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 the 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 the ways to treat back pain below the shoulder blades.

chest anatomy

The scapular area belongs to the thoracic spine and is located at the height of the thorax. It is necessary to study the anatomy of this area to understand which organs can bother the patient directly and indirectly.

The main anatomical elements include:

1. The vertebral column: consists of the spinal cord and the vertebrae, the intervertebral discs. It is an important part of the entire musculoskeletal system, it protects the spinal cord from damage.
2. The right and left scapula belong to the bony structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bony structure has many pits and depressions. These are the places of attachment of ligaments, tendons, and muscles. The blades have high strength, so they can easily withstand constant static loads.
3. The clavicle is the bone that connects the shoulder blade to the chest.
4. Heart: responsible for the functionality of the cardiovascular system, it pumps blood through the 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 flat bones attached to the spine behind and in front of the sternum.

The nature of pain

The shoulder blades are located in the posterior part of the back and are close to the humerus and the clavicle. This is a paired bone of a triangular shape, to which the rhomboid and partially trapezius muscles are attached. These muscle groups make the upper shoulder girdle mobile. The shoulder blades are connected to each other with the ribs to form a strong frame of the torso. Any discomfort in this area can lead to significant discomfort and limited mobility of the upper back. For this reason, the pain cannot be tolerated and you should immediately consult a doctor.

The variety of pain sensations is divided into several classifications:

1. Pain and its character depending on the localization of unpleasant sensations: in the middle of the shoulder blades, to the left or to the right, whether there is irradiation to the chest or between the ribs, the pain is felt higher or lower.
2. By the nature of the sensations: unpleasant sensations, tightness, sharp pain, whining, irradiation, pulsation.
3. The duration of the pain is episodic attacks, it is felt constantly, increases sharply, unpleasant sensations occur after physical activity.

Very often, pulling pains indicate problems with the spine and rarely indicate other related problems.

main reasons

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

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

In 90% of cases, as statistics indicate, discomfort in the shoulder blades is caused by back pain. The human spine is responsible for walking upright, therefore it bears a significant load. A careful attitude towards one's own health helps improve well-being when physical inactivity and poor posture cause discomfort. The situation worsens with age.

injuries

If the patient has a bruise or sprain, there may be pain below the shoulder blade with movement or strain. In the acute period, the pain is constant and is felt even at rest. Depending on the location of the injury, the pain occurs on the left or right side of the shoulder blades. The most common types of damage are bone or muscle corset.

Other types of traumatic injuries:

1. Injury. It is characterized by superficial pain. Very often, the superficial soft tissues, the upper muscle layer and the subcutaneous fat are bruised. Unpleasant sensations occur under the shoulder blades, and below, swelling and a locally localized inflammatory process appear. Specific treatment is usually not required. This pain goes away on its own in a few weeks.
2. Fracture or crack: the pain is sharp and has no reflection and is concentrated at the site of injury. Even the slightest movement of the hand causes excruciating sensations. In such a situation, the patient is shown complete rest, so as not to worsen the situation with a fracture.
3. Dislocations, displacement of the vertebrae. In this case, the pain will be localized not only in the region of the shoulder blade, but also in the back at the level of the thoracic region. Often pain occurs due to compression of the nerve endings in the spinal canal, indicating damage to the intervertebral discs.

Trauma is easy to identify. During movement, a crunch is felt, swelling of the tissue is observed at the site of the hematoma.

osteochondrosis

The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the level of the crest. Unpleasant sensations arise due to pinched nerve endings. With an injury to the thoracic region in the upper part of the patient, he feels sharp scapular pain that radiates to the arm. The side depends on the injury to the specific nerve roots. When squeezing the blood vessels, there is an increase in pressure, headache and dizziness.

If the lower part of the thoracic region is affected, the patient has unpleasant sensations in the lower back of the scapula. It is also given to the left or right hand, 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 throughout the day, even at night. Often against the background of osteochondrosis, bulges or hernias occur.

Scoliosis

Violation of posture is the most common disease of the spine that occurs at a young age. The first problems are already observed from the first grades of school: children do not control the correct posture and do not understand why adults require them to sit evenly. Over time, abnormal movement habits develop. A person sits in a position that is comfortable for him, but this position causes a static overload of the muscles and the development of imbalance. If the spine remains in an antalgic position for a long time, a curvature occurs, which is fraught with consequences.

