, persistent pains between the shoulder blades, below them, are most often caused by muscle tension, which in turn is explained by professional specifics - sitting in the office, behind a sewing machine, driving a car, etc. Usually, back pain under the shoulder blades is not associated with life-threatening pathologies, and even with dystrophic changes of the spine, since the thoracic region is not mobile, it is quite stable and stable. The most common injuries, changes, less frequent inflammation, are related to the muscular system of the interscapular region, and ligaments and tendons can be stretched.

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

Pain, which is caused by damage, stretching of tendons, is felt differently, causes a feeling of pain under the shoulder blades, often the painful symptom is reflected in the area of the heart. Also, the person complains of numbness of the hands, a burning sensation, "creeping buttocks. " Such pain can not be neutralized by heart medication, but you can get rid of it very easily:

Periodically change your body position, preferably every half hour. If the job is sitting, it is necessary to get up, walk around, make circular movements with arms, shoulders, gather and spread the shoulder blades.
It is recommended to set aside 20-30 minutes a day for stretching exercises for the muscles of the interscapular zone, and for general muscle tone of the body. Regular exercise will prevent muscle cramps and pain behind the shoulder blades.
It is necessary to periodically massage the shoulder-scapular zone, the collar zone.
Occasionally you can perform the following exercise: place a small (tennis) ball on the floor, lie on it with your upper back and "roll" the ball, adding it vertically and between the paddles.

If the symptom of back pain under the shoulder blades is accompanied by cough, subfebrile temperature, pain intensifies when breathing, cough reflex, it is necessary to consult a doctor, to be examined in order to exclude diseases of the broncho-pulmonary system.