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Pain under the shoulder blade

pain under the left shoulder blade from behind

Pain under the scapula is a clinical sign of many pathological conditions, including gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology and others.

The symptoms of pain 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 spasms due to tension or pain in the internal organs located in the scapular region.

Causes of pain under the shoulder blades

Regio scapularis - this is the name of the back area limited by lines - the most common in the upper part of the body between the unpaired vertebral process of the VII cervical vertebra and the clavicle, below - the medial-vertical line along the neck. the lower edge of the shoulder blades, 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, localization of the symptom and the accompanying clinical signs, because the scapular region itself can be damaged only in case of injury - shock, bruising.

Causes of pain under the shoulder blades can be:

  • LSRS - scapula-costal, scapula-costal syndrome or skeletal muscle-lifting syndrome. If the muscle connected to the transverse processes of the upper vertebrae of the neck is hypothermic, damaged, inflamed, or overexerted, it is unable to perform its normal function - bending the neck and lifting the spine. Symptomatically, PRS - scapular-rib syndrome manifests itself in the form of painful, sometimes severe pain in the shoulder girdle, above and below the shoulder blade. Often the pain spreads to the shoulder, the lateral part of the sternum. The most painful point is the place of attachment of the muscle, if you press on it, the pain intensifies and spreads to the neck. In addition, a characteristic feature of LS is the sound of a crisis when moving the shoulders and arms. Dynamic constant loads, as well as static stress, can create a situation where the pain under the shoulder blade stabilizes and is aggravated by a cold, draft.
  • YABZH - gastric ulcer, as the most common cause of pain radiating under the shoulder blades. Symptoms begin with dull, aching pain, vomiting, which increases or decreases after taking the drug. The pain is directly related to food intake, seasonality, and most often spreads to the left - from the epigastrium to the left shoulder blade, chest and back. Symptoms of pain in peptic ulcer are usually divided into hunger, late or early pain. In addition, PU is usually accompanied by nausea at the peak of pain, vomiting and heartburn in 75-80% of cases.
  • It also includes the causes of pain under the scapula, called vegetative or often psychosomatic pain. Such sensations are similar to the symptoms of angina pectoris, cardiological pains, because they cause a feeling of tightness, burning in the chest, which is intensified and the arm, under the shoulder blade, under the clavicle, more often to the left, the heart area. The symptoms of pain can be both severe and painful, of an indeterminate nature. The main differential symptom of vegetative pain is the lack of effect after taking cardio medications - they do not relieve pain and pressure. As a rule, relaxants and sedatives promote vegetative-vascular attack.
  • Osteochondrosis of the thoracic or cervical spine can cause unilateral dull, long-lasting, excruciating pain, starting at the back of the head and spreading below the shoulder blade. The pain can occur in the early hours of the morning, exacerbated by static load (sedentary work), sudden movements of the body. This condition is accompanied by radiating pain in the arm, under the shoulder blade, paresthesia of the joint, dizziness, visual disturbances. Symptoms are removed with warming massages, ointments, hot baths.
  • Intercostal neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and is characterized by paroxysmal, unilateral pain that is intense in nature. The sensation of pain spreads through the intercostal muscles and cavities and is intensified by deep breathing, coughing, sneezing, prolonged physical exertion, walking. Clinically, intercostal syndrome is characterized by palpation of the innervation area, which is not typical for cardiac pathologies, osteochondrosis. Pain due to constant muscle tension can spread to the lower back, but most stabbing manifests itself with a burning sensation under the shoulder blade.
  • An attack of angina pectoris begins with pain in the middle of the chest (retrosternal cavity), spreads rapidly, spreads to the left, and extends under the clavicle, 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: Acute, sharp pains on the left side of the chest, under the shoulder blade, are characteristic of angina pectoris when a person is exposed to physical or psycho-emotional stress. Pulling, aching pain, may indicate an attack of angina at rest in the absence of external, provocative causes of pain symptoms.
  • The causes of pain under the shoulder blade can be associated with a severe, life-threatening condition - perforation of the stomach ulcer, accompanied by intense, sharp pain that spreads under the clavicle and under one of the shoulder blades. The characteristic sign of perforation is vomiting, the patient's position is compressed hands, knees to the stomach (fetal position). This symptom requires urgent medical attention, as well as cardialgia.
  • 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 exacerbated by the accumulation of effusion and elongation of the pericardium during coughing, changes in body position, the sensations may be painful in nature, but are often "thrown" into the neck, under the left shoulder blade. Exacerbation of the inflammatory process often leads to the clinical picture of "acute abdomen".
  • Rupture of the aorta - rupture of the wall of the aorta (aneurysm). A life-threatening condition accompanied by severe pain with displacement between the back, shoulder blades or under one of them. The pain often spreads to the left, under the arm and under the left shoulder blade, and along the ruptured aorta. The most dangerous consequences of this symptom are stroke (if the blood flow to the carotid arteries is disrupted), heart attack (if the blood flow to the coronary arteries is disrupted), mesenteric thrombosis, paralysis of the legs (if the blood flow to the iliac arteries is disrupted), spinal cord damage (if the blood flow to the vertebral arteries is disrupted).
  • Herniated disc of the thoracic spine. The disease is rarely diagnosed because the thoracic region is very stable in this sense. Persistent, aching, and increasing pain in the area of the disorder and pathological focus gradually intensifies, often resembling symptoms of diseases of the broncho-pulmonary or cardiovascular systems. The main characteristic feature of hernias may be muscle tension between the shoulder blades and visible curvature of the spine. The diagnosis is confirmed by X-ray and MRI.
  • GSD is cholelithiasis, and colic can manifest itself as paroxysmal, excruciating pain, spreading to the right, under and above the shoulder blade.
  • Causes of pain under the shoulder blade can be respiratory diseases - pneumonia or pleurisy. With inflammation of the lungs, the pain is localized in the tissue according to the pathological focus, if the process develops in the posterior parts, there is pain in the back, between the shoulder blades or under them. Inflammation of the pleura is also accompanied by stitch pain between the shoulder blades, often under one of them. The pain is intensified by the cough reflex, breathing.
  • Myositis is an inflammatory process in the muscles due to hypothermia, SARS or overexertion, less frequent bruising. In acute inflammation, the pain occurs suddenly or develops gradually, and in chronic inflammation it is excruciating and painful. Pain symptoms are associated with movements, physical activity, changes in posture, and tendencies.

