pain under the shoulder blade

24 April 2022

Pain under left shoulder blade from behind

Pain under the shoulder blade 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 pain symptom can be different 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 spasms of skeletal muscles due to tension or with a reflection of pain emanating from the internal organs in the scapula region.

Causes of pain under the shoulder blades

Regio scapularis - this is the name of the scapular region delimited by lines - in the upper part of the body between the unpaired spinous process of the most prominent VII cervical vertebra and the clavicles, below - a medial-vertical line along the lower edge of the scapulae, as well as a line from the armpits toto the edge of the deltoid. The diagnosis of pain under the shoulder blade depends on the nature of the symptom, its localization and the accompanying clinical signs, since the shoulder blade region itself can hurt only in the event of an injury - a blow, a bruise.

Causes of pain under the shoulder blades can be the following:

LSRS - Scapulocostal, scapular-costal syndrome, or syndrome of the muscle that elevates the scapula. When the muscle that attaches to the transverse processes of the upper cervical vertebrae is hypothermic, injured, inflamed, or overworked, it cannot perform its function normally - tilt the neck and elevate the shoulder blade. Symptomatically, PRS scapula rib syndrome manifests itself in the form of aching, sometimes intense pain in the shoulder girdle, at the tip of the scapula and below. Often the feeling of pain spreads to the shoulder, the lateral part of the sternum. The most painful point is where the muscle attaches. When you press it, the pain becomes acute and radiates to the throat. In addition, a characteristic sign of LS is the crunch when moving the shoulders and arms. Dynamic constant loads, as well as static stress, can lead to a condition when the pain under the shoulder blade becomes constant and is aggravated by cold and drafts.
YABZH - gastric ulcer, as the most common cause of referred pain under the shoulder blades. The symptom begins with dull, aching pains that increase or decrease after taking medication, vomiting. 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 pain symptom of gastric ulcer is usually divided into hunger, late or early pain. In addition, bedsores are usually accompanied by nausea at the peak of pain, vomiting in 75-80% of cases, and heartburn.
Also vegetative or as they are often referred to as psychosomatic pain are among the causes of pain under the shoulder blade. Such sensations resemble signs of angina pectoris, cardiological pains, as they cause a feeling of squeezing and burning in the chest, which intensifies and radiates to the arm, under the shoulder blade, under the collarbone, more often to the left region of the heart. The pain symptom can be both intense and painful, and of an indefinite nature. The main distinguishing feature for vegetative pain is the lack of effect after taking cardio drugs - they do not relieve pain or pressure. As a rule, relaxation and sedatives help with a vegetative-vascular attack.
Osteochondrosis of the thoracic or cervical spine can cause unilateral, dull, persistent, aching pain that usually begins at the back of the head and spreads to below the shoulder blade. Pain can appear in the early hours of the morning, intensify with static loads (sedentary work) and with sudden movements of the body. This condition is accompanied by referred pain in the arm, under the shoulder blade, paresthesia of the limbs, dizziness, blurred vision. 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 is expressed in paroxysmal, unilateral pains surrounding intense nature. The sensation of pain spreads along the intercostal muscles, bursts 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 area, which is not typical for heart diseases, osteochondrosis. Due to the constant muscle tension, the pain can spread down - to the lower back, but most often it is manifested by stabbing sensations, burning under the shoulder blade.
An attack of angina pectoris begins with pain in the middle of the chest (retrosternal space), which quickly spreads, spreads to the left and gives way 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 of myocardial infarction. In addition, a distinction is made between the causes of angina: severe, acute pain in the left chest, under the shoulder blade, is characteristic of angina when a person is subjected to physical or psychoemotional stress. Drawing, aching pain may indicate a resting attack of angina if there are no external, provocative causes of the pain symptom.
The causes of pain under the shoulder blade can be associated with a serious, life-threatening condition - perforation of a stomach ulcer, which is accompanied by strong, sharp pain radiating under the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, the patient's posture is folded hands, knees to the stomach (fetal position). This symptom requires immediate medical attention, as well as cardiac pain.
Yuert's symptom or a sign of an inflammatory process in the pericardium, accompanied by the release of exudate. The main manifestations of exudative pericarditis are retrosternal pain, shortness of breath, high body temperature and fever. The pain is aggravated by the accumulation of effusions and stretching of the pericardium when coughing, the change in posture, the sensations can be painful, but most often they "shoot" in the nape under the left shoulder blade. Exacerbation of the inflammatory process often causes the clinical picture "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 displacement under one of them. Most often, the pain shifts to the left, radiating up the arm and under the left shoulder blade, and spreading along the dissecting aorta. The most dangerous consequences of this symptom can be a stroke (if the blood flow in the carotid arteries is disturbed), myocardial infarction (if the blood flow in the coronary arteries is disturbed), mesenteric thrombosis, paralysis of the legs (if the blood flow disorder of the iliac artery), spinal cord injury (if theblood flow in the vertebral arteries is disturbed).
Herniated disc in the thoracic spine. The disease is rarely diagnosed since the thoracic region is quite stable in this sense. Constant, aching and growing pains in the area of injury and the pathological focus gradually become more intense, often similar to the symptoms of diseases of the bronchopulmonary or cardiovascular system. The main features of a hernia can be muscle tension between the shoulder blades and a visible curvature of the spine. The diagnosis is confirmed by X-ray studies, MRI.
GSD is cholelithiasis, colic can also manifest itself as 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 pneumonia, the pain is localized in the tissues according to the pathological focus, if the process develops in the posterior sections, pain appears in the back, between the shoulder blades or below. Inflammation of the pleura is also accompanied by shooting pains between the shoulder blades, often under one of them. The pain is aggravated by cough reflex, breathing.
Myositis is an inflammatory process in the muscles as a result of hypothermia, SARS or overexertion, less often due to bruises. Pain occurs suddenly in the acute course or develops gradually, with chronic inflammation it has a pulling, aching character. The pain symptom is associated with movements, physical activity, changes in posture and inclinations.

