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Pain in the shoulder blade and below: which may indicate discomfort

Pain in and under the shoulder blade can occur with nerve damage, spinal diseases, shoulder girdle, or somatic pathologies. The cause can be determined by clinical signs, conditions of the syndrome and anamnestic data.

back pain in the shoulder blades

Pain in the scapular region can be felt during inhalation, felt in half of the body or on each side of the arm. In some cases, such symptoms are the "first call" of the flare-up period, which can be prevented once the trigger is identified.

Causes and localization

Pain under the shoulder blade is usually visible during movement - there is an awkward turn, standing for a long time with a bent back before it. This indicates local damage for a variety of reasons.

There are few pathologies with unilateral lesions that only hurt on the right or left side under the scapula - usually the severity of the symptoms is individual. This is due to the symmetrical arrangement of nerve roots extending from the spinal cord.

Injuries

If there is pain under the right and left shoulder blades, it may be the result of damage to the bones and muscle frame. There is no serious localization of symptoms, the severity depends on the traumatic factor. The clinic is usually acute, begins abruptly and takes a chronic course.

Causes of traumatic pain under the left or right shoulder blade include:

  1. Bruises - in such cases the pain is superficial, in most cases the muscles are damaged. Usually the back muscles under and below the shoulder blades ache, swelling and local inflammation develop. After 2-3 weeks, the symptoms disappear.
  2. Cracks and fractures are more serious injuries, the pain is concentrated in the scapula itself. Strengthens in the slightest movement, the patient can not move his arm and bend.
  3. Subluxation and displacement of the vertebrae - this causes joint pain at and below the level of the shoulder blades, sometimes the bone structures compress the nerve roots.

Injuries are characterized by sharp pain under the right or left shoulder blade, which is also spontaneous. There may be a crisis during the movements and often swelling appears.

Osteochondrosis

If the disease affects the thoracic spine, the patient has back pain near and below the shoulder blades. This is due to compression of the nerves or spinal cord due to deformation of the articular disc. The pathology develops gradually, and as the distance between the vertebrae decreases, the pathological clinic becomes more difficult.

The localization of pain depends on the affected area:

  1. If osteochondrosis destroys the articular discs of the thoracic region 2 to 6, pain is felt in the scapula. It usually spreads to the neck and arms. When the vessels constrict, dizziness appears, and intracranial pressure may increase.
  2. When the joints of 6-12 segments are affected, the pain spreads under the left or right shoulder blade, spreading down, to the corresponding half of the body, and to the lower back.

The spinal roots of the thorax cause the plexuses that innervate the arms and torso. Therefore, when you squeeze them, the pain spreads along their course.

With osteochondrosis, the discomfort is one-sided - pain in the right or left side and below the shoulder blade, depending on the curvature of the spine.

Scoliosis

This is a transverse bending of the spine due to excessive tension of the muscles that support the posture. This causes the roots and spinal cord to constrict, causing pain to appear under the right or left shoulder blade. The pathology is usually accompanied by:

  1. Respiratory failure - unilateral curvature of the spine causes chest deformation, which affects the function of the lungs, one of which is compressed, and the other assumes the lost function.
  2. Disorders of the heart - the frequency of contractions and changes in heart rate, shortness of breath and pale skin.
  3. The appearance of a visible deformity of the chest is the main cause of pain under the right or left shoulder blade. The vertebrae move sideways with the ribs, causing the bone structures to move downward on the side of the curvature and damage the spinal cord with their branches.

If the spinal cord is compressed during scoliosis, the back usually aches between and below the shoulder blades, and attention is severely limited. If muscle spasms are combined, the symptom spreads to neighboring structures.

Kyphosis

The posterior flexion of the spine is characterized by the forward displacement of the shoulder girdle, and a gradual flexion is seen. There is pain on the shoulder blade - usually bilateral, on the arm and neck. The following mechanisms are involved in its formation:

  1. Neurogenic - due to curvature, the distances between the vertebral bodies in the anterior parts decrease, which leads to compression of the branches of the spinal cord. There is excruciating pain in the right and left shoulder blades, which can spread to the collarbone, neck and shoulder.
  2. Muscular - Bending of the spine causes overloading of the muscles of the shoulder blades and the collar area, which can cause painful spasms below.

As a result of kyphosis, the vertebral artery is constricted, and cerebral circulation is disrupted. The work of internal organs is deteriorating.

Spondylarthrosis

If the right or left shoulder blade hurts, one of the reasons may be spondylosis - damage to the facet joints and intervertebral discs. Accompanied by loss of movement, stiffness is visible, most often expressed in the morning.

