Pain under the shoulder blade

24 April 2022

pain under the blade of the left shoulder from the back

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

The pain symptom can vary in intensity and localization - under the blade of the right or left shoulder, and sometimes restrict a person's motor activity. Pain under the shoulder is most often associated with skeletal muscle spasms due to tension or with a 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 shoulder region, which is bordered by stripes - in the upper part of the body between the unpaired spinous process of the most prominent VII neck vertebra and the clavicle bones, below - a medial line-vertical along the lower edge of the shoulder blade, as well as a line from the armpits to the edge of the deltoid muscle. The diagnosis of pain under the scapula depends on the nature of the symptom, its localization and the accompanying clinical signs, as the scapular region itself can be damaged only in case of injury - a stroke, a bruise.

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

LSRS - scapulocostal syndrome, scapulo-costal or scapular muscle syndrome. If the muscle that adheres to the transverse processes of the upper neck vertebrae is hypothermic, injured, inflamed, or stressed, it is unable to perform its function normally - tilting the neck and lifting the scapula. Symptomatically, PRS - scapular-rib syndrome manifests itself in the form of painful pain, sometimes strong in the shoulder girdle, at the top of the shoulder blade and below it. Often the sensation of pain spreads to the shoulder, to the side of the sternum. The most painful point is the point of attachment of the muscle, if you press it, the pain becomes acute, radiating up to the neck. Moreover, a characteristic sign of LS is the sound of a crack when moving the shoulders and arms. Constant dynamic 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, current.
YABZH - gastric ulcer, as the most common cause of radiating pain under the shoulder blades. Symptoms begin with dull, aching pain that increases or decreases after taking the medication, vomiting. The pain is directly related to food intake, seasonality and most often radiates to the left - from the epigastrium to the blade of the left shoulder, chest and spine. The pain symptom in gastric 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.
Causes of shoulder pain include vegetative or, as it is often called, psychosomatic pain. Such sensations are similar to the signs of angina pectoris, cardiac pain, as they cause a feeling of tightness, burning in the chest, which intensifies and radiates to the arm, under the shoulder blade, under the clavicle, most often to the left, for him. heart region. The pain symptom can be strong and painful, of indefinite 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 in a vegetative-vascular attack.
Osteochondrosis of the thoracic spine or cervix can cause dull, elongated, and painful unilateral pain, which most often begins in the back of the head and spreads below the shoulder blade. The pain may appear in the early morning hours, intensify with static load (sedentary work), with sudden body movements. This condition is accompanied by radiating pain in the arm, under the shoulder blade, paresthesia of the limbs, dizziness, visual disturbances. Symptoms are removed with warm 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 with paroxysmal pain, unilateral, of intense surrounding nature. The sensation of pain spreads along the muscles between the ribs, spaces and is intensified by deep breathing, coughing, sneezing, with prolonged physical exertion, walking. In the clinical sense, intercostal syndrome is manifested by palpation of the innervation area, which is not typical for cardiac pathologies, osteochondrosis. Due to the constant tension of the muscles, the pain can spread below - in the lower back, but most often it is manifested by a sharp, burning sensation under the shoulder blade.
The attack of angina pectoris begins with pain in the middle of the chest (retrosternal space), which spreads rapidly, spreads to the left and gives under the clavicle, in the back, under the blade of the left shoulder. Pain is not always relieved by taking nitroglycerin, vasodilators, which can serve as a signal for myocardial infarction. In addition, there is a difference between the causes of angina pectoris: Severe, acute pain on 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. Attractive, painful pain may indicate an attack of angina at rest, when there are no external provocative causes for the pain symptoms.
Causes of pain under the shoulder blade can be associated with a serious, life-threatening condition - perforation of the stomach ulcer, which is accompanied by severe and sharp pain radiating under the clavicle and under one of the shoulder blades. Characteristic sign of perforation is vomiting, the patient's posture is tight with hands, knees on stomach (fetal position). This symptom requires immediate medical attention as well as cardiology.
Yuert 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 intensifies due to the accumulation of ejaculation and stretching of the pericardium during coughing, change of body posture, the sensations may be painful in nature, but most often they "shoot" in the neck, under the blade of the left shoulder. Worsening of the inflammatory process often causes the clinical appearance of "acute abdomen".
Aortic dissection - dissection of the aortic wall (aneurysm). 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 to the arm and under the blade of the left shoulder, spreading along the dissecting aorta. The most dangerous consequences of this symptom can be a stroke (if blood flow to the carotid arteries is disturbed), a heart attack (if blood flow to the coronary arteries is disturbed), mesenteric thrombosis, paralysis of the legs (ifblood flow to the iliac arteries is disturbed), spinal cord injury (if blood flow to the vertebral arteries is disturbed).
Thoracic spinal disc herniation. The disease is rarely diagnosed, as the chest region is quite stable in this sense. Persistent, painful, and increasing pain in the area of injury 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 may be muscle tension between the shoulder blades and a noticeable curvature of the spine. The diagnosis is confirmed by X-ray examinations, MRI.
GSD is a cholelithiasis, abdominal pain can also manifest as paroxysmal, excruciating pain, radiating to the right, below the shoulder blade and above.
Causes of pain below the shoulder blade can be due to respiratory diseases - pneumonia or pleurisy. With inflammation of the lungs, the pain is localized in accordance with the pathological focus on the tissue, if the process takes place in the posterior sections, there is pain in the back, between the edges of the shoulders or under them. Inflammation of the pleura is also associated with suturing pain between the shoulder blades, often under one of them. The pain is aggravated by the cough reflex, breathing.
Myositis is an inflammatory process in muscles as a result of hypothermia, SARS or hypertension, less commonly due to bruising. The pain appears suddenly in the acute course, or develops gradually, has an attractive character, hurts in chronic inflammation. The pain symptom is associated with movements, physical activity, change of posture, and tendencies.

