Pain under the shoulder blades

24 April 2022

pain under the left shoulder blade from behind

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

Pain symptoms can vary in intensity and localization - under the right or left shoulder blade, and sometimes limit a person’s motor activity. Pain under the scapula is most often associated with skeletal muscle spasm due to tension or with the reflection of pain arising from internal organs located in the scapular area.

Causes of pain under the shoulder blades

Regio scapularis - this is the name of the scapular area, bounded by a line - in the upper part of the body between the unpaired spinous process of the most prominent cervical vertebra VII and the collarbone, below - a medial -vertical line along the lower edge of the shoulder blade, as wellline from the armpit to the edge of the deltoid muscle. The diagnosis of pain under the scapula depends on the nature of the symptoms, its localization and the accompanying clinical signs, because the scapular area itself can only be painful in the event of an injury - a blow, a bruise.

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

LSRS - scapulocostal, scapular -costal syndrome or scapular -lifting muscle syndrome. If the muscle attached to the transverse process of the upper vertebrae of the neck is hypothermic, injured, inflamed or overly stressed, it is unable to perform its function normally - to tilt the neck and raise the scapula. Symptomatically, PRS - rib syndrome manifests itself in the form of pain, sometimes strong pain in the shoulder girdle, at the top of the shoulder blades and below. Often the sensation of pain spreads 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 acute, radiating up to the neck. In addition, the hallmark of the LS is a crisp sound when moving the shoulders and arms. Dynamic constant loads, as well as static stress, can create conditions where pain under the shoulder blades becomes constant, exacerbated by exposure to cold, drafts.
YABZH - gastric ulcer, as the most common cause of pain under the shoulder blades. Symptoms begin with a dull ache, pain that increases or decreases after taking the drug, vomiting. Pain is directly related to food intake, seasonal and most often radiates to the left - from the epigastrium to the left shoulder blade, to the chest and back. Symptoms of pain in gastric ulcers are 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 pain or often called psychosomatic pain is also included in the causes of pain under the scapula. Such a sensation is similar to the signs of angina pectoris, cardiological pain, as it causes a squeezing, burning sensation in the chest, which intensifies and radiates to the arms, under the shoulder blades, under the collarbone, more often to the left, to the heart area. The symptoms of pain can be intense and painful, its nature is unlimited. The main distinguishing sign of vegetative pain is the lack of effect after taking cardio medications - they do not relieve pain or stress. As a rule, relaxants and sedatives help with vegetative-vascular attacks.
Osteochondrosis of the thoracic or cervical spine can cause dull, prolonged, painful unilateral pain, which most often begins at the back of the head and spreads down the shoulder blades. Pain can occur in the early morning, intensified by static load (sedentary work), with sudden body movements. The condition is accompanied by radiating pain in the arms, under the shoulder blades, limb paresthesia, dizziness, visual disturbances. Symptoms are removed with a warming massage, ointment, warm bath.
Intercostal neuralgia is the most common cause of pain below the shoulder blades. Symptoms develop rapidly and are expressed in paroxysmal, side pain, surrounding intense nature. The sensation of pain spreads along the intercostal muscles, space and intensifies with deep breathing, coughing, sneezing, with prolonged physical exertion, walking. In the clinical sense, intercostal syndrome is indicated by palpation of the innervating area, which is not typical for cardiac pathology, osteochondrosis. Due to the constant muscle tension, the pain can spread lower - to the lower back, but is most often indicated by a stabbing, burning sensation under the shoulder blades.
An attack of angina pectoris begins with pain in the middle part 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, a vasodilator, which can serve as a signal of myocardial infarction. In addition, there are differences between the causes of angina pectoris: Severe, acute pain in the left side of the chest, below the shoulder blades, is characteristic of angina pectoris when a person experiences physical or psycho-emotional stress. Interestingly, aching pain may indicate an angina attack at rest, when there is no external cause provoking the pain symptoms.
The cause of pain under the shoulder blades can be attributed to a severe and life -threatening condition - the penetration of a stomach ulcer, which is accompanied by strong and sharp pain radiating under the collarbone and under one of the shoulder blades. The hallmark of perforation is vomiting, the posture of the patient is gripped hands, knees to the abdomen (position of the fetus). These symptoms require immediate medical attention, as well as cardialgia.
Yuert's symptoms or signs of inflammatory processes in the pericardium, accompanied by the release of exudates. The main manifestations of exudative pericarditis are retrosternal pain, shortness of breath, high body temperature, and fever. The pain increases due to the accumulation of effusions and stretching of the pericardium when coughing, changing body posture, the sensation can be painful, but often they "shoot" to the neck, below the left shoulder blade. The severity of the inflammatory process often leads to a clinical picture of "acute abdomen".
Aortic dissection - surgery of the wall (aneurysm) of the aorta. A life -threatening condition, accompanied by severe pain in the back, between the shoulder blades or by a shift under one of them. Often, the pain shifts to the left, radiating to the arm and under the left shoulder blade, spreading along the dissecting aorta. The most dangerous consequences of these symptoms can be stroke (if carotid artery blood flow is disrupted), heart attack (if coronary artery blood flow is disrupted), mesenteric thrombosis, leg paralysis (if iliac artery blood flow is disrupted), spinal cord injury (if flowdisturbed vertebral artery blood).
Herniated disc of the thoracic spine. The disease is rarely diagnosed, as the thoracic region is relatively stable in this sense. Persistent, aching and increasing pain in the area of violation and pathological focus gradually becomes intense, often similar to the symptoms of diseases of the bronco-pulmonary or cardiovascular system. The main hallmark of a hernia can be muscle tension between the shoulder blades and visible curvature of the spine. The diagnosis is confirmed by X-ray examination, MRI.
GSD is cholelithiasis, colic can also manifest itself as paroxysmal, unbearable pain, radiating to the right, under the shoulder blades and upwards.
The cause of pain under the shoulder blades can be due to a respiratory disease - pneumonia or pleurisy. With pneumonia, the pain is localized according to the pathological focus in the tissue, if the process develops in the back, there is pain in the back, between the shoulder blades or below it. Inflammation of the pleura is also accompanied by pain of the sutures between the shoulder blades, often under one of them. The pain is exacerbated by the reflex of coughing, breathing.
Myositis is an inflammatory process in the muscles due to hypothermia, SARS, or too much energy, less often caused by bruising. Pain occurs suddenly in the acute course, or develops gradually, has an interesting character, pain in chronic inflammation. Pain symptoms are associated with movement, physical activity, changes in posture, and inclination.