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 specialty has its own scheme for collecting anamnesis, examination, testing and examinations, but often there are cases when the pain symptom is "masked" and does not indicate the true cause. Therefore, 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, which a person is "accustomed" to, often lubricates the diagnostic picture, resulting in a loss of time and a more difficult to achieve a therapeutic effect.

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

  • Constant pain in the back with radiation under the shoulder blade, does not decrease for 2-3 days.
  • Pain under the scapula with static stress (sitting) in people over 50 years.
  • Pain that spreads under the shoulder blades, increasing at night or in a horizontal position.
  • Pain with fever.
  • Pain in the arm, shoulder joint.
  • Pressure starting in the middle of the chest, pain that causes burning.
  • Heart medications, painkillers that do not stop with sedatives.
  • Belt pain that spreads under the shoulder blade.
  • Acute, severe pain with vomiting.

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

  • Acute pain in the middle of the back, extending under the left shoulder blade. The pain begins in the morning and intensifies with movement.
  • Acute, severe pain under the shoulder blades.
  • Dull pain under the shoulder blades is aggravated by lifting the arms.
  • The drawing, aching pain under the scapula, is so widespread.
  • Pain under the left back and a feeling of tightness in the chest.
  • Pain, burning in the form of an area localized under the shoulder blades.
  • When the cough starts, the pain intensifies.
  • The burning sensation under the shoulder blade is replaced by numbness in the arm.
  • Severe pain after vomiting.

Despite the various causes of pain under the shoulder blades, there are differential symptoms - danger signals that allow an experienced physician to rule out relatively benign diseases associated with dorsalgia. The following are the alarming symptoms that can be accompanied by pain in the shoulder blades:

  • Hyperthermia - 38-40 degrees.
  • Spontaneous pain provokes an increasing and "acute abdominal" condition.
  • Shortness of breath, cyanosis of the skin.
  • Swelling of the hands.
  • Pain that does not pass during rest.
  • Vomiting.
  • Lowering blood pressure. pulse.
  • Don't faint.

Low back pain under the shoulder blades

Pain in the back can be associated with many diseases, but most often it is associated with deformity of the spine, especially the feeling of numbness of the extremities, tingling sensation in the fingers.

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

  • Curvature of the spine - kyphosis.
  • Disc herniation in the chest.
  • Lateral curvature of the spine - kyphoscoliosis.
  • Coronary artery disease.
  • Periarthritis of the shoulder.
  • Intercostal neuralgia.
  • Frontal curvature of the spine - scoliosis.
  • Angina - tension or rest.
  • Degeneration of the thoracic spine without rupture.
  • YABZH - peptic ulcer of the stomach.
  • Cholecystitis.
  • Hepatic colic with dyskinesia of the gallbladder.
  • Dry pleurisy.
  • I have pneumonia.
  • Inflammation of the interscapular muscles, tendons, supraspinous ligaments.

