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Pain under the shoulder blade

pain in the left shoulder blade from behind

Sub-scapular pain is a clinical symptom of a number of pathological conditions, which may include gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology, and others.

The symptoms of pain can vary in intensity and localization - below the right or left shoulder blade and sometimes limit a person’s motor activity. Sub-scapular pain is most commonly associated with spasms of skeletal muscle tension or reflection of pain from internal organs in the scapular region.

Causes of pain under the shoulder blades

Regio scapularis - the name of the scapular region delimited by lines - is the most protruding VII in the upper part of the body. cervical vertebra between the odd spiky protrusion and the clavicle, below - the mid-vertical line along the spine. the lower edge of the scapulae and a line from the armpit to the edge of the deltoid muscle. The diagnosis of scapular pain depends on the nature and location of the symptom and the accompanying clinical symptoms, as the scapular region itself can only be pained in the event of an injury - concussion.

Causes of pain under the shoulder blades can include:

  • LSRS - scapulocostal, scapula-costal syndrome or scapular lifting muscle syndrome. If the muscle that attaches to the transverse extensions of the upper vertebrae of the neck is hypothermic, damaged, inflamed, or overloaded, it will not be able to perform its function normally — tilting the neck and raising the shoulder blade. Symptomatically, PRS - scapular rib syndrome occurs as aching, sometimes severe pain in the shoulder girdle, at the top and below the scapula. The pain often spreads to the shoulder, the side of the sternum. The most painful point is the point of attachment of the muscle, when pressed, the pain becomes acute, radiating all the way to the neck. In addition, a characteristic sign of LS is the crackling that is heard when the shoulders and arms are moved. Dynamic constant loads as well as static stress can create a condition in which the pain under the shoulder blade becomes constant, exacerbated by cold drafts.
  • YABZH - gastric ulcer as the most common cause of radiating pain under the shoulder blades. The symptom begins with dull, aching pains that increase or decrease after taking medication or vomiting. Pain is directly related to food intake, seasonality, and most commonly radiates to the left — from the epigastrium to the left scapula, to the chest, and to the back. The pain symptoms of a stomach ulcer are usually divided into hungry, late or early pain. In addition, PU is usually accompanied by nausea at the onset of pain, with vomiting and heartburn in 75-80% of cases.
  • Vegetative or as it is often called psychosomatic pain is also one of the causes of shoulder pain. Such sensations are similar to those of angina pectoris, a sign of cardiac pain in that they cause a tight, burning sensation in the chest that intensifies and radiates to the arm, under the scapula, under the collarbone, more often to the left, the region of the heart. The symptoms of pain can be intense and painful, indeterminate. The main distinguishing sign of vegetative pain is the lack of effect after taking cardiac drugs - they do not relieve the pain or pressure. Relaxants and sedatives usually help in vegetative-vascular attack.
  • Osteochondrosis of the thoracic or cervical spine can cause dull, prolonged, aching pain on one side that most often begins in the back of the head and extends below the shoulder blade. The pain may occur in the early morning hours, it may be exacerbated by static exertion (sitting work) and sudden exercise. This condition is accompanied by radiating pain in the arm, under the shoulder blade, paresthesia of the limb, dizziness, visual disturbances. The symptom is removed with a warming massage, ointments and a warm bath.
  • Intervertebral neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and is expressed in paroxysmal, one-sided pain surrounding an intense nature. The feeling of pain spreads along the intercostal muscles, in spaces, and intensifies during deep breathing, coughing, sneezing, prolonged physical exertion, and walking. In a clinical sense, intercostal syndrome is manifested by palpation of the innervating area, which is not typical of cardiac pathologies, osteochondrosis. Due to the constant muscle tension, the pain can spread lower - to the lower back, but is most often manifested by a stinging sensation, burning under the shoulder blade.
  • An attack of angina pectoris begins with pain in the middle of the chest (retrosternal space) that spreads quickly, spreads to the left, and occurs below the clavicle, behind the left scapula. Pain is not always relieved by taking nitroglycerin, a vasodilator that can serve as a sign of a heart attack. In addition, a distinction must be made 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 exposed to physical or psycho-emotional stress. Tensile, aching pain may indicate a resting angina attack when there is no external, provocative cause of the pain symptom.
  • The causes of pain below the shoulder blade can be linked to a severe, life-threatening condition - perforation of a stomach ulcer - with severe, sharp pain radiating below the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, the patient's posture is clasped hands, knees to the stomach (fetal position). This symptom requires immediate medical attention as well as cardialgia.
  • Yuert is a symptom or sign of an inflammatory process in the pericardium, accompanied by the release of secretions. The main manifestations of exudative pericarditis are retrosternal pain, shortness of breath, fever, and fever. The pain is exacerbated by the accumulation of fluid in the cough and the elongation of the pericardium, changes in posture, and sensations may be aching, but most often "shoot" in the neck, under the left shoulder.
  • Dissection of the aorta - dissection of the aortic wall (aneurysm). A life-threatening condition with severe back pain, displacement between the shoulder blades or under one. Most often, the pain shifts to the left, radiating under the arm and left scapula, and spreads along the dissecting aorta. The most dangerous consequences of this symptom may be cerebral haemorrhage (if the blood flow to the carotid arteries is disrupted), heart attack (if the blood supply to the coronary arteries is disrupted), mesenteric thrombosis, paralysis of the legs. ).
  • Chest spine injured. The disease is rarely diagnosed because the chest region is quite stable in this sense. Constant, aching, and increasing pain in the area of injury and the pathological focus gradually intensifies, often similar to the symptoms of diseases of the bronchopulmonary or cardiovascular system. The main characteristic symptom of a hernia may be muscle tension between the shoulder blades and visible curvature of the spine. The diagnosis is confirmed by X-ray examinations and MRI.
  • GSD is also a gallbladder, colic can manifest as rapid, unbearable pain that radiates to the right, below and above the shoulder blade.
  • The cause of pain under the shoulder blade can be respiratory illnesses - pneumonia or pleurisy. In pneumonia, the pain is localized according to the abnormal focus in the tissue, if the process develops in the posterior stages, pain occurs in the back, between or below the shoulder blades. Inflammation of the pleura is also accompanied by suturing pain between the shoulder blades, often under one. The pain is exacerbated by the cough reflex, breathing.
  • Myositis is an inflammatory process in the muscles due to hypothermia, SARS, or overexertion, less commonly due to bruises. Pain occurs suddenly in an acute course or gradually, with aching and aching in chronic inflammation. Pain symptoms are associated with movements, physical activity, postural changes, and tendencies.