In adulthood, many people experience hypodynamia, a state of low physical activity, when a person leads an exclusively sedentary lifestyle. The result is persistent back pain due to muscle weakness. If there is a curvature in the thoracic region, then the pain is localized in the region of the shoulder blades. Sometimes there is discomfort that radiates in the cervical region. A characteristic difference in scoliosis is that one shoulder is higher than the other in a relaxed, upright state.

In the initial examination, the therapist can see the disease. It is necessary to treat the disease for a long time and with the help of an integrated approach. To relieve the painful condition, you need to establish a lifestyle, stop being nervous and start moving. Under stress, muscle tone can increase, which will lead to a deterioration in well-being. Massage helps a lot, it is also useful to perform exercise therapy for the back.

hernias and bulges

The appearance of an intervertebral hernia is a serious condition characterized by a protrusion of the spinal canal through the annulus fibrosus of the disc. The previous condition of the hernia is protrusion. With protrusion, the disc is partially damaged and the annulus fibrosus is stretched. Hernias occur during strong physical exertion, due to lifting heavy objects. The hereditary factor plays an important role in its appearance. If the family has close relatives with hernias or bulges, then they are very likely to occur with age in children.

If a hernia or protrusion is located at the level of the thoracic region, pain occurs in the region of the shoulder blades. There is also radiation of pain to the arm or shoulder. The side depends on the specific pinched nerve roots. Painful shooting is explained by the defeat of the nerve endings, which are pinched due to excessive compression on the back.

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

kyphosis

This is a curvature similar to scoliosis, but in the opposite direction. If with scoliosis the spine is curved to the right or left, then with kyphosis there is a pronounced tilt of the upper shoulder girdle. One of the characteristic signs of the disease is a sensation of pain in the interscapular zone in the presence of external signs of pathology. It hurts under the left or right shoulder blade, depending on the nature of the curvature. The pain usually occurs on both sides and occurs in the arms and neck. There are two main mechanisms for the formation of pathology:

1. neurogenic. During the appearance of curvature, degenerative processes occur in the spine, which causes pinching of the nerve roots of the spinal cord. There are aching pains in the region of the right and left scapula, giving in the neck, clavicle or arm, less often in the shoulder joint.
2. Muscular. Being constantly in a concave state causes muscle imbalance and overexertion. In the upper back, the muscles are tense, which causes their hypertonicity and severe pain. The rest of the back muscles also suffer. Hypotension can occur in the lumbar region.

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

spondyloarthrosis

Sometimes the development of spondyloarthrosis indicates pain on the right or left side in the region 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 more pronounced in the morning.

Pathology manifests itself in several stages:

1. Deformation and destruction of cartilage. If blood circulation is impaired in this area, the integrity of the connective tissue is destroyed, due to which the articular disc becomes thinner. Restoration processes in bone and connective tissue are significantly impaired. Increased physical activity in this area leads to microtrauma.
2. More deforming changes occur. Seals appear on the disc, mobility worsens, which leads to further destruction of cartilage tissue. The patient may constantly feel pain, even in a calm state.
3. The terminal stage is ossification, the formation of osteophytes. These growths injure adjacent joints, tendons, muscles, and ligaments. In this case, an operation will be necessary.

A characteristic manifestation of spondyloarthrosis in the initial stage is the appearance of pain only during physical exertion. The discomfort at rest subsides, since there is no traumatic factor.

intercostal neuralgia

This condition refers to disorders of the vagus nerve. When a pathology occurs, a sharp shooting pain appears in the shoulder blade, ribs and chest. This type of pain is often mistaken for a heart attack. A characteristic difference is the lack of a clear localization in the region of the heart. Unpleasant sensations intensify with inspiration. The pain is accompanied by a feeling of constriction. If the patient believes that he has angina pectoris, after taking nitroglycerin, there is no relief.

Pain under the right or left shoulder blade indicates innervation in specific areas. Numbness and spasm are not typical of this disease 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). Intercostal neuralgia therapy should be managed by a neurologist.

