Pain under the shoulder blades from the back - causes, symptoms and treatment

Pain in the thoracic region at the level of the shoulder blades can indicate back problems, pain in internal organs and a reflection of heart discomfort. To find out the cause, you need to clearly explain the complaints to the doctor and undergo an examination. Depending on the diagnosis, therapy is prescribed. You should also consider in detail ways to treat back pain under the shoulder blades.

Chest anatomy

The scapular zone belongs to the thoracic spine and is located at the level of the chest. It is necessary to study the anatomy of this area in order to understand which organs can directly and indirectly disturb the patient.

The main anatomical elements include:

1. Spinal column - consists of spinal cord and vertebrae, intervertebral discs. It is an important part of the entire musculoskeletal system, it protects the spinal cord from damage.
2. The right and left shoulder blades belong to the bony structures of the upper shoulder girdle. They look like a triangle and have straight bones. This bone structure has many pits and depressions. These are the places where ligaments, tendons and muscles attach. The blades have high strength, so they can easily withstand constant static loads.
3. The collarbone is the bone that connects the scapula to the chest.
4. Heart - is responsible for the functionality of the cardiovascular system, pumps blood through veins and arteries.
5. The lungs are a paired respiratory organ responsible for gas exchange processes.
6. Esophagus, stomach - belong to the digestive organs.
7. Ribs - provide a protective function of the chest. These are straight bones attached to the spine behind and in front of the sternum.

The nature of pain

The scapulae are located on the back of the back and are close to the humerus and collarbone. This is a paired triangle-shaped bone, to which rhomboid and partially trapezius muscles are attached. These muscle groups make the upper shoulder girdle mobile. The blades are joined together with the ribs to form a solid frame of the hull. Any discomfort in this area can lead to significant discomfort and limited upper back mobility. For this reason, the pain cannot be tolerated and consult a doctor immediately.

The variety of pain sensations is divided into several classifications:

1. Pain and its character according to the localization of unpleasant sensations - in the middle of the shoulder blades, left or right, whether the radiation is in the chest or between the ribs, the pain is felt more or lower.
2. Sensation by nature - uncomfortable, tingling sensations, acute pain, whining, radiation, pulsation.
3. The duration of pain is episodic attacks, it is felt constantly, it increases sharply, unpleasant feelings occur after physical activity.

Most often, traction pain indicates spine problems and rarely signals other related problems.

The main reasons

Symptoms of pain under the shoulder blades occur due to such disorders:

• stomach pain (stomach ulcer, gastritis);
• digestive disorders (heartburn, esophageal reflux);
• disorders of the cardiovascular system (myocardial infarction, pericarditis);
• lung problems (bronchitis, pneumonia);
• degenerative disorders of the ridge, spine;
• trauma, inflammation, sprains, myositis;
• neurological disorders.

In 90% of cases, as statistics show, discomfort in the shoulder blades is caused by back pain. The human spine is responsible for upright walking, so it carries a significant load. Taking care of your own health helps improve well-being when physical inactivity and poor posture cause discomfort. The situation is getting worse with age.

Injuries

If the patient has a bruise or sprain, pain under the shoulder blade may occur when moving or straining. In the acute period, the pain is constant and is felt even at rest. Depending on the location of the injury, pain occurs on the left or right side of the shoulder blades. The most common types of damage are bones or a muscular corset.

Other types of traumatic injuries:

1. Injury. It is characterized by superficial pain. Bruises most often affect the superficial soft tissues, the upper muscle layer and subcutaneous fat. Unpleasant sensations occur under the shoulder blades and below, swelling and locally localized inflammatory process occur. No special treatment is usually required. This pain disappears on its own within a few weeks.
2. Fracture or crack - the pain is acute and has no reflection and is concentrated at the site of injury. Even the slightest movement of the hand causes painful sensations. In such a situation, the patient is shown complete peace, so that the situation does not get worse with a fracture.
3. Dislocations, vertebral displacement. In this case, the pain will be localized not only in the area of the shoulder blade, but also in the back at the level of the thoracic region. Pain often occurs due to compression of nerve endings in the spinal canal, which indicates damage to the intervertebral discs.

Trauma is easy to recognize. During the movement, a squeak is felt, swelling of the tissue at the site of the bruise is noticed.

Osteochondrosis

The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the level of the ridge. Unpleasant sensations occur due to pinched nerve endings. With a lesion of the thoracic region in the upper part, the patient feels sharp pain in the scapulae radiating to the arm. The side depends on the lesion of specific nerve roots. Compression of blood vessels increases pressure, headache and dizziness.

If the lower thoracic region is affected, then the patient has unpleasant sensations in the lower back from the scapula. It also gives on the left or right arm, depending on the location of the pinched nerve. Over time, the pain becomes more intense, the patient begins to feel discomfort not only during motor activity, but also during the rest period. Difficult situation - discomfort is felt 24 hours a day, even at night. Bumps or hernias often occur in the background of osteochondrosis.

