Pain under the shoulder blade

24 April 2022

pain under the left shoulder blade of the back

Pain under the scapula is a clinical sign of many pathological conditions, which can 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 limit the motor activity of a person. Pain under the shoulder blade is most often associated with spasms of skeletal muscles due to tension or reflection of pain emanating from 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 unpaired spinous process of the seventh most protruding cervical vertebra and the clavicles, below - a linemid-vertical along the lower edge of the shoulder blades, as well as a line from the armpits to the edge of the deltoid muscle. 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 hurt only with injury - a blow, a bruise.

The causes of pain under the shoulder blades can be as follows:

LSRS - scapulocostal, scapulocostal syndrome or syndrome of the muscle that lifts the scapula. If the muscle that attaches to the transverse processes of the upper vertebrae of the neck is hypothermic, injured, inflamed or overworked, it is not able to perform its function normally - tilting the neck and lifting the shoulder blade. Symptomatically, PRS - scapular rib syndrome manifests itself in the form of aching, sometimes severe pains in the shoulder girdle, at the top of the scapula and below. Often the pain sensation spreads to the shoulder, the lateral part of the sternum. The most painful point is the attachment point of the muscle, if you press on it, the pain becomes sharp, radiating to the neck. Also, a characteristic sign of LS is the sound of a crunch when moving the shoulders and arms. Dynamic constant loads, as well as static stress, can create a condition in which the pain under the shoulder blade becomes constant, aggravated by exposure to cold, drafts.
YABZH - gastric ulcer, the most common cause of radiating pain under the shoulder blades. The symptom begins with dull aching pains that increase or decrease after taking medication, 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, the bedsore is usually accompanied by nausea at the height of the 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. Such sensations are similar to signs of angina pectoris, heart pain, as they cause a pinching, burning sensation in the chest, which intensifies and radiates to the arm, under the shoulder blade, under the collarbone, moreoften to the left, to the region of the heart. The symptom of pain can be both intense and aching, indefinite in nature. The main differential sign of vegetative pain is the lack of effect after taking cardio drugs - they do not relieve pain or pressure. As a rule, relaxants and sedatives help with a vegetative-vascular attack.
Osteochondrosis of the thoracic or cervical spine can cause dull, prolonged, aching one-sided pain, which most often begins in the back of the head and spreads under the shoulder blade. The pain can occur early in the morning, intensify with a static load (sedentary work), with sudden movements of the body. This condition is accompanied by radiating pain in the arm, under the scapula, limb paresthesia, dizziness, visual disturbances. The symptom is eliminated with warming massages, ointments, a warm bath.
Intercostal neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and results in paroxysmal, one-sided pain, encircling an intense nature. The pain sensation spreads along the intercostal muscles, becomes more spaced and intensifies with deep breathing, coughing, sneezing, with prolonged physical exertion, walking. In the clinical sense, the intercostal syndrome is manifested by palpation of the innervating zone, which is not typical for heart pathologies, osteochondrosis. Due to constant muscle tension, the pain can spread lower - in the lower back, but most often manifests itself as stabbing, burning sensations under the shoulder blade.
An attack of angina begins with pain in the middle of the chest (retrosternal space), which quickly spreads, spreads to the left and gives under the collarbone, in the back, under the left shoulder blade. Pain is not always relieved by taking nitroglycerin, vasodilators, which can serve as a signal for myocardial infarction. In addition, there is a distinction between the causes of angina pectoris: intense, sharp pain in the left side of the chest, below the shoulder blade, is characteristic of angina pectoris when a person is subjected tophysical or psycho-emotional stress. Pulling, aching pain may indicate an angina attack at rest, when there are no external causes provoking the pain symptom.
The causes of pain under the shoulder blade can be associated with a serious and life-threatening condition - the perforation of a stomach ulcer, which is accompanied by strong, sharp pains radiating under the collarbone and under one of theshoulder blades. A characteristic sign of perforation is vomiting, the posture of the patient is hands together, knees against 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 the 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 painful in nature, but more often they "shoot"in the neck, under 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. Life-threatening condition, accompanied by severe pain in the back, between the shoulder blades or with displacement under one of them. Most often the pain moves to the left, radiates to the arm and under the left scapula, spreading along the dissecting aorta. The most dangerous consequences of this symptom can be a stroke (if the blood flow from the carotid arteries is disturbed), a heart attack (if the blood flow from the coronary arteries is disturbed), mesenteric thrombosis, paralysis of the legs (if the blood flow of the iliac arteries is disturbed), spinal cord injury (if the blood flow of the vertebral arteries is disturbed).
Disc herniation of the thoracic spine. The disease is rarely diagnosed, since the chest region is quite stable in this sense. Constant, aching and increasing pain in the affected area and the pathological focus gradually become intense, often similar to symptoms of diseases of the bronchopulmonary or cardiovascular systems. The main characteristic sign of a hernia can be muscle tension between the shoulder blades and a visible curvature of the spine. The diagnosis is confirmed by radiographic examinations, MRI.
GSD is cholelithiasis, colic can also be manifested by paroxysmal, unbearable pain, radiating to the right, under the scapula and above.
The causes of pain under the shoulder blade can be respiratory diseases - pneumonia or pleurisy. With inflammation of the lungs, the pain is localized depending on 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 stinging 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 resulting from hypothermia, SARS or overstrain, less often due to bruising. Pain arises suddenly in the acute course or develops gradually, has a pulling and aching character in chronic inflammation. The symptom of pain is associated with movement, physical activity, change in posture and tilts.