Symptoms of pain under the shoulder blades

Symptoms of pain below the shoulder blades are so varied that there is still no uniform, standard differential diagnosis algorithm in clinical practice. Each medical profession has its own schemes for collecting a history, examination, testing, and examinations, but there are often cases where the pain symptom is "obscured" and does not indicate the true cause. the nature of the pain, all the conditions under which it occurs. In addition, the chronic pain to which one is "accustomed" often lubricates the diagnostic picture, resulting in a loss of time, the therapeutic effect is much more difficult to achieve.

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

  • Drawing, permanent back pain with irradiation under the shoulder blade that does not go away within 2-3 days.
  • Shoulder pain caused by static stress (sedentary work) in people over 50 years of age.
  • Pain radiating below the shoulder blades is exacerbated at night or in a horizontal position.
  • Pain with fever.
  • Pain accompanied by numbness of the arm and shoulder.
  • Pressure, burning pain, begins in the middle of the chest.
  • Pain not relieved by heart medications, sedatives.
  • Radiating belt pain under the shoulder blade.
  • Sharp, 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, below the left shoulder blade. The pain started in the morning and worsened with movement.
  • Sharp, severe pain under the shoulder blades.
  • Dull pain under the shoulder blades, aggravated by raising the arms.
  • Drawing, aching pain under the shoulder blade, extending to the waist.
  • Pain under the left shoulder and a feeling of constriction in the chest.
  • Pain under the shoulder blades in the form of a localized area, burning.
  • The pain worsens when the cough manifests.
  • The pain under the shoulder blade is replaced by a burning sensation, numbness in the arm.
  • Severe pain that resolves after vomiting.

Despite the variety of causes of pain under the shoulder blades, there are signs of danger - signs of danger that allow an experienced doctor to rule out relatively benign diseases associated with dorsalgia. Alarm symptoms that may accompany shoulder pain include:

  • Hyperthermia - 38-40 degrees.
  • Spontaneous pain, growing and provoking "acute abdominal" condition.
  • Shortness of breath, cyanosis of the skin.
  • Swelling of the hands.
  • Pain not at rest.
  • What number.
  • Decreased blood pressure. pulse.
  • Faint.

Back pain under the shoulder blades

Back and scapular pain can be associated with many diseases, but it is most often caused by deformity of the spine, especially if it is accompanied by a feeling of numbness in the limbs, tingling in the fingers.

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

  • Curvature of the spine - kyphosis.
  • Disc herniation in the chest region.
  • Lateral curvature of the spine - kyphoscoliosis.
  • Coronary heart disease.
  • Shoulder periarthritis.
  • Intercostal neuralgia.
  • Anterior curvature of the spine - scoliosis.
  • Angina - exertion or rest.
  • Protrusion (degeneration) of the thoracic spine without rupture.
  • YABZH - stomach ulcer.
  • Cholecystitis.
  • Hepatic colic with concomitant dyskinesia of the gallbladder.
  • Dry pleurisy.
  • Pneumonia.
  • Inflammation of the intercostal muscles, tendons, supraspinous ligaments.