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 unified standard algorithm for differential diagnosis. Each medical specialty has its own schemes for collecting anamnesis, examination, tests and examinations. However, there are often cases when the pain symptom is "masked" and does not indicate the true cause. Therefore, the patient must describe as accurately as possible the nature of the pain, all the circumstances under which it occurs. In addition, chronic pain lubricates, to which a person has "accustomed" often 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 shoulder blade require immediate medical attention?

Drawing, constant pain in the back with radiation under the shoulder blade, which does not go away within 2-3 days.
Pain under the shoulder blade with static loads (sedentary work) in people over 50 years of age.
Pain that radiates under the shoulder blades and increases at night or in a horizontal position.
pain with fever.
Pain accompanied by numbness in arm, shoulder.
Tender pain, burning, beginning in the middle of the chest.
Pain that is not relieved by heart medication or sedatives.
Girdle pain radiating under the shoulder blade.
Sharp, severe pains with vomiting.

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

Sharp pain in middle of back, extending below left shoulder blade. The pains started in the morning and got worse with movement.
Sharp, intense pain under the shoulder blades.
Dull pain under shoulder blades, aggravated by raising arms.
Drawing, aching pain under shoulder blade, spreading to waist.
Pain under left shoulder blade and chest tightness.
Pain under the shoulder blades in the form of a localized area, burning.
The pain gets worse when the cough occurs.
Pain under the shoulder blade is replaced by a burning sensation, numbness in the arm.
Severe pain that goes away after vomiting.

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

Hyperthermia - 38-40 degrees.
Spontaneous pains that grow and provoke the condition of "acute abdomen".
shortness of breath, cyanosis of the skin.
swelling of the hands.
Pain that does not go away with rest.
To throw up.
drop in blood pressure. Pulse.
fainting.

Back pain under the shoulder blades

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

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

Curvature of the spine - kyphosis.
Herniated disc in the chest area.
Lateral curvature of the spine - kyphoscoliosis.
Coronary heart disease.
shoulder periarthritis.
intercostal neuralgia.
Frontal curvature of the spine - scoliosis.
Angina - exertion or rest.
Bulging (degeneration) of the intervertebral disc of the thoracic spine without rupture.
YABZH - gastric ulcer.
cholecystitis.
Hepatic colic with concomitant dyskinesia of the gallbladder.
Dry pleurisy.
Lung infection.
Inflammation of the interscapular muscles, tendons, supraspinous ligaments.

Pain under the shoulder blade on the left

Symptoms of pain under the left shoulder blade can accompany such diseases:

Periodic pain under the left shoulder blade may indicate a developing peptic ulcer. The pain increases rapidly, is accompanied by nausea, and then vomiting, the symptom is associated with food intake or its lack - hungry pains. The pain begins in the epigastrium and spreads sideways - radiating to the right or left, most often under the left chest and under the left shoulder blade.
Vegetative crises are also characterized by left-sided pain massaging under cardiopathy. Pain under the left shoulder blade, pulling, aching, often causing feelings of anxiety, not stopping nitroglycerin and other heart drugs - this is a typical sign of psychogenic conditions.
Most often, myocardial infarction has clinically pronounced symptoms - burning sensation 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 - 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 belts, radiating to the right or left under the shoulder blade. The symptom may worsen with a change in posture and 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 provoke pain under the left shoulder blade. The pain symptom is accompanied by dizziness, nausea, numbness of the hands or one hand.
Ulcer perforation is an acute condition characterized by very severe pain radiating to the area of the clavicle below the shoulder blade. In addition to severe pain, the patient is characterized by a posture with his knees pressed to his stomach, cold sweat, cyanosis, a drop in blood pressure and a pulse.