Symptoms of pain under the shoulder blades

The 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 scheme for collecting anamnesis, examinations, tests and examinations, however, there are often cases when the symptoms of pain are "masked" and do not indicate the real cause. That is why the patient is required to describe as accurately as possible the nature of the pain, all the conditions in which it occurs. In addition, chronic pain, to which a person has become "accustomed", often lubricates the diagnostic picture, as a result of which time is lost and the therapeutic effect is more difficult to achieve.

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

Drawing, persistent pain in the back with irradiation under the shoulder blades, which does not subside within 2-3 days.
Pain under the scapula with static pressure (sedentary work) in people over 50 years of age.
Pain radiating under the shoulder blades, increasing at night or in a horizontal position.
I'm sick with a fever.
The pain is accompanied by numbness of the arms, shoulders.
The pain causes pressure, burning, starting in the middle of the chest.
Pain that does not go away with heart medication, sedatives.
Belt pain creeps under the shoulder blades.
Sharp 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, extending below the left shoulder blade. The pain starts in the morning and is exacerbated by movement.
Sharp and severe pain under the shoulder blades.
Dull pain under the shoulder blades, aggravated by raised hands.
Drawing, aching pain under the scapula, spreading to the waist.
Pain under the left scapula and a feeling of narrowing in the chest.
Pain under the shoulder blades in the form of localized areas, burning.
The pain gets worse when the cough comes.
Pain under the shoulder blades is replaced by a burning sensation, numbness of the arm.
Severe pain that disappears after vomiting.

Despite the variety of reasons that give rise to symptoms of pain under the shoulder blades, there are differential signs - danger signals that allow experienced doctors to exclude relatively benign diseases associated with dorsalgia. Worrying symptoms that may accompany pain in the shoulder blades are the following signs:

Hyperthermia - 38-40 degrees.
Spontaneous, enlarged pain and provoking an "acute abdominal" condition.
Shortness of breath, cyanosis of the skin.
Swollen hands.
Pain that does not subside during rest.
vomiting.
Decreased blood pressure. nadi.
Fainted.

Back pain under the shoulder blades

Pain in the back, in the scapular area can be associated with many diseases, but often it is caused by deformation of the spinal column, especially if accompanied by numbness in the legs, tingling in the fingers.