Symptoms of pain below the shoulder blades

The symptoms of pain below the shoulder blades are so diverse that in clinical practice there is not yet a single standard algorithm for differential diagnosis. Each medical specialization has its own schemes for collecting anamnesis, examination, testing, and examinations, however, there are often times when the pain symptom is "masked" and does not indicate the true cause. This is why the patient is asked to describe as accurately as possible the nature of the pain, all the circumstances in which it appears. Moreover, chronic pain, with which a person is "accustomed", often lubricates the diagnostic appearance, as a result of which time is lost and the therapeutic effect is much more difficult to achieve.

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

Drawing, constant pain in the back with radiation under the shoulder blade, which does not go away within 2-3 days.
Pain under the scapula with static stress (sedentary work) in persons over 50 years old.
Pain radiating below the shoulder blades, rising at night or in a horizontal position.
Fever with fever.
Pain accompanied by numbness of the arm, shoulder.
Pain that causes pressure, burning, that starts in the middle of the chest.
Pain that is not relieved by heart medications, sedatives.
Belt pain radiating below the shoulder blade.
Severe and severe pain with vomiting.

Symptoms of pain below the shoulder blades are most commonly described as follows:

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

Despite the variety of causes that provoke a symptom of pain below the shoulder blades, there are differential signs - danger signals that allow an experienced physician to rule out relatively benign diseases associated with dorsalgia. The alarming symptoms that can accompany pain in the shoulder blades are the following signs:

Hyperthermia - 38-40 degrees.
Spontaneous pain, growing and provoking the condition of "acute abdomen".
Shortness of breath, skin cyanosis.
Swelling of the hands.
Pain that does not subside at rest.
Vomiting.
Drop in blood pressure. pulse.
Faint.

Back pain under the shoulder blades

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

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

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

Pain under the shoulder blade on the left

Symptoms of pain under the left shoulder may be associated with such diseases:

Periodic pain under the blade of the left shoulder may signal a developing stomach ulcer. The pain increases rapidly, is accompanied by nausea and then vomiting, the symptoms are accompanied by food intake or lack thereof - hungry pain. The pain starts in the epigastrium and spreads sideways - right or left, most often radiating under the left chest and under the blade of the left shoulder.
Vegetative crises are also characterized by pain in the left side, massages under cardiopathy. Pain under the left shoulder blade, traction, pain, often causing a feeling of fear, not stopping with nitroglycerin and other heart medications - this is a typical sign of psychogenic conditions.
Myocardial infarction most often has clinically pronounced symptoms - burning in the middle of the chest, radiating pain in the left side of the jaw, in the arm, under the blade of the left shoulder, numbness of the limb, mixed.
Angina pectoris - pain attacks can develop with tension, stress (angina pectoris) or as a worsening of a chronic form (angina pectoris rest).
Intercostal neuralgia is associated with acute pain, often in the groin, radiating to the right or left below the shoulder blade. Symptoms can be intensified by a change in body posture, physical activity. The pain is relieved by warming up, relaxing the muscles.
Both cervical and thoracic osteochondrosis is also one of the reasons that provokes pain under the blade of the left shoulder. The symptom of pain is accompanied by dizziness, nausea, numbness of the hands or one hand.
Ulcer perforation is an acute condition, which is expressed by very strong pain radiating to the clavicle area, below the shoulder blade. In addition to intense pain, the patient is characterized by a posture with knees pressed into the stomach, cold sweats, cyanosis, drop in blood pressure, and pulse.