Pain under the left shoulder blade

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

  • Periodic pain under the left shoulder blade may indicate the development of a stomach ulcer. The pain increases rapidly, accompanied by nausea and then vomiting, the symptom is associated with food intake or lack thereof - hunger pains. The pain begins in the epigastrium and spreads to the side - to the right or left, mostly under the left breast and under the left shoulder blade.
  • Vegetative crises are also characterized by left-sided pain, massage under cardiopathy. Pain under the left shoulder blade, pulling, aches, often creates a feeling of fear, not stopping with nitroglycerin and other heart medications - this is a typical sign of psychogenic conditions.
  • The most common clinical manifestations of myocardial infarction are burning in the middle of the chest, pain in the left side of the jaw, arm, under the left shoulder blade, numbness, nausea.
  • Angina pectoris - pain attacks can develop as tension, stress (angina pectoris) or exacerbation of a chronic form (rest angina pectoris).
  • Intercostal neuralgia is accompanied by sharp pain, often extending to the right or left under the shoulder blade. Symptoms may be exacerbated by changes in body position or physical activity. The pain is relieved by warming up and relaxing the muscles.
  • Both cervical and thoracic osteochondrosis are one of the leading causes of pain under the left shoulder blade. Symptoms of pain are accompanied by dizziness, nausea, numbness of the hands or one side.
  • Ulcer perforation is an acute condition characterized by severe pain that spreads to the clavicle area under the shoulder blade. In addition to severe pain, the patient's knees are characterized by a posture pressing on the stomach, cold sweat, cyanosis, decreased blood pressure and pulse.

Pain under the right shoulder blade

Symptoms of pain under the right shoulder blade are associated with the following diseases:

  • Biliary colic with spasm of the bladder, ducts due to blockage with stones. The pain is sharp, cutting, localized under the right rib and spreads to the back under the shoulder blade.
  • Pain under the right shoulder blade can be triggered by a diaphragmatic abscess. The symptoms are very severe, aggravated by inhalation, not even deep, but spread to the right.
  • Acute pyelonephritis begins with pain in the lower back, then spreads higher and is transmitted under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination and fever.
  • Myofascial syndrome is also a cause of pain under the right scapula. These are chronic muscle pains associated with irritation of certain trigger points.
  • Herpes is sometimes found among the factors that cause pain symptoms under the right shoulder blade - shingles. It is a viral disease that is not considered life-threatening, but causes very severe, unbearable pain, burning sensations and numbness. Herpes is characterized by rash, itching and muscle pain that spreads under the shoulder blade.
  • Osteochondrosis is one of the most common causes of radiating pain under the shoulder blades, including the right.
  • Right-sided pneumonia. Pain with pneumonia manifests itself in the most acute stage, there may be a fever, feverish condition.

If the pain is under the shoulder blade

Any pain symptom that "gives" is called radiation. The pulse of visceral pain can be so strong that the irritation of the primary nerve branch is rapidly transmitted along the chain to the last branch, ie far from the original source. Pain is caused by the organ most affected by inflammation under the scapula and can occur for the following reasons:

  • Increased pressure in the intestines with inflammation, ulcerative process. The ulcer and the postbulbar part of the duodenum radiate to the right under the backbone.
  • Biliary colic (gallbladder, liver).
  • Acute pain under the left shoulder blade and during an attack of angina pectoris when there is a feeling of pressure, compression.
  • Pericarditis can also present with pain referred to under the shoulder blades.
  • Aortic dissection (aneurysm) manifests itself with severe chest pain that spreads to the neck, left side, shoulder, under the shoulder blade.
  • Pneumothorax (spontaneous) - a sharp pain in the chest with a reflection under the scapula, in the region of the scapula.
  • Exacerbation of pancreatitis.
  • Renal colic.
  • Acute musculoskeletal dorsalgia.
  • Myocardial infarction.
  • Osteochondrosis of the cervical spine.

Referred pain may be transient, but may also indicate the development of an acute condition that requires urgent medical attention. If the pain is under the shoulder blade and is not stopped by antispasmodics, heart medication, you should consult a doctor who will prescribe an examination, differential diagnosis and adequate treatment.