In addition, back pain below the shoulder blades is provoked 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.
Curvature of the anterior spine - scoliosis.
Angina - exercise or rest.
Protrusion (degeneration) of the thoracic spinal disc without rupture.
YABZH - peptic ulcer of the stomach.
Cholecystitis.
Hepatic colic with gallbladder equivalent dyskinesia.
Dry pleurisy.
Pneumonia.
Inflammation of interscapular muscles, tendons, supraspinous ligaments.

Pain under the shoulder blade on the left

Symptoms of pain below the left shoulder blade may be associated with diseases such as:

Periodic pain under the left shoulder blade may indicate a developing stomach ulcer. The pain increases rapidly, accompanied by nausea, and then vomiting, symptoms associated with food intake or its absence - hunger pangs. 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 crises are also characterized by left side pain, massaging under cardiopathy. Pain under the shoulder blades on the left side, pulling, aching, often causing fear, do not stop with nitroglycerin and other heart medications - this is a typical sign of a psychogenic state.
Myocardial infarction most often has clinically expressed 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 of the limbs, nausea.
Angina pectoris - an attack of pain can develop with tension, stress (angina pectoris) or as a chronic exacerbation (rest angina pectoris).
Intercostal neuralgia is accompanied by acute pain, often of the pelvis, radiating to the right or left below the shoulder blades. Symptoms may increase with changes in body posture, physical activity. The pain is relieved by warming the body, relaxing the muscles.
Osteochondrosis, both cervical and thoracic, is also one of the causes of pain under the left shoulder blade. Symptoms of pain are accompanied by dizziness, nausea, numbness of the hands or one hand.
Ulcer perforation is an acute condition, expressed in very severe pain that radiates to the area of the collarbone, below the shoulder blade. In addition to severe pain, patients are characterized by posture with knees pressed to the abdomen, cold sweats, cyanosis, decreased blood pressure, and pulse.

Pain under the shoulder blade on the right side

Symptoms of pain that manifest itself below the right shoulder blade are associated with diseases such as:

Biliary colic with spasm of the bladder, ducts as a result of clogging with stones. The pain is sharp, cutting, localized under the right rib and radiating backwards under the shoulder blades.
Pain under the shoulder blade on the right side can be triggered by a diaphragmatic abscess. These symptoms are very acute, aggravated by inhalation, though not deep, most often radiating to the right.
Pyelonephritis in its acute form begins with pain in the lumbar region, which then spreads higher and is given under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination, high body temperature.
Myofascial syndrome is also a common cause of pain under the scapula on the right side. This is a chronic muscle pain associated with irritation of certain trigger points.
Among the factors that trigger the symptoms 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 severe pain, soreness, burning and numbness. Herpes is a typical rash, itching, and muscle pain that radiates under the shoulder blades.
Osteochondrosis is one of the most common causes of pain that radiates under the shoulder blades, including the right one.
Right side pneumonia. Pain with pneumonia most often manifests itself in the acute stage, there may be a fever, a febrile state.

If pain gives under the shoulder blades

Any pain symptom that "eliminates" is called radiation. The impulse of visceral pain can be so strong that the irritation of the main nerve branch is transmitted rapidly along the chain to the last branch, that is, away from the original source. Pain gives under the scapula most often from organs affected by inflammation and can be triggered by the following reasons:

Increased pressure in the intestine with inflammation, ulcerative processes. The postbulbar portion of the duodenum with the ulcer radiates to the right below the scapula.
Biliary colic (where the bile, liver).
Acute pain gives under the left shoulder blade and during an attack of angina pectoris, when there is a sensation of pressure, compression.
Pericarditis can also present with referred pain under the shoulder blades.
Aortic dissection (aneurysm) is manifested by severe chest pain radiating to the neck, left side, shoulder, below the shoulder blades.
Pneumothorax (spontaneous) - acute pain in the chest with reflection under the scapula, in the scapular area.
Severity of pancreatitis.
Kidney colic.
acute musculoskeletal dorsalgia.
Myocardial infarction.
Osteochondrosis of the cervical spine.

The pain referred may be temporary, but may also signal that an acute condition is developing that requires immediate medical attention. If the pain gives under the shoulder blades and is not stopped by antispasmodics, cardiac drugs, you should see a doctor who will conduct an examination, differential diagnosis and prescribe adequate treatment.