Causes of pain under the left shoulder blade behind the back: heart disorders

Back pain often indicates a heart disorder. Why back pain is a referred pain phenomenon indicating coronary artery disease, myocardial infarction, or pericarditis. If there is a stabbing pain of a sudden nature, which increases with physical exertion, but there are no symptoms of spinal diseases, then you should urgently visit a cardiologist for a consultation. Self-treatment or procrastination can bring the situation to a critical state.

The most common causes of discomfort in the heart, causing pain under the left shoulder blade from behind from the back:

1. Myocardial infarction. In addition to irradiation, the patient feels pain in the region of the heart muscle. The causes of the pathology are associated with the blockage of large arteries and veins by a thrombus. If the thrombotic plaque breaks off and blocks vascular flow around the heart, a heart attack will occur. In this state, one must act quickly, otherwise the patient will die. The root cause of the pathology that has arisen is atherosclerosis, agglutination of erythrocytes, platelets with increased coagulation.
2. Ischemic heart disease or angina pectoris. According to information in a medical article, an attack of coronary artery disease develops suddenly. There is a dull ache, which is paroxysmal in nature. The attack is easily stopped by taking nitroglycerin. The disease requires increased medical supervision, since it can occur at the most unexpected moment. If the attack lasts more than a few hours and the medicine does not help, you should call an ambulance. In addition to discomfort in the heart, the patient's breathing becomes reality, shortness of breath occurs, which is aggravated by physical exertion.
3. Pain under the left shoulder blade behind the back may indicate the development of an attack of pericarditis. The pathology is characterized by the accumulation of fluid with an inflammatory lesion of the serous membrane of the heart. Diagnosis includes testing for inflammatory markers, including rheumatic tests. Pericarditis is usually a complication of a previous infectious disease, including respiratory diseases of the upper and lower respiratory tract. Long-term complex therapy is carried out.

Diseases of the respiratory system

In the presence of prolonged respiratory diseases, the patient may eventually experience radiating pain in the area of the shoulder blades. Most often, complications are caused by such diseases:

1. Chronic or acute bronchitis. In the early stages, the disease is characterized by a dry cough. Gradually, irritation of the larynx increases, and a wet cough occurs. If the disease has developed against the background of SARS, then there is an increase in body temperature. The disease does not require specific therapy, it is enough to observe bed rest, drink more warm liquid. Rarely, antipyretics and antibiotics may be needed.
2. Pleuritis. If the patient complains of severe chest pain with possible radiation, cough, shortness of breath, and fever, then the specialist should rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural plates, followed by the accumulation of liquid sputum in the pleural cavity. The disease is difficult to bear. Comprehensive treatment with antibiotics and antituberculous drugs is required.
3. Pneumonia. It often develops as a complication of SARS. Pneumonia is characterized by a severe course, accompanied by cough, shortness of breath, chest pain when breathing in, and strong fever. 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 area of the shoulder blades have a character of reflected pain. What problems can arise:

1. Gastritis or stomach ulcer. If there is a reflex pain syndrome, then the patient feels unpleasant discomfort in the lower thoracic region (the lower part of the shoulder blades on both sides). It may look like muscle pain. With an attack of pain in the stomach, a burning sensation in the solar plexus can be felt in parallel. Diseases are treated in a complex way, drugs are used to reduce acidity, healing agents (proton pump inhibitors). If a bacterial pathogen is found, antibiotics are prescribed.
2. Esophageal reflux, heartburn. Discomfort occurs in the chest area, often radiates to the scapula area. The cause of the pathology is the return of the contents of the stomach to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour eructation, a feeling of lump in the throat. In rare cases, vomiting occurs. To prevent an attack, you should limit your intake of fried, spicy, and fatty foods. Acid-reducing antacids based on magnesium and aluminum hydroxide are used for symptomatic treatment.

editorial opinion

Unpleasant sensations in the scapular zone are most often associated with an exacerbation of diseases of the musculoskeletal system. Less often, heart disorders, problems in terms of neurology, diseases of the stomach and respiratory system cause discomfort. For more information on the causes of back pain, it is recommended to study the corresponding article on our website.