The clinical picture changes as the pathology progresses: >

  1. Destruction of cartilage - the lack of blood circulation disrupts the integrity of connective tissue, the articular disc becomes brittle, becomes more damaged and recovers more slowly. At this stage, strong physical force leads to microtrauma, pain that spreads to the area of the shoulder blades and down.
  2. Deformation of the articular disc - seals appear that impede mobility. This leads to new destruction that slows down the regeneration process, and the patient feels pain in the back and shoulder blades.
  3. The appearance of bone growths is characteristic of the advanced stage of the disease. Neoplasms damage joints, muscles, blood vessels and nerves.

With spondylosis, there may be pain between or below the back shoulder blades - an attack usually occurs before physical activity. At rest, symptoms are reduced because bone growth does not damage the surrounding tissues.

Protrusion and hernia

Under these conditions, severe pain under the left and right shoulder blades resulting from compression of the spinal cord or its roots is disturbing. As a result of pinching, the sensitivity along the nerve fibers is impaired.

The localization of symptoms is as follows:

  1. Pain in the shoulder blades and above - when a protrusion or hernia in the cervicothoracic region or 1-3 thoracic segments are affected. The symptom intensifies when you try to bend your head and turn it to the side.
  2. Pain in the intercapsular region - in this case, the middle parts may be affected, from 3 to 6. Anxiety increases when both hands are pulled to the side, deeply inhaled, or turned.
  3. Severe pain under the right and left shoulder blades - 6 to 12 articular discs are affected, may be involved in lower back pathology. In this case, there is a risk of developing a hernia because this part of the spine is loaded more than before.

Unlike spondylosis, herniated and protruding pains do not last long at rest. This is due to the constant squeezing of the nerve, which is aggravated by muscle spasms.

Radiculitis

This is the compression of the spinal roots that accumulate in the strong sciatic nerve. If its upper parts are affected, the patient feels pain under and below the scapula, becomes bilateral, aggravated by bending and sudden movements.

As the disease progresses, additional symptoms may appear: >

  1. There is low back pain that spreads to the lower extremities - the sharp stabbing pain is felt as an electric current along the nerve pathway.
  2. Burning pains in the back, lumbar region or under the shoulder blades indicate prolonged pinching of the spinal roots in the lumbar region.
  3. Cramps and loss of sensation usually occur in the lower back, hips, and sometimes there is numbness along the nerve fibers in the thighs, lower legs, and feet.

Shoulder-scapular periarthritis

This condition is understood as inflammation of the shoulder joint and surrounding tissues, stiffness occurs, disappears only after warming up.

The pain is concentrated in the area of the right or left shoulder blade and below, depending on the development of hemispheric motor skills (right or left hand). It appears first after training and then at rest. Additional symptoms appear along the way:

  • Headache;
  • numbness of hands;
  • impaired mobility of the spine.

With humeroscapular periarthrosis, the clinical manifestations increase when the arm is raised - pain in the right or left shoulder, shoulder blade area. Gradually, the range of motion decreases, the stiffness progresses.

Neuralgia

Another cause of pain under the right or left shoulder blade is inflammation of the nerves in this area. The disease is caused by hypothermia, draft. Most affected:

  1. Suprascapular and supraspinous nerves - there is pain in the right or left shoulder blade from the back, mainly concentrated in the clavicle. Sometimes the discomfort spreads to the shoulder, which indicates the defeat of the skin branches of this area.
  2. Subscapular and infraspinatus nerves - in this case, depending on the injured side, there is pain right or left under the spine. If the muscles of the same name are involved, the clinical manifestations are aggravated when the arms move downwards and are missed from behind.
  3. Intercostal nerves - usually 1-4 pairs. These branches go along the lower edge of the ribs, the pain occurs not only in the shoulder blades and below, but also on the sides of the chest, sometimes in the front.

Symmetry is not typical for neuralgia - if the left half of the body is exposed to drafts, there is pain in the neck, chest and shoulder blades on this side.

Heart disease

The branches of the parasympathetic trunk, which connects with the spinal cord and its roots, go to the heart. Therefore, heart disease can cause pain in the scapula and below. Mild forms of myocardial infarction are usually latent. It may be accompanied by the following symptoms:

  1. Dull or burning pain felt behind the sternum or under the left shoulder blade - can last for hours, increases during walking, but disappears a little at rest.
  2. Shortness of breath - is accompanied by pain, which can manifest itself in a few days.
  3. Tachycardia - an increase in heart rate, sometimes with arrhythmias.
  4. Other symptoms include increased blood pressure, dizziness, nausea, and vomiting.

Problems of the gastrointestinal tract

Gastrointestinal problems as a cause of pain under the left shoulder blade

Similar to the previous mechanism, the pain spreads along the nerve fibers. Clinical signs can be bilateral, but in most cases there is a certain pattern in which symptoms appear depending on the location of the internal organs.

Pain under the left left shoulder blade is caused by the following diseases:

  • pancreatitis;
  • gastritis;
  • gastric ulcer.