Pain under the shoulder blades when inhaling

Symptoms of pain under the scapula, aggravated by inhalation, are characteristic of the following pathological signals:

Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain can increase with bending, movement, subsiding in a horizontal or lateral position. Fluid accumulated 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 indicated by weakness, retrosternal pain, which becomes more intense when inhaled.
Pain below the shoulder blades with deep breathing may indicate intercostal neuralgia, which manifests itself in the form of girdle pain that seems to tighten the chest.
Gallbladder disease, cramps, colic, may also be accompanied by symptoms of pain associated with inhalation.
Renal colic (pyelonephritis, renal abscess) may also be accompanied by pain in the hypochondrium, so strong that it spreads throughout the epigastric region, giving under the scapula and increasing with inspiration.

Severe pain under the shoulder blades

Severe severe pain under the scapula - left or right - is a reason to seek medical help, often the symptoms of such pain cannot be stopped on their own, and it may also indicate a life -threatening condition. Severe pain below the shoulder blades can be triggered by diseases such as:

A stabbing, sharp, shooting pain, which increases during inspiration, reflected in the shoulder, may be a sign of spontaneous pneumothorax. Additional clinical symptoms of pneumothorax are rapid shortness of breath, tachycardia, decrease in blood pressure, slow pulse, increase (compensation) in the veins in the neck.
Severe pain, which radiates below the scapula and is accompanied by arterial hypertension, indicates exacerbation of osteochondrosis of the thoracic spine. Simultaneous back pain below the scapula, headache and jumps in blood pressure are obvious symptoms of pinched nerve endings in the cervical or thoracic region. Pain can increase when turning the body, shooting when bending or moving, and is not stopped by heart medication, sedatives.
Severe pain below the shoulder blades may be associated with the penetration of ulcers of the upper abdomen. 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 sweats, facial cyanosis, characteristic posture - the knee is pulled to the chest.
Hepatic (biliary) colic is also indicated by severe pain, radiating to the right, under the shoulder blades, in the neck and even in the right eye area. Pain symptoms are associated with blockage of the bile ducts after eating fried and fatty foods.
The purulent process in the area between the diaphragm and the organ located below, subdiaaphragmatic abscess is an acute condition that requires immediate medical attention. Bacterial infections that develop in this form can trigger general intoxication, sepsis. In fact, this is purulent peritonitis, limited by the diaphragm, indicated by severe pain in the hypochondrium, radiating to the right - shoulder, below the shoulder blade. Also typical hyperthermia up to 40 degrees, fever, nausea.

Strong radiating pain symptoms are not recommended to last for more than an hour, if it can not be stopped in any way, you need to call emergency help.

Pain in the back of 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 symptoms, considering them temporary, temporary. Improper determination of the cause, the factor that gives rise to such pain, can lead to the development of chronic diseases that are difficult to treat.

Persistent and persistent pain between the shoulder blades, below it, is most often caused by muscle tension, which in turn is explained by professional specifics - sedentary work in the office, at a sewing machine, driving a car, and so on. Usually, back pain below the shoulder blade is not associated with life -threatening pathology and also with dystrophic changes in the spine, because the thoracic region is not mobile, it is relatively stable and stable. Often, violations, changes, less frequent inflammation, related to the muscular system of the interscapular area, ligaments and tendons can also be stretched.

This type of pain, which is related to the muscles, is characterized by a feeling of heaviness, tension, which quickly passes with active movement (exercise), massage or warming up.

Pain, caused by damage, stretching of tendons, is felt differently, it causes pain under the shoulder blades, often the symptoms of pain are reflected in the heart area. Also, a person complains of numbness of the hands, a tingling sensation, "creeping creep". It is not possible to neutralize such pain with heart medication, but you can get rid of it and do it easily:

Change body position periodically, preferably every half hour. If the work is not active, you need to get up, take a walk, make circular movements with your hands, shoulders, bring them together and spread your shoulder blades.
It is advisable to spend 20-30 minutes daily for stretching exercises for the muscles of the interscapular zone, and for the general muscle tone of the body. Regular exercise will help prevent muscle cramps and pain in the back of the shoulder blades.
It is necessary to periodically massage the shoulder-scapular zone, the collar zone.
Periodically, you can do the following exercises: place a small ball (tennis) on the floor, lie on it with your upper back and "roll" on the ball, send it vertically and between the shoulder blades.

If symptoms of pain from the back below the shoulder blades are accompanied by cough, subfebrile temperature, increased pain with breathing, cough reflex, you should see a doctor, checked to exclude diseases of the bronco-pulmonary system.