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 pain symptom is "hidden" 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, to which a person has become "accustomed", often lubricates the diagnostic picture, which wastes time and makes the therapeutic effect much more difficult to achieve.

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

Pulling, constant pain in the back with irradiation under the scapula, which does not subside in 2-3 days.
Pain under the shoulder blade with static stress (sedentary work) in people over 50 years old.
Pain that radiates under the shoulder blades, increasing at night or in a horizontal position.
Pain with fever.
Pain accompanied by numbness in the arm, shoulder.
Burning, pressing pain, starting in the middle of the chest.
Pain that is not relieved by heart medications, sedatives.
Waist pain radiating below shoulder blade.
Sharp and intense pain with vomiting.

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

Sharp pain in the middle of the back, extending under the left shoulder blade. The pain started in the morning and is worse with movement.
Sharp and intense pain under the shoulder blades.
Dull pain under the shoulder blades, worse on raising the arms.
Drawing, aching pain under the shoulder blade, extending to the waist.
Pain under the left shoulder blade and feeling of constriction in the chest.
Pain under the shoulder blades in the form of a localized, burning area.
The pain gets worse when the cough appears.
The pain under the shoulder blade is replaced by a burning sensation, numbness in the arm.
Severe pain that disappears after vomiting.

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

Hyperthermia - 38-40 degrees.
Spontaneous pain, increasing and causing the state of "acute abdomen".
Shortness of breath, cyanosis of the skin.
Swelling of the hands.
Pain that does not subside with rest.
Vomit.
Drop in blood pressure. impulse.
Fainting.

Back pain under the shoulder blades

Pain in the back, in the scapular region can be associated with many diseases, but most often it is due to a deformation of the spine, especially if 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.
Periarthritis of the shoulder.
Intercostal neuralgia.
Frontal curvature of the spine - scoliosis.
Angina - exertion or rest.
Protrusion (degeneration) of the disc of the thoracic spine 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 left shoulder blade

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

Periodic pain under the left shoulder blade may signal a developing stomach ulcer. The pain increases rapidly, is accompanied by nausea, then vomiting, the symptom is associated with food intake or its absence - hungry pains. The pain begins in the epigastrium and spreads laterally - to the right or left, most often radiating under the left breast and under the left shoulder blade.
Vegetative seizures are also characterized by pain 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 medications - this is a typical sign of psychogenic disorders.
Myocardial infarction most often has clinically pronounced symptoms - burning in the middle of the chest, pain radiating to the left side of the jaw, to the arm, under the left shoulder blade, numbness in 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 pains, often belting, radiating to the right or left under the scapula. The symptom may intensify with a change in body posture, physical activity. Pain is relieved by warming up, relaxing the muscles.
Osteochondrosis, both cervical and thoracic, is also one of the reasons that provoke 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 results in very severe pain radiating to the collarbone area, below the shoulder blade. In addition to severe pain, the patient is characterized by a posture with the knees pressed against the stomach, cold sweats, cyanosis, low blood pressure and pulse.