Pain under the shoulder blade on the left side

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

  • Intermittent pain under the left shoulder blade may indicate the development of a gastric ulcer. The pain worsens rapidly, accompanied by nausea and then vomiting, a symptom linked to or lack of food intake - hungry pains. The pain begins in the epigastrium and spreads to the side - to the right or left, most commonly under the left breast and under the left shoulder blade.
  • Vegetative crises are also characterized by pain on the left side and massage during cardiopathy. Pain under the shoulder blade on the left side, pulling, aching, often causing fear, nitroglycerin and other heart medications do not stop - this is a typical sign of psychogenic conditions.
  • Myocardial infarction is most often associated with clinically significant symptoms - a burning sensation in the middle of the chest, in the left side of the jaw, in the arm, under the left shoulder, numbness in the limb, and nausea.
  • Angina pectoris - attacks of pain can develop as tension, stress (angina pectoris) or an exacerbation of a chronic form (resting angina pectoris).
  • Intervertebral neuralgia is accompanied by acute pain, often in the belt, which radiates to the right or left below the shoulder blade. The symptom may be exacerbated by changes in posture and physical activity. The pain is relieved by warming up and relaxing the muscles.
  • Osteochondrosis of the neck and chest is also one of the causes of pain under the left shoulder blade. The pain symptom is accompanied by dizziness, nausea, numbness in one hand or one hand.
  • Ulcer perforation is an acute condition that manifests itself in very severe pain that radiates to the area of the clavicle below the scapula. In addition to intense pain, the patient is characterized by stomach pressure pressed to the stomach, cold sweat, cyanosis, drop in blood pressure, and pulse.

Pain under the shoulder blade on the right side

The pain symptom below the right shoulder blade is associated with the following conditions:

  • Gallbladder with bladder spasm due to blockage of canals with stones. The pain is sharp, cutting, localized under the right rib, and radiating to the back under the shoulder blade.
  • Pain under the right shoulder blade can be caused by an abscess in the diaphragm. The symptom is very acute, aggravated by inhalation, not even deep, most often radiating to the right.
  • Pyelonephritis begins in acute form with pain in the lumbar region, which later spreads higher and falls below the right shoulder blade. The purulent process of the right kidney is accompanied by painful urination and elevated body temperature.
  • Myofascial syndrome is also the cause of pain under the right shoulder blade. These are chronic muscle aches associated with irritation of certain trigger points.
  • Herpes is sometimes one of the factors that causes pain under the right shoulder - shingles. It is a viral disease that is not considered life-threatening but causes very severe, unbearable pain, a burning sensation and numbness. Herpes is a typical rash, itching, and muscle pain that radiates below the shoulder blade.
  • Osteochondrosis is one of the reasons why it often causes radiant pain under the shoulder blades, including the right side.
  • Right pneumonia. Pneumonia pain most often occurs in the acute stage, fever, febrile condition may occur.

If the pain gives under the shoulder blade

Any pain symptoms that "let go" are called radiation. The impulse of visceral pain can be so strong that irritation of the primary nerve branch quickly spreads along the chain to the final branch, i. e. , away from the original source. Under-shoulder pain most often comes from an organ affected by inflammation and can be caused by:

  • Increased intestinal pressure with inflammation, ulcerative process. The ulcerated postbulbar part of the duodenum radiates to the right below the scapula.
  • Bile colic (gallbladder, liver).
  • Acute pain occurs under the left shoulder blade and during an attack of angina pectoris when there is a feeling of pressure, compression.
  • Pericarditis can also occur with pain under the shoulder blades.
  • Aortic dissection (aneurysm) is manifested by severe chest pain that radiates to the neck, left side, shoulder, and under the shoulder blade.
  • Pneumothorax (spontaneous) - acute pain in the chest, with reflection below the shoulder blade, in the region of the shoulder blade.
  • Exacerbation of inflammation of the pancreas.
  • Kidney colic.
  • Acute musculoskeletal dorsalgia.
  • Myocardial infarction.
  • Osteochondrosis of the cervical spine.

The pain referred to may be temporary, but may also indicate the development of an acute condition that requires immediate medical attention. If the pain under the shoulder blade is relieved and is not stopped by antispasmodics or heart medications, see a doctor who will perform an examination, differential diagnosis and prescribe appropriate treatment.