Patients with these diseases usually complain of dyspeptic disorders, nausea and vomiting. If internal bleeding occurs, pale skin, dark stools, decreased blood pressure, and weakness are noted.

Pain under the right shoulder blade from the back is accompanied by:

  • cholelithiasis;
  • hepatitis;
  • cirrhosis of the liver;
  • ulcerative lesion of the duodenum.

Other reasons

In addition to these factors, pain under the shoulder blades can be caused by:

  1. An uncomfortable mattress - if you fail and lie on your right side, you may feel pain under the left shoulder blade in the back as the curved spine compresses the spinal roots in the morning.
  2. Pleurisy - pain in the scapular region occurs when breathing due to friction of the layers, reaching the peak in deep breathing.
  3. Polio - is accompanied by pathological neurological symptoms, often with back pain.
  4. Intoxication - Severe poisoning or a cold can manifest itself with muscle aches, tremors and fever.
  5. VVD - vegetovascular dystonia is accompanied by changes in blood pressure, interruptions in heart function and shortness of breath, and sometimes a feeling of discomfort in the back.
  6. Kidney disease - such pathologies are characterized by aching or stabbing pain under the right shoulder blade, diuresis and discoloration of the urine, and general symptoms.
  7. Subdiaphragmatic abscess - if there is pus in the upper abdomen, there will be pain, fever and signs of intoxication under the shoulder blades during inhalation.
  8. Mental Disorders - In some cases, pain in the shoulder blades and below may be the result of such disorders. The exact mechanism of its occurrence has not been studied.

The nature of pain

Pain in the shoulder blades and lower back may be different, a certain group of pathologies can be assumed by their nature, and sometimes a provocative factor can be identified:

  1. Lumbago is characteristic of constricted nerves - a sharp stabbing pain caused by a sharp turn of the body, raising the arm. This is the main difference from cholelithiasis, in which the symptoms do not subside from the movements.
  2. Pain, throbbing or burning pain indicates pathology of the internal organs. The latter selection occurs when the roots of the spinal cord are compressed, but grow with movement and can become sutures.
  3. Severe narrowing pain in the area of the shoulder blades and below is characteristic of a hernia. Sometimes lumbago is accompanied by numbness of the limbs.
  4. Cutting pain of varying intensity is characteristic of neuralgia, and drilling is often accompanied by inflammation of the joints.

Which doctor treats pain in the shoulder blades?

If you feel pain in the scapula and below, you should make an appointment with a neurologist. If there are no compressed nerves, the specialist will refer you to an orthopedist, cardiologist, gastroenterologist or urologist, depending on the suspected disease.

Diagnostics

Laboratory and instrumental examinations are performed in the scapular region and below to determine the cause of the disorder:

  1. X-ray or CT - using these methods, you can detect osteochondrosis, curvature of the spine and the consequences of injuries.
  2. MRT >- Depending on the suspected pathology, the spine, shoulder joint or internal organs are examined.
  3. ECG - helps diagnose heart disease.
  4. Blood and urine tests are informative for some somatic pathologies, inflammation of muscles and joints.
  5. Ultrasound - is prescribed for somatic diseases when it is impossible to pass an MRI.

Usually, pain under the shoulder blades occurs due to neurological reasons. Therefore, CT and MRI are considered the "gold standard" in the diagnostic protocol.

General principles of treatment

The main task is to eliminate the symptoms and the trigger. First, the patient's well-being stabilizes, then the underlying pathology is treated.

The therapy program includes:

  1. Medications - Analgesics are usually prescribed to relieve pain and inflammation. Then, depending on the underlying disease, funds are prescribed - antibiotics, gastroprotectants, diuretics.
  2. Physiotherapy - strengthens the spine, treats somatic diseases. Medicinal electrophoresis is used in the field of shoulder blades, warm-up procedures, SWT.
  3. Massage - warming is performed with spinal cord injury. Such procedures relax the muscles above and below the shoulder blades, and improve posture. In this case, you need professional help from a chiropractor or osteopath.
  4. Gymnastics is performed after pain relief, a program is developed depending on the disease suffered by a physiotherapist, rehabilitation specialist.

Prevention

After successful treatment, patients are advised to follow a prophylactic program to prevent recurrence of the pathology:

  • pay attention to your posture;
  • choose a mattress and orthopedic pillow of medium hardness;
  • massage the shoulder blades and below twice a week;
  • follow a low-calorie diet for obesity;
  • get rid of bad habits;
  • prevention of somatic pathology (if there is a history);
  • see a doctor every six months.

Pain in the shoulder blades and below may be neurological or somatic in nature. When nerves are damaged, the symptoms become acute and sudden, appearing spontaneously.

Pathologies of internal organs and joints are characterized by gradual and long-term pain, the clinic is always accompanied by additional symptoms. In the initial stages, analgesics are prescribed, and after diagnosis, the program is completed with etiological therapy and strengthening procedures.