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

Pain in the thoracic region at the level of the shoulder blades may indicate back problems, pain in the internal organs, and heart discomfort. To find out the cause, you must 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 low back pain under the shoulder blades.

Chest anatomy

The scapular zone belongs to the thoracic spine and is located at chest level. 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. The spine consists of the spinal cord and vertebrae, the intervertebral discs. It is an important part of the entire musculoskeletal system, 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 triangles and are flat bones. There are many holes and depressions in this bone structure. These are the ligaments, tendons and muscles that connect. 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. The heart is responsible for the function of the cardiovascular system, pumping blood through the arteries and veins.
5. The lungs are the paired respiratory organs responsible for gas exchange processes.
6. Esophagus, stomach - refers 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 shoulder blades are located behind the back and are close to the humerus and clavicle. It is a triangular paired bone with rhomboid and partially trapezius muscles connected. These muscle groups move the upper shoulder girdle. The shoulder blades are attached to the ribs to create a solid frame of the body. Any discomfort in this area can cause significant discomfort and limited mobility of the upper back. For this reason, the pain is unbearable and you should see a doctor immediately.

The variety of pain sensations is divided into several classifications:

1. Pain and its nature depends on the localization of unpleasant sensations - in the middle of the shoulder blades, left or right, whether there is radiation between the chest or ribs, the pain is felt higher or lower.
2. Due to the nature of the sensations - unpleasant, tingling sensations, sharp pain, wheezing, radiation, pulsation.
3. The duration of pain is episodic attacks, constantly felt, sharply increasing, unpleasant sensations occur after physical activity.

Traction pain often indicates spinal problems and rarely indicates other related problems.

The main reasons

Symptoms of pain under the shoulder blades occur due to the following 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 spine;
• trauma, inflammation, sprains, myositis;
• neurological disorders.

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

Injuries

If the patient has a bruise or sprain, the pain under the shoulder blade may be caused by movement or tension. In the acute period, the pain is constant and is felt even at rest. Depending on the location of the injury, the pain may be on the left or right side of the shoulder blades. The most common types of damage are bone or muscle corsets.

Other types of traumatic injuries:

1. injury. It is characterized by superficial pain. Often suffers from superficial soft tissue, upper muscle layer and subcutaneous fat caries. Unpleasant sensations appear under and below the shoulder blades, swelling and a localized inflammatory process are visible. Usually no special treatment is required. This pain goes away on its own in a few weeks.
2. Fracture or fracture - the pain is sharp and there is no reversal and is concentrated at the site of injury. Even the slightest movement of the hand causes unbearable feelings. In this case, the patient is given complete rest so as not to aggravate the condition with a fracture.
3. Dislocations, vertebral displacement. 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 the pain is caused by compression of the nerve endings in the spinal canal, which indicates damage to the intervertebral discs.

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

Osteochondrosis

The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the level of the spine. Unpleasant sensations occur due to compressed nerve endings. In the upper part of the patient feels a sharp scapular pain that spreads to the arm with damage to the thoracic region. The side depends on the specific nerve root damage. When squeezing blood vessels, there is an increase in blood pressure, headache and dizziness.

If the lower part of the thoracic region is affected, the patient has an unpleasant sensation in the lower back below the scapula. It also gives left or right, depending on the location of the compressed nerve. Over time, the pain intensifies, the patient begins to feel discomfort not only during motor activity, but also at rest. Difficult situation - anxiety is felt even at night. Often, against the background of osteochondrosis, protrusions or tears occur.

Scoliosis

Posture disorders are the most common spinal disease that occurs at an early age. The first problems are already observed in the first grades of school - children do not control the correct posture and do not understand why adults are required to sit together. Over time, abnormal movement habits develop. A person sits in a position that is comfortable for him, but this position causes static loading of 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.

During adolescence, many people experience hypodynamics - a state of low physical activity when a person leads a sedentary lifestyle only. The result is persistent back pain due to muscle weakness. If there is a curvature in the thoracic region, the pain is localized in the area of the shoulder blades. Sometimes there is radiation discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in a standing, relaxed position.

At the initial examination, the therapist can see the disease. The disease needs to be treated over a long period of time and with an integrated approach. To alleviate the painful situation, you need to establish a lifestyle, stop being nervous and start taking action. Under stress, muscle tone can increase, which can lead to poor well-being. Massage helps a lot