Scoliosis

Posture disorders are the most common disease of the spine that occurs at an early age. The first problems are noticed from the first grade of school - children do not control proper posture and do not understand why adults require them to sit evenly. Abnormal movement habits develop over time. The person sits in a position that is comfortable for him, but that position causes static muscle overload and the development of imbalance. If the spine remains in an antalgic position for a long time, curvature occurs, which is fraught with consequences.

In adulthood, many people experience hypodynamics - a state of low physical activity, when a person leads a sedentary lifestyle. The result is persistent back pain due to muscle weakness. If there is curvature in the thoracic region, then the pain is localized in the scapular region. Radiation of discomfort in the cervical region sometimes occurs. The characteristic difference of scoliosis is that one shoulder is higher than the other in a standing, relaxed state.

At the initial examination, the therapist may notice the disease. The disease needs to be treated for a long time and with the help of an integrated approach. To alleviate the painful condition, it is necessary to establish a way of life, stop being nervous and start moving. Under stress, muscle tone can increase, which will cause a deterioration in well-being. Massage helps a lot, it is also useful to conduct back exercise therapy.

Hernias and protrusions

The appearance of an intervertebral hernia is a serious condition characterized by protrusion of the spinal canal through the fibrous ring of the disc. The previous condition of the hernia is protrusion. In protrusion, the disc is partially damaged and the fibrous ring is stretched. Hernias occur during intense physical exertion, due to lifting heavy loads. Hereditary factors play an important role in their appearance. If the family has close relatives with hernias or protrusions, then it is very likely that they will appear in children with age.

If the hernia or bulge is at the level of the thoracic region, then there is pain in the area of the shoulder blades. There is also radiation pain in the arm or shoulder. The side depends on the specific pinched nerve root. Painful shooting is explained by the defeat of nerve endings, which are tightened due to excessive compression in the back.

When the lower back is affected, back pain affects the leg, and when a cervical hernia occurs, the pain spreads to the head. In any situation, a hernia requires a complex treatment aimed at relaxing the back, relieving acute pain and removing muscle tension. In case of hernias and protrusions, it is useful to carry out exercise therapy, to attend physiotherapy procedures. In rare and advanced cases, surgery is required.

Kyphosis

This curvature is similar to scoliosis, but in the opposite direction. If in scoliosis the spine is curved to the right or left, then in kyphosis the curvature of the upper shoulder girdle is expressed. One of the characteristic signs of the disease is a feeling of pain in the interscapular zone with the presence of external signs of pathology. Pain below the left shoulder blade or right, depending on the nature of the curvature. Usually the pain occurs on both sides and gives in the hands, neck. There are two main mechanisms for the development of pathology:

1. Neurogenic. When curvature occurs, degenerative processes occur in the spine, which causes pinching of the nerve roots of the spinal cord. There is pain in the area of the right and left shoulder blades, which is applied to the neck, collarbone or arm, less often to the shoulder joint.
2. Muscular. Constant concave condition causes muscle imbalance and overexertion. In the upper back the muscles are tightened, causing their hypertonicity and severe pain. Other back muscles are also affected. Hypotension may occur in the lumbar region.

As a result, the vertebral artery is compressed, which causes a permanent violation of cerebral circulation. Gradually there is a deterioration in well-being, there are failures in the work of internal organs. With such a patient it is necessary to perform complex work, including the services of a rehabilitator, exercise therapy.

Spondylarthrosis

Sometimes the development of spondyloarthritis indicates pain on the right or left side of the shoulder blades. The disease is characterized by damage to the facet joints and intervertebral discs. With the development of the disease there is a loss of mobility, there is a feeling of stiffness, which is most pronounced in the morning.

The pathology manifests itself in several stages:

1. Cartilage deformation and destruction. If the blood circulation in this zone is disturbed, then the integrity of the connective tissue is destroyed, due to which the articular disc becomes thinner. Restorative processes in bone and connective tissue significantly worsen. Increased physical activity in this area leads to microtrauma.
2. Further deforming changes occur. Disks appear in the disc, mobility worsens, which leads to increased destruction of cartilage tissue. The patient may constantly feel pain, even in a state of calm.
3. The terminal phase is ossification, osteophyte formation. These growths damage adjacent joints, tendons, muscles and ligaments. In that case, surgery will be needed.

The characteristic manifestation of spondyloarthritis in the initial phase is the appearance of pain only during physical exertion. Discomfort at rest subsides, because there is no traumatic factor.