Pain under the shoulder blade on the right

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

Biliary colic with spasm of the bladder, ducts from obstruction with stones. The pain is sharp, cutting, localized under the right rib and radiating backwards under 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, radiating to the right most often.
Pyelonephritis in acute form begins with pain in the lumbar region, which later spreads higher and appears under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination and increased body temperature.
Myofascial syndrome is also the cause that produces pain under the right shoulder blade. This is chronic muscle pain associated with irritation of certain trigger points.
Among the factors provoking a pain symptom under the right shoulder blade, sometimes herpes is also found - shingles. This is a viral disease that is not considered life-threatening, but causes very severe, unbearable pain, burning, and numbness. Herpes is typical of a rash, itching and muscle pain radiating under the shoulder blade.
Osteochondrosis is one of the reasons that often provokes radiating pain under the shoulder blades, including the right one.
Right-sided pneumonia. Pain with pneumonia most often manifests itself in the acute stage, there may be fever, a febrile condition.

When the pain under the shoulder blade gives way

Any pain symptom that "tells" is called radiation. The impulse of visceral pain can be so intense that the irritation of the primary nerve branch is transmitted quickly along the chain to the terminal branch, that is, far from the original source. The pain below theScapula most often starts from the organ affected by the inflammation and can be triggered by such reasons:

Increased pressure in the intestines with inflammation, ulcer 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 feelings of pressure and compression.
Pericarditis can also present with radiating pain under the shoulder blades.
An aortic dissection (aneurysm) is characterized by severe chest pain that radiates to the neck, left side, shoulder, and under the shoulder blade.
Pneumothorax (spontaneous) - acute chest pain with a reflection under the shoulder blade in the area of the shoulder blade.
worsening of pancreatitis.
Renal colic.
Acute musculoskeletal dorsalgia.
Heart attack.
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 under the shoulder blade subsides and is not stopped by antispasmodics or heart drugs, you should consult a doctor who will conduct an examination, differential diagnosis and appropriate treatment.

Pain under the shoulder blades when inhaling

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

Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain may increase when bending, moving, 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 inhaled.
Pericarditis is an inflammatory process in the pericardium, the disease is manifested by weakness, retrosternal pain, which intensifies with inhalation.
Pain under the shoulder blades with a deep breath may indicate intercostal neuralgia, which manifests itself in the form of belt pain that seems to tighten the chest.
Diseases of the gallbladder, 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 on inspiration.

Severe pain under the shoulder blade

Severe severe pain under the shoulder blade - left or right - is a reason to seek medical help, 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:

A sharp, stabbing pain that increases during inspiration and is reflected in the shoulder can be a sign of spontaneous pneumothorax. Other clinical symptoms of pneumothorax are rapidly developing shortness of breath, tachycardia, drop in blood pressure, slow pulse, a (compensatory) increase in the veins in the neck.
Severe pain radiating under the shoulder blade and accompanied by arterial hypertension indicates an exacerbation of osteochondrosis of the thoracic spine. Simultaneous back pain under the shoulder blade, headache and erratic blood pressure are clear symptoms of pinched nerve endings in the neck or chest. The pain can increase when turning the body, shooting when bending or moving, and is not stopped by heart drugs, sedatives.
Severe pain under the shoulder blade can be associated with perforation of the epigastric ulcer. If the perforation progresses rapidly, the pain increases literally every minute, the general clinical picture of the ulcer is typical - acute pain during radiation, vomiting, cold sweat, cyanosis of the face, characteristic posture - knees pulled to the chest.
Hepatic (biliary) colic also manifests itself in severe pain that radiates to the right, under the shoulder blade, to the neck and even to the area around the right eye. The pain symptom is associated with obstruction of the bile ducts after eating fried, fatty foods.
A purulent process in the area between the diaphragm and the underlying organs, the subdiaphragmatic abscess, is an acute condition that requires immediate medical attention. A developing bacterial infection in this form can provoke general intoxication, sepsis. In fact, we are talking about purulent peritonitis, limited by the diaphragm and 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.

Holding a strong, radiating pain symptom for more than an hour is not recommended. If it cannot be stopped by available means, you must call 911.

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, since it is transient and transient. Untimely determination of the cause, the factor that provokes such pain, can lead to the development of chronic, difficult-to-treat diseases.

Persistent, persistent pain between the shoulder blades below is most often caused by muscle tension, which, in turn, is explained by occupational peculiarities - sedentary work in the office, at 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 in theSpine connected, as the thoracic region is not mobile, it is quite stable and stable. Most often, injuries, changes, less often inflammation relate to the muscles of the interscapular region, ligaments and tendons can also be stretched.

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

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

Change the position of the body regularly, preferably every half hour. If the work is seated, you need to get up, walk around, make circular movements with your hands and shoulders, bring your shoulder blades together and spread them.
It is advisable to spend 20-30 minutes a day on stretching exercises for the muscles of the interscapular zone and for the general muscle tone of the body. Regular exercise prevents muscle spasms and pain behind the shoulder blades.
It is necessary to regularly massage the shoulder-shoulder zone, the collar zone.
Periodically, you can do 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 pain symptom from behind under the shoulder blades is accompanied by cough, subfebrile temperature, pain when breathing, cough reflex, you should consult a doctor and undergo an examination to exclude diseases of the bronchopulmonary system.