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pain under the shoulder blade

Pain from the left side of the back under the shoulder blade

Subscapular pain is a clinical symptom of many pathological conditions, which may include gastrointestinal, cardiac, neurological disorders, as well as osteochondrosis, intervertebral hernia, bronchopulmonary disease, and others.

Pain symptoms can vary in intensity and location - under the right or left shoulder blade, sometimes limiting a person's motor activities. Pain under the scapula is most often associated with spasm of the skeletal muscles, either due to tension or a reflection of pain from internal organs in the scapula area.

Causes of pain under the shoulder blade

Regio scapularis - this is the name for the area of the scapula, bounded by the line - on the upper part of the body, between the most prominent cervical vertebra VII and the unpaired spinous process of the clavicle, below - along the mid-vertical line along the lower border of the scapula, and from the axilla to theA line at the edge of the deltoid. The diagnosis of subscapular pain depends on the nature of the symptoms, their localization and the accompanying clinical symptoms, since the scapular region itself can only be injured in the event of an injury - blows, bruises.

Pain under the shoulder blade can be caused by:

  • LSRS - Scapular Rib, Scapular Rib Syndrome, or Muscular Syndrome Elevating the Scapula. If the muscle that attaches to the transverse process of the vertebrae in the upper neck is hypothermic, injured, inflamed, or stressed, it cannot perform its proper function—tilting the neck and raising the shoulder blades. Symptomatically, PRS-scapular rib syndrome presents with pain in the shoulder girdle, top and bottom of the shoulder blade, sometimes severe. Usually the pain spreads to the shoulder, the outer part of the breastbone. The most painful place is the attachment point of the muscle, and with one click, the pain becomes intense and radiates up to the neck. Also, a feature of the LS is the crunching noise it makes when moving the shoulders and arms. Dynamic constant loads as well as static stresses cause pain under the scapula to become constant and exacerbated by exposure to cold, drafts.
  • YABZH - gastric ulcer, the most common cause of pain radiating below the shoulder blade. Symptoms begin with dull aches, pain, and vomiting that increase or decrease after taking the drug. Pain is directly related to food intake, seasonality, and most often radiates to the left—from the upper abdomen to the left shoulder blade, to the chest and back. Painful symptoms of stomach ulcers are usually categorized as hunger, late or early pain. In addition, PU is often accompanied by nausea, 75-80% vomiting, and heartburn at peak pain.
  • Vegetative pain or commonly referred to as psychosomatic pain is also included among the causes of subscapular pain. The sensations are similar to signs of angina, heart pain in that they cause a squeezing, burning sensation in the chest that intensifies and radiates to the arms, under the shoulder blades, under the collarbone, and more commonly on the left side, the heartarea. Pain symptoms can be both severe and painful and are indeterminate in nature. The main distinguishing sign of vegetative pain is that heart medications don't work—they don't relieve pain or stress. Often, relaxants and sedatives help with vegetative vascular attacks.
  • Osteochondrosis of the thoracic or cervical spine can cause unilateral dull, persistent pain, most commonly in the back of the head and spreading down below the shoulder blades. Pain may occur early in the morning and is exacerbated by static loads (sedentary work) and sudden body movements. This condition is accompanied by radiating pain in the arms, under the shoulder blades, paresthesias in the limbs, dizziness, and visual disturbances. Relieve symptoms with warm massages, ointments, and warm baths.
  • Intercostal neuralgia is the most common cause of pain under the shoulder blade. Symptoms develop rapidly and manifest as paroxysmal, unilateral pain with severe encircling. Pain spreads along the intercostal muscles, spaces, and is exacerbated by deep breathing, coughing, sneezing, prolonged physical exertion, and walking. Clinically, intercostal syndrome presents as palpation of innervated areas, which is not typical for cardiac pathology, osteochondrosis. The pain spreads to the lower back due to the constant muscle tension, but most commonly a tingling sensation, a burning sensation under the shoulder blade.
  • The onset of angina starts as pain in the middle of the chest (retrosternal space) that spreads quickly, to the left side, and below the collarbone, back, and under the left shoulder blade. Taking nitroglycerin and vasodilators doesn't always relieve pain, which can signal a myocardial infarction. In addition, the etiology of angina pectoris differs: when a person is under physical or psycho-emotional stress, severe acute pain under the shoulder blade on the left side of the chest is characteristic of angina pectoris. When pain symptoms are not caused by an external stimulus, pulling, pain may indicate an angina attack at rest.
  • The cause of subscapular pain may be related to a serious, life-threatening condition - a perforated gastric ulcer with intense, severe pain radiating below the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, and the patient is in a folded-hands position with knees toward the stomach (fetal position). This symptom requires immediate medical attention, as well as heartache.
  • Yuert's symptoms or signs of an inflammatory process in the pericardium with the release of exudate. The main manifestations of exudative pericarditis are retrosternal pain, shortness of breath, elevated body temperature, and fever. Pain increases due to fluid buildup and stretching of the pericardium when coughing, changing body position, and the sensation may be natural, but most commonly they "shoot" into the neck below the left shoulder blade. The exacerbation of the inflammatory process often leads to the clinical presentation of "acute abdomen".
  • Aortic dissection - a dissection of the wall of the aorta (aneurysm). A life-threatening condition with severe pain in the back, between the shoulder blades, or under one of the shoulder blades. In most cases, the pain will be transferred to the left side, radiating down the arm and under the left scapula, spreading along the anatomical aorta. The most dangerous consequences of this condition may be stroke (if blood flow to the carotid arteries is disturbed), heart attack (if blood flow to the coronary arteries is disturbed), mesenteric thrombosis, leg paralysis (if blood flow to the iliac arteries is disturbed)disturbance), spinal cord injury (if blood flow to the vertebral arteries is disturbed).
  • Thoracic disc herniation. The disease is rarely diagnosed because the chest area is fairly stable in this sense. Persistent, progressive pain and growing pains in the area of infringement and pathological focus often resemble symptoms of bronchopulmonary or cardiovascular disease. The main feature of a hernia is muscle tension between the shoulder blades and a visible curvature of the spine. Diagnosis is confirmed by X-ray examination, MRI.
  • GSD is a form of gallstone disease, and colic can also present as paroxysmal, excruciating pain that radiates to the right, under and above the shoulder blade.
  • The cause of pain under the shoulder blade may be due to respiratory disease - pneumonia or pleurisy. With inflammation of the lungs, pain is localized according to pathological lesions in the tissue, and if the process develops posteriorly, there is pain in the back, between or below the shoulder blades. Pleural inflammation is also accompanied by pain in the suture between the shoulder blades, usually under one of the shoulder blades. Cough reflex, breathing aggravated pain.
  • Myositis is an inflammatory process of muscles due to hypothermia, SARS, or overwork, less commonly with bruises. Pain occurs suddenly in acute course, or develops gradually, and in chronic inflammation has the characteristics of pulling, pain. Pain symptoms are related to movement, physical activity, postural changes and tendencies.

Symptoms of pain under the shoulder blade

The symptoms of subscapular pain are so diverse that there is still no single standard differential diagnosis algorithm in clinical practice. Each medical specialty has its own protocol for collecting medical records, examinations, tests and examinations, but there are often cases where pain symptoms are "masked" and the real cause cannot be explained. This is why the patient is asked to describe as accurately as possible the nature of the pain, and all the circumstances in which the pain occurs. Additionally, chronic pain that a person has "getting used to" often lubricates the diagnostic image, thus wasting time and making it more difficult to achieve therapeutic results.

What symptoms of pain under the shoulder blade require immediate medical attention?

  • Drawing, persistent back pain after subscapular irradiation that does not subside within 2-3 days.
  • Pain under the shoulder blade due to static stress (sitting for long periods of time) in people over the age of 50.
  • Pain that radiates below the shoulder blade and is worse at night or in a horizontal position.
  • Fever and pain.
  • The pain is accompanied by numbness in the arms and shoulders.
  • The pain causes pressure, burning, and starts in the middle of the chest.
  • Pain that cannot be relieved by heart medications or sedatives.
  • Band pain radiating below the shoulder blade.
  • Severe, severe pain with vomiting.

The symptoms of pain under the shoulder blade are most often described as follows:

  • Severe pain in the middle of the back, extending below the left shoulder blade. The pain starts in the morning and gets worse with exercise.
  • Severe, severe pain under the shoulder blade.
  • There was a dull pain under the shoulder blade, which was aggravated by raising the arm.
  • As I painted, the pain under the shoulder blades spread all the way to the waist.
  • Pain under the left shoulder blade and a constriction in the chest.
  • Pain, burning in the localized area under the shoulder blade.
  • The pain worsens during a coughing attack.
  • The pain under the shoulder blade is replaced by a burning and numbness in the arm.
  • Severe pain that disappeared after vomiting.

Although the causes of subscapular pain symptoms vary, there are different signs—red flags that allow an experienced doctor to rule out relatively benign conditions associated with back pain. Worrying symptoms that may accompany shoulder blade pain are the following signs:

  • Hyperthermia - 38-40 degrees.
  • An "acute abdomen" state of spontaneous pain, growth and irritation.
  • Shortness of breath, cyanosis of the skin.
  • Swollen hands.
  • Pain that does not subside with rest.
  • Vomit.
  • Blood pressure drops. pulse.
  • syncope.

back pain under the shoulder blade

Pain in the back and shoulder blade area can be associated with many conditions, but the most common cause is a deformed spine, especially if it is accompanied by numbness in the extremities and tingling in the fingers.

In addition, back pain under the shoulder blade is caused by these diseases, conditions:

  • Spinal curvature - kyphosis.
  • Thoracic disc herniation.
  • Scoliosis - kyphosis.
  • Coronary artery disease.
  • Frozen shoulder.
  • Intercostal neuralgia.
  • Frontal curvature of the spine - scoliosis.
  • Angina - with exertion or rest.
  • Unruptured thoracic disc herniation (degenerative).
  • YABZH - gastric peptic ulcer.
  • cholecystitis.
  • Hepatic colic with gallbladder dyskinesia.
  • Dry pleurisy.
  • pneumonia.
  • Inflammation of the interscapular muscles, tendons, and supraspinous ligaments.

Pain under left shoulder blade

Pain symptoms under the left shoulder blade may be associated with:

  • Periodic pain under the left shoulder blade may signal a developing stomach ulcer. The pain increases rapidly, accompanied by nausea, then vomiting, and the symptoms are related to food intake or lack - the pain of hunger. The pain begins in the upper abdomen and spreads laterally—to the right or left, most commonly under the left breast and under the left shoulder blade.
  • A vegetative crisis is also characterized by pain on the left side, massage under a heart attack. Pain, pulling, pain under the left shoulder blade, often causing a feeling of fear that cannot be stopped with nitroglycerin and other heart medications - a classic sign of mental illness.
  • Myocardial infarction usually has clinically apparent symptoms - burning in the middle of the chest, pain radiating to the left side of the jaw, arm, under the left shoulder blade, numbness in the extremities, nausea.
  • Angina - Painful attacks may be accompanied by tension, stress (angina), or worsening of the chronic form (resting angina).
  • Intercostal neuralgia is accompanied by acute pain, usually in the form of a band, radiating to the right or left below the scapula. Symptoms may worsen with changes in body posture and physical activity. Relieve pain by warming up and relaxing your muscles.
  • Cervical and thoracic osteochondrosis is also a cause of pain under the left shoulder blade. Painful symptoms are accompanied by dizziness, nausea, and numbness in one or one hand.
  • A perforated ulcer is an acute condition that presents with very severe pain radiating to the clavicle area below the shoulder blade. In addition to severe pain, the patient's characteristics include knee position against stomach, cold sweat, cyanosis, drop in blood pressure, and pulse.

Pain under right shoulder blade

Pain symptoms under the right shoulder blade are associated with:

  • Biliary colic is accompanied by spasm of the bladder, due to a stone blocking the duct. The pain is severe, stabbing, and is located under the right rib cage and radiates to the back under the shoulder blade.
  • Pain under the right shoulder blade may be caused by a diaphragmatic abscess. Symptoms are very acute, aggravated by inhalation, not even deep, and most often radiate to the right.
  • The acute form of pyelonephritis begins with pain in the lumbar region, then spreads higher and is administered under the right scapula. The purulent process of the right kidney was accompanied by painful urination and an increase in body temperature.
  • Myofascial syndrome is also a cause of pain under the right shoulder blade. These are chronic muscle pains associated with stimulation of certain trigger points.
  • Among the factors that cause symptoms of pain under the right shoulder blade, herpes zoster is also sometimes found. It's a viral disease that's not life-threatening, but it can cause very severe, excruciating pain, burning, and numbness. Herpes is a typical rash, itching, and muscle pain that radiates below the shoulder blade.
  • Osteochondrosis is one of the frequent causes of pain radiating below the shoulder blade, including the right shoulder blade.
  • Right pneumonia. Pain with inflammation of the lungs occurs most often in the acute phase, and may be accompanied by a state of fever and fever.

If the pain is under the shoulder blade

Any "leaked" pain symptoms are called radiation. The urge for visceral pain can be so strong that the stimulus of the primary nerve branch is quickly transmitted along the chain to the last branch, i. e. away from the original source. Pain under the shoulder blade most often comes from organs affected by inflammation and can be triggered by:

  • With inflammation, the intestinal pressure of the ulceration process increases. There is an ulcer at the back of the duodenal bulb, radiating to the right below the scapula.
  • Biliary colic (gallbladder, liver).
  • Acute pain occurs under the left shoulder blade and during an angina attack, when there is pressure, a feeling of pressure.
  • Pericarditis can also present as referred pain below the scapula.
  • Aortic dissection (aneurysm) presents as severe chest pain that radiates to the neck, left side, shoulder, and below the shoulder blade.
  • Pneumothorax (spontaneous) - Acute pain in the chest with a reflex below the scapula, located in the area of the scapula.
  • Pancreatitis worsens.
  • Renal colic.
  • Acute musculoskeletal back pain.
  • myocardial infarction.
  • Cervical osteochondrosis.

Referred pain may be short-lived, but it may also indicate a developing acute disorder that requires immediate medical attention. If pain develops under the shoulder blade and is not treated with antispasmodics, and the heart medication is stopped, you should consult a doctor who will perform an examination, differential diagnosis and prescribe appropriate treatment.

Pain under the shoulder blade when inhaling

Pain under the shoulder blade, aggravated by inhalation, is a sign of the following conditions:

  • Dry pleurisy is an inflammatory process of the pleura (lining of the lungs). Pain may increase with flexion, movement, horizontal position, or subsidence on the side. When you inhale, the fluid that builds up in the pleural cavity can cause swelling and pain under the shoulder blades.
  • Pericarditis is an inflammatory process within the pericardial sac, and the disease manifests as weakness, pain behind the sternum, which becomes more intense with inhalation.
  • Pain under the shoulder blades when breathing deeply may indicate intercostal neuralgia, which manifests as girdle pain that appears to tighten the chest.
  • Gallbladder disease, cramps, and colic may also be accompanied by painful symptoms associated with inhalation.
  • Renal colic (pyelonephritis, renal abscess) may also be accompanied by flank pain so severe that it spreads over the entire epigastric area, appears under the shoulder blade and increases with inspiration.

severe pain under the shoulder blade

Severe, severe pain under the shoulder blade - on the left or right side - is a reason to seek medical help, this pain usually doesn't stop on its own and can also indicate a life-threatening condition. Severe pain under the shoulder blade can be caused by:

  • Dagger, sharp, shooting pain, increased on inspiration, reflected in the shoulder, possibly a sign of spontaneous pneumothorax. Other clinical symptoms of pneumothorax rapidly progress to tachypnea, tachycardia, decreased blood pressure, slow pulse, and increased jugular veins (compensatory).
  • Severe pain radiating below the scapula with arterial hypertension indicates worsening of thoracic osteochondrosis. Simultaneous back pain, headache, and increased blood pressure under the shoulder blade are obvious symptoms of compressed nerve endings in the neck or chest. Pain worsens when you turn your body, or when you bend over or move. Heart medications and sedatives do not relieve the pain.
  • Severe pain under the shoulder blade may be related to a perforated upper gastric ulcer. If the perforation progresses rapidly, the pain increases practically every minute, and the general clinical presentation of the ulcer is typical - acute pain with radiation, vomiting, cold sweats, facial cyanosis, characteristic posture - knees pulled to the chest.
  • Hepatic (biliary) colic also presents as severe pain radiating to the right side, under the shoulder blade, neck, and even the right eye area. Painful symptoms are associated with blocked bile ducts after eating fried high-fat foods.
  • A subphrenic abscess is a purulent process between the diaphragm and the organs below and is an acute condition that requires immediate medical attention. This form of bacterial infection can cause systemic poisoning, sepsis. In fact, this is purulent peritonitis, limited by the diaphragm, manifesting as severe pain in the flanks, radiating to the right - the shoulder, below the scapula. Also typically high fever up to 40 degrees, fever, nausea.

Intense radiating pain symptoms are not recommended for more than an hour, and if they cannot be stopped by existing means, an emergency call is required.

pain behind shoulder blade

Often, the pain behind the shoulder blade is not intense, so people don't pay attention to the symptoms, thinking it's temporary and short-lived. Failure to identify the cause, which is what causes this pain, can lead to the development of a chronic, difficult-to-treat disease.

Persistent, persistent pain between the shoulder blades, below them, is most often caused by muscle tension, which in turn can be explained by professional details - sedentary work in the office, sewing machine, driving, etc. Often, back pain under the scapula is not associated with life-threatening lesions or even dystrophic changes in the spine because the chest area is immobile and therefore very stable and stable. In most cases, the invasion, change (and less commonly inflammation) is related to the musculature of the interscapular region, and the ligaments and tendons can also be stretched.

This muscle-related pain is characterized by a heavy, tense feeling that disappears quickly with active movement (exercise), massage, or warm-up.

Pain caused by injury, tendon stretching feels different, it causes a pain sensation under the shoulder blade, usually the pain symptoms are reflected in the heart area. Additionally, one person complained of numbness, tingling, and "goose bumps" in the hands. It is impossible to neutralize this pain with heart medication, but you can get rid of it and do this very simply:

  • Change your body position regularly, preferably every half hour. If the job is sedentary, you need to stand up, move around, and make circular motions with your hands and shoulders, closing and spreading your shoulder blades together.
  • It is recommended to spend 20-30 minutes per day doing stretches for the interscapular region and general muscle tone. Regular exercise will help prevent muscle spasms and pain behind the shoulder blades.
  • It is necessary to massage the scapular area and the collar area regularly.
  • You can do this regularly: place a small (tennis) ball on the floor with your upper back flat on it, and "roll" on the ball, passing it vertically between your shoulder blades.

If symptoms of back pain below the shoulder blades are accompanied by cough, hypothermia, increased breathing pain, and cough reflex, you should consult a doctor for tests to rule out bronchopulmonary disease.