Pain under the shoulder blade on the right

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

Biliary colic with bladder spasm, ducts due to stone blockage. The pain is sharp, sharp, localized below the right rib, and radiates to the spine below the shoulder blade.
Pain below the shoulder blade on the right can be caused by a diaphragmatic abscess. The symptom is very acute, aggravated by inhalation, not even deep, radiating more often to the right.
Acute pyelonephritis begins with pain in the lumbar region, which then spreads upward and is delivered below the blade of the right shoulder. The purulent process in the right kidney is accompanied by painful urination, elevated body temperature.
Myofascial syndrome is also the cause that provokes pain under the right shoulder. These are chronic muscle aches accompanied by irritation of certain stimulus points.
Among the factors that provoke a symptom of pain under the blade of the right shoulder, sometimes there is also herpes - herpes. It is a viral disease that is not considered life threatening but causes very strong, excruciating pain, burning sensation and numbness. Herpes is typical of a rash, itching, and muscle ache that radiates under the shoulder blade.
Osteochondrosis is one of the reasons that often provokes radiant pain under the shoulder blades, including the right one.
Pneumonia of the right side. Pain with inflammation of the lungs most often manifests itself in the acute phase, there may be fever, a feverish condition.

If the pain gives under the shoulder blade

Any symptom of pain that "gives you away" is called radiation. The impulse of visceral pain can be so intense that irritation of the primary nerve branch is transmitted rapidly along the chain to the final branch, i. e. away from the original source. The pain most often appears under the scapula from the organ affected by inflammation and can be caused by such reasons:

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

The pain referred may be transient, but it may also signal that an acute condition is developing that requires immediate medical attention. If the pain gives under the shoulder blade and is not stopped by 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

A symptom of pain under the scapula, aggravated by suction, 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 flexion, movement, decrease in horizontal or lateral position. Accumulation of fluid in the pleural cavity provokes swelling and pain under the scapula during suction.
Pericarditis is an inflammatory process in the pericardial sac, the disease is manifested by weakness, retrosternal pain, which become more intense when inhaled.
Pain under the shoulder blades with a deep breath may indicate intercostal neuralgia, which manifests itself in the form of girdle pain that appears to tighten the chest.
Gallbladder diseases, spasms, abdominal pain, may also be accompanied by a pain symptom associated with absorption.
Renal colic (pyelonephritis, kidney abscess) can also be associated with pain in the hypochondrium, so intense that it spreads throughout the epigastric region, gives under the scapula and grows with inspiration.

Severe pain under the shoulder blade

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

Dagger pain, sharp, shooting, which increases during inspiration, reflected in the shoulder, may be a sign of spontaneous pneumothorax. Additional clinical symptoms of pneumothorax are rapidly developing shortness of breath, tachycardia, a drop in blood pressure, a slow pulse, an (compensatory) increase in the veins in the neck.
Severe pain, which radiates under the scapula and is accompanied by arterial hypertension, indicates a worsening of thoracic spine osteochondrosis. Simultaneous back pain under the shoulder, headache, and a jump in blood pressure are a clear symptom of tight nerve endings in the cervical or thoracic region. The pain may increase as the body returns, shoots when bent 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 stomach. If the perforation progresses rapidly, the pain increases literally every minute, the general clinical appearance of the ulcer is typical - acute pain with radiation, vomiting, cold sweat, facial cyanosis, characteristic posture - knees pulled up to the chest.
Hepatic (biliary) colic is also manifested by severe pain, which radiates 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 located below, the subdiaphragmatic abscess is an acute condition that requires immediate medical attention. A bacterial infection developing in this form can provoke general intoxication, sepsis. In fact, this is purulent peritoneum, limited by the diaphragm, 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, mixed.

A strong symptom of radiating pain is not recommended to be endured for more than an hour, if you can not stop with the available means, you should call emergency help.

Pain behind the shoulder blades

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

Persistent, persistent pain between the shoulder blades, below them, is most often caused by muscle tension, which in turn is explained by professional specifics - sitting in the office, in a sewing machine, driving a machine, etc. Usually, back pain under the shoulder blades is not associated with life-threatening pathology and even with dystrophic changes in the spine, as the chest region is not mobile, it is quite stable and stable. Most often, violations, changes, less often inflammation, are associated with the muscular system of the intercapsular region, ligaments and tendons can also be stretched.

Pain of this type, accompanied by muscle, is characterized by a feeling of heaviness, tension, which pass quickly with active movements (exercises), massage or warmth.

The pain, which is caused by the injury, the stretching of the tendons, is felt differently, causes a feeling of pain under the edges of the shoulders, often the symptom of pain is reflected in the region of the heart. Also, a person complains of numbness of the hands, a tingling sensation, "crawling groups". 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 body position, preferably every half hour. If the work is sedentary, you should get up, walk around, make circular movements with the hands, shoulders, join and spread the shoulder blades.
It is advisable to spend 20-30 minutes a day for tightening exercises for the intercapular area muscles and for the general tone of the body muscles. Regular exercise will help prevent muscle spasms and pain behind the shoulder blade.
It is necessary to periodically massage the shoulder-scapular area, the collar area.
Periodically, you can perform the following exercise: place a small ball (tennis) on the floor, lie on it with your upper back and "roll" the ball, passing it vertically and between the edges of the shoulders.

If a symptom of back pain below the shoulder blades is accompanied by cough, subfebrile fever, pain increases with breathing, cough reflex, you should consult a doctor, be examined to rule out diseases of the broncho-pulmonary system.