Pain during shoulder inhalation

The symptom of scapular pain, exacerbated by inhalation, is a hallmark of the following pathologies:

  • Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain may increase with bending, moving, in a horizontal position or sideways. Fluid that accumulates in the pleural cavity when inhaled causes swelling and pain under the shoulder blade.
  • Pericarditis is an inflammatory process in the pericardium, the disease is manifested by weakness, retrosternal pain, which becomes more intense when inhaled.
  • Pain under the shoulder blades with deep breathing may indicate intercostal neuralgia, which manifests as belt pains that appear to tighten the chest.
  • Diseases of the gallbladder, cramps, colic, and respiratory pain may also accompany it.
  • Renal colic (pyelonephritis, kidney abscess) may be accompanied by pain in the hypochondria, so severe that it spreads throughout the epigastric region, under the scapula, and is exacerbated by inhalation.

Severe pain under the shoulder blade

Severe, severe pain under the shoulder blade - left or right - warrants medical attention, and often such a pain symptom cannot be stopped on its own and can indicate a life-threatening condition. Severe pain under the shoulder blade can be caused by the following diseases:

  • Dagger, sharp, shooting pain that intensifies during inspiration, is reflected in the shoulder, and may be a sign of spontaneous pneumothorax. Other clinical symptoms of pneumothorax include rapidly developing shortness of breath, tachycardia, drop in blood pressure, slow pulse, and enlargement of the jugular veins.
  • The severe pain that radiates under the shoulder blade and is accompanied by arterial hypertension indicates an exacerbation of osteochondrosis of the thoracic spine. Concomitant back pain under the shoulder blade, headache, and a jump in blood pressure are clear symptoms of pinched nerve endings in the neck or chest region. The pain may increase when the body is turned, it may shoot when bending or moving, and the heart medications and sedatives will not disappear.
  • Severe pain under the shoulder blade can be associated with perforation of the upper gastric ulcer. If the perforation progresses rapidly, the pain literally increases every minute, the general clinical picture of the ulcer - acute pain with irradiation, vomiting, cold sweat, cyanosis of the face, characteristic posture - with the knee up to the chest.
  • Liver (bile) colic also manifests as severe pain that radiates to the right, under the shoulder blade, in the neck, and even around the right eye. The symptom of pain is associated with blockage of the bile ducts after eating fried, fatty foods.
  • The purulent process between the diaphragm and the underlying organs, the subdiaphragmatic abscess, is an acute condition that requires immediate medical attention. The resulting bacterial infection in this form can cause general poisoning, sepsis. In fact, it is a purulent peritonitis that is limited by the diaphragm and manifests itself in severe pain in the hypochondria that radiates to the right - under the shoulder, under the shoulder blade. Also typical hyperthermia up to 40 degrees, fever, nausea.

It is not recommended to endure a strong radiating pain symptom for more than an hour; if the available means cannot stop it, call an ambulance.

Pain behind the shoulder blades

The pain behind the shoulder blades between them is usually not intense, so one does not pay attention to the symptom and considers it to be temporary. Premature identification of the cause of such pain can lead to the development of chronic, difficult-to-treat diseases.

The most frequent and persistent pain between the shoulder blades under the shoulder blades is most often caused by muscle tension, which is explained by professional characteristics - sitting in the office, sewing machine, driving a car, etc. Back pain under the shoulder blades is not usually associated with life-threatening pathologies or even dystrophic lesions of the spine because the chest region is not mobile, fairly stable, and stable. The most common injuries, changes, and less often the inflammations are related to the muscular system of the interscapular region, and the ligaments and tendons can also be elongated.

These types of muscle aches are characterized by a feeling of heaviness and tension that quickly goes away with active movements (exercises), massage or warming up.

The pain caused by the injury and stretching of the tendons can be felt differently, it causes a sore feeling under the shoulder blades, often the symptoms of the pain are reflected around the heart. In addition, a person complains of numbness in their hands, a tingling sensation, "creeping goosebumps. " Such pain cannot be neutralized with heart medication, but it can get rid of it and simply do:

  • Change your body position regularly, preferably every half hour. If it is a sedentary job, you need to stand up, walk around, make circular movements with your hands and shoulders, bring your shoulders together and unfold.
  • It is advisable to spend 20-30 minutes a day on exercises for the muscles of the inter-shoulder zone and the general muscle tone of the body. Regular exercise helps prevent muscle cramps and pain behind the shoulder blades.
  • The shoulder-shoulder zone, the collar zone, should be massaged regularly.
  • You can do the following exercise on a regular basis: place a small (tennis) ball on the floor, lie on it with your upper back, and "roll" the ball, passing vertically and between your shoulder blades.

If the back symptom under the shoulder blades is accompanied by cough, subfebrile fever, increased pain on breathing, cough reflex, a doctor should be consulted to rule out diseases of the bronchial lung system.