Pain under the shoulder blades while breathing

Symptoms of pain aggravated by inhalation under the scapula are a signal of the following pathologies:

  • Dry pleurisy is an inflammatory process in the pleura, the mucous membrane of the lungs. Pain may increase with bending, movements, and may decrease in a horizontal position or on the side. Fluid accumulated in the pleural cavity causes swelling and pain under the scapula when breathing.
  • Pericarditis is an inflammatory process in the pericardial sac, the disease manifests itself with weakness, retrosternal pain, exacerbated during inhalation.
  • Pain under the shoulder blades with deep breathing may indicate intercostal neuralgia, which manifests itself in the form of lumbar pain that compresses the chest.
  • Gallbladder, spasm, colic diseases may also be accompanied by symptoms of pain associated with inhalation.
  • Renal colic (pyelonephritis, kidney abscess) can also be accompanied by pain in the hypochondrium, so strong that it spreads to the entire epigastric region, gives under the scapula and increases with inspiration.

Severe pain under the shoulder blade

Severe pain under the scapula - left or right - is a reason to seek medical attention, often such a pain symptom cannot be stopped on its own, and it can also indicate a life-threatening condition. Severe pain under the shoulder blade can cause the following diseases:

  • Increased stabbing in the shoulder during inspiration may be a sign of sharp, shooting pain, spontaneous pneumothorax. Additional clinical symptoms of pneumothorax include rapidly developing shortness of breath, tachycardia, low blood pressure, slow pulse, and an increase in compensatory blood vessels in the neck.
  • Severe pain radiating under the scapula and accompanied by arterial hypertension indicates an exacerbation of thoracic lumbar osteochondrosis. Simultaneous low back pain, headache, and a jump in blood pressure under the scapula are clear signs of nerve endings being compressed in the cervical or thoracic region. Pain may increase when the body rotates, hits when bending or moving, and is not stopped by heart medications or sedatives.
  • Severe pain under the shoulder blade may be associated with perforation of the upper gastric ulcer. If the perforation progresses rapidly, as if the pain increases every minute, the general clinical picture of the ulcer is typical - sharp pain with radiation, vomiting, cold sweat, facial cyanosis, characteristic posture - the knees are stretched to the chest.
  • Hepatic (bile) colic is also manifested by severe pain that spreads to the right, under the shoulder blade, in the neck and even in the area of the right eye. Symptoms of pain are associated with obstruction of the bile ducts after fried, fatty foods.
  • A purulent process in the area between the diaphragm and the organs below it is an acute condition that requires urgent medical attention. A bacterial infection that develops in this form can cause general intoxication, sepsis. In fact, it is a purulent peritonitis limited to the diaphragm, manifested by severe pain in the hypochondrium, spreading to the right shoulder, under the shoulder blade. Also typical hyperthermia up to 40 degrees, fever, nausea.

It is not recommended to tolerate the symptoms of severe radiation pain for more than an hour, if it can not be stopped by available means, you should call an ambulance.

Pain behind the shoulder blades

The pain behind the shoulder blades, between them, is usually not strong, so the person does not pay attention to the symptom, considering it temporary. Failure to identify the cause of such pain in time can lead to the development of chronic, difficult-to-treat diseases.

Between the shoulder blades, the constant, persistent pain under them is most often caused by muscle tension, which in turn is explained by the characteristics of the profession - sitting in the office, sewing machine, driving a car, etc. Usually, low back pain under the shoulder blades is not associated with life-threatening pathologies and even dystrophic changes in the spine, because the thoracic region is quite stable and stable because it is not mobile. Often disorders, changes, less often inflammation, affect the muscular system of the interscapular region, ligaments and tendons can also stretch.

This type of muscle pain is characterized by a feeling of heaviness and tension that passes quickly with active movements (exercises), massage or warming up.

Pain caused by tendon damage and stretching is felt differently, creates a feeling of 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, tingling, "creeping gases". It is not possible to neutralize such pain with heart medication, but you can get rid of it and do it in a very simple way:

  • Change your body position periodically, preferably every half hour. If the work is sedentary, it is necessary to stand up, walk around, make circular movements with your hands and shoulders, bring the shoulder blades together and spread.
  • It is recommended to spend 20-30 minutes a day on stretching exercises for the muscles of the interscapular zone and the overall muscle tone of the body. Regular exercise will help prevent muscle spasms and pain behind the shoulder blades.
  • The shoulder-scapular area and collar area should be massaged periodically.
  • Periodically you can do the following exercise: place a small (tennis) ball on the ground, lie on your back and "roll" on the ball, pass it between the vertical and shoulder blades.

Symptoms of back pain under the shoulder blades include cough, subfebrile fever, increased pain with breathing, accompanied by a cough reflex, you should consult a doctor to rule out diseases of the broncho-pulmonary system.