Pain under the right shoulder blade

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

Biliary colic with bladder spasm, ducts due to blockage with stones. The pain is sharp, cutting, localized under the right rib and radiating to the back under the scapula.
Pain under the right shoulder blade can be triggered by a diaphragmatic abscess. The symptom is very acute, aggravated by even shallow inhalation, most often radiates to the right.
Pyelonephritis in acute form begins with pain in the lumbar region, which then spreads higher and is transmitted under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination, elevated body temperature.
Myofascial syndrome is also the cause that causes pain under the shoulder blade on the right. These are chronic muscle pain associated with irritation of certain trigger points.
Among the factors that provoke a painful symptom under the right shoulder blade, sometimes also herpes - shingles is found. This is a viral disease that is not considered fatal, but 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 causes radiating pain under the shoulder blades, including the right.
Right side 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 gives under the shoulder blade

Any pain symptom that "shows up" is called radiation. The visceral pain impulse can be so intense that irritation from the primary nerve branch is quickly transmitted up the chain to the final branch, that is, away from the original source. Pain most often gives under the scapula of 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 gives under the left shoulder blade and during an attack of angina, when there are feelings of pressure, compression.
Pericarditis can also present with referred pain below the shoulder blades.
Aortic dissection (aneurysm) manifests as severe chest pain radiating to the neck, left side, shoulder, below the scapula.
Pneumothorax (spontaneous) - sharp pain in the chest with a reflection 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 may be transient, but may also signal that an acute condition is developing that requires immediate medical attention. If the pain gives way under the scapula and is not stopped by antispasmodics, heart medications, you need to consult a doctor who will conduct an examination, differential diagnosis and prescribe adequate treatment.

Pain under the shoulder blades when inhaling

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

Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain may increase with bending, movement, subside in a horizontal position or on the side. The accumulation of fluid in the pleural cavity causes swelling and pain under the shoulder blade when inhaling.
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 as girdle pain that seems to constrict the chest.
Gallbladder diseases, spasms, colic, can also be accompanied by a painful symptom related to 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 under the shoulder blade

Severe, severe pain under the shoulder blade - left or right - is a reason to see a doctor, often such a pain symptom cannot be stopped on its own, and it can also indicate life-threatening conditions. Severe pain under the shoulder blade can be triggered by such diseases:

Dagger, sharp, throbbing pain, which increases during inspiration, is reflected in the shoulder, can be a sign of spontaneous pneumothorax. Additional clinical symptoms of pneumothorax rapidly develop shortness of breath, tachycardia, drop in blood pressure, slow pulse, increase (compensatory) in the veins of the neck.
Severe pain, which radiates under the scapula and is accompanied by high blood pressure, indicates an exacerbation of osteochondrosis of the thoracic spine. Simultaneous back pain under the shoulder blade, headache and increased blood pressure are a clear symptom of pinching of nerve endings in the cervical or chest region. The pain may increase when rotating the body, shooting when bending or moving, and is not stopped by heart medications, sedatives.
Severe pain under 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 - sharp pain with radiation, vomiting, cold sweats, 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 symptom of pain is associated with blockage of the bile ducts after eating fried and fatty foods.
A purulent process in the area between the diaphragm and the organs below it, subdiaphragmatic abscess is an acute condition that requires immediate medical attention. A developing bacterial infection in this form can cause general intoxication, sepsis. In fact, it is a purulent peritonitis, limited by the diaphragm, manifested by severe pain in the hypochondrium, radiating to the right - the shoulder, under the scapula. 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 available means, you should call emergency help.

Pain behind the shoulder blades

The pain behind the shoulder blades, between them, is usually not intense, so the person does not pay attention to the symptom, considering it temporary, transient. Untimely determination of the cause, the factor that provokes such pain, can lead to the development of chronic diseases that are difficult to treat.

Persistent and persistent pain between the shoulder blades, under them, is most often caused by muscle tension, which, in turn, is explained by professional specifics - sedentary work in the office, at a sewing machine, drivinga car, etcUsually, back pain under the shoulder blades is not associated with life-threatening pathologies and even dystrophic changes in the spine, since the chest region is not mobile, it is quite stable and stable. Most often, violations, changes, less often inflammation, concern the muscular system of the interscapular region, ligaments and tendons can also be stretched.

Pain of this kind, 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 causes a feeling of pain under the shoulder blades, often the symptom of pain is reflected in the region of the heart. Also, a person complains of numbness in the hands, a tingling sensation, "crawling goosebumps". It is not possible to neutralize such pain with heart medication, 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, it is necessary to get up, walk around, make circular movements with the hands, shoulders, bring the shoulder blades together and apart.
It is advisable to devote 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" over the ball, passing it vertically and between the shoulder blades.

If a painful symptom of the back under the shoulder blades is accompanied by cough, subfebrile temperature, increased pain when breathing, cough reflex, you need to see a doctor, be examinedto exclude diseases of the bronchopulmonary system.