Intercostal neuralgia

This condition is related to vagus nerve disorders. When pathology appears, there is a sharp pain that shoots into the shoulder blade, ribs and chest. This type of pain is often confused with a heart attack. The characteristic difference is the lack of clear localization in the area of the heart. Unpleasant sensations are intensified by inspiration. The pain is accompanied by a feeling of tightness. If the patient thinks he has angina pectoris, then there is no relief after taking nitroglycerin.

Pain under the right or left shoulder blade indicates innervation of certain areas. Numbness and spasm are not typical of this pathological process. Given the specificity of the symptoms of the disease, the specialist will make a diagnosis without any problems. Treatment consists of the use of injectable B vitamins and myotropic drugs (muscle relaxants). The treatment of intercostal neuralgia should be performed by a neurologist.

Causes of pain under the left shoulder blade from the back - heart disorders

Back pain often indicates a heart disorder. Why back pain is a phenomenon of directed pain that indicates coronary artery disease, myocardial infarction or pericarditis. If a sudden sting occurs, which is intensified by physical exertion, but there are no symptoms of spinal disease, it is necessary to urgently visit a cardiologist for a consultation. Self-medication or procrastination can bring the situation to a critical state.

The most common causes of heart problems, which cause pain under the left shoulder blade from the back:

1. Myocardial infarction. In addition to radiation, the patient feels painful pain in the area of the heart muscle. Causes of pathology are associated with blockage of large arteries and venous thrombi. If the thrombotic plaque separates and blocks the vascular flow around the heart, a heart attack will occur. In this condition one should act quickly, otherwise the patient will die. The main cause of the resulting pathology is atherosclerosis, agglutination of erythrocytes, platelets with increased coagulation.
2. Ischemic heart disease or angina pectoris. According to the information from the medical article, the attack of coronary artery disease occurs suddenly. There is dull pain, which is paroxysmal in nature. The attack is easily stopped by taking nitroglycerin. The disease requires further medical supervision, because it can occur at the most unexpected moment. If the attack lasts more than a few hours and the medication does not help, it is necessary to call an ambulance. In addition to the discomfort in the heart, the patient experiences shortness of breath, shortness of breath, which worsens with physical exertion.
3. Pain under the left shoulder blade from the back may indicate the development of an attack of pericarditis. The pathology is characterized by fluid accumulation with an inflammatory lesion of the serous membrane of the heart. Diagnosis includes testing for markers of inflammation, including rheumatic tests. Pericarditis is often a complication of previous infectious diseases, including respiratory diseases of the upper and lower respiratory tract. Long-term, complex therapy is performed.

Diseases of the respiratory system

In the presence of prolonged respiratory diseases, the patient may eventually experience radiating pain in the scapular region. The most common complications are caused by such diseases:

1. Chronic or acute bronchitis. In the early stages of the disease is characterized by dry cough. The irritation of the larynx gradually increases and a wet cough occurs. If the disease developed on the background of SARS, then there is an increase in body temperature. The disease does not require specific therapy, it is enough to stick to bed, drink more warm fluids. Rarely, antipyretics and antibiotics may be needed.
2. Pleurisy. If the patient complained of severe chest pain with possible radiation, cough, difficulty breathing and fever, then the specialist must rule out or confirm this disease. Pleuritis is characterized by inflammation of the pleural leaves, followed by accumulation of liquid sputum in the pleural cavity. The disease is difficult to tolerate. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is needed.
3. Pneumonia. They often develop as a complication of SARS. Pneumonia is characterized by a severe course, followed by cough, difficulty breathing, chest pain when inhaling and high temperature. The disease is confirmed by chest X-ray and can be treated with antibiotics.

Diseases of the gastrointestinal tract

All disorders of the gastrointestinal tract that cause discomfort in the scapular region have a reflected painful character. What problems can arise:

1. Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, then the patient feels uncomfortable discomfort in the lower chest (lower shoulder blades on both sides). It can look like muscle pain. In addition to the attack of abdominal pain, a burning sensation in the solar plexus can be felt at the same time. Diseases are treated in a complex way, drugs to reduce acidity, drugs (proton pump inhibitors) are used. If a bacterial pathogen is found, antibiotics are prescribed.
2. Esophageal reflux, heartburn. Discomfort occurs in the chest area, often spreading to the scapular area. The cause of the pathology is the return of the stomach contents to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour belching, a feeling of a lump in the throat. In rare cases, vomiting occurs. To prevent an attack, you need to limit the consumption of fried, spicy and fatty foods. Symptoms include antacids that reduce magnesium-based acid and aluminum hydroxide.

Editorial opinion

Unpleasant sensations in the scapular zone are most often associated with worsening of diseases of the musculoskeletal system. Less often, heart disorders, neurological problems, diseases of the stomach and respiratory system lead to discomfort. To learn more about the causes of back pain, we recommend that you read the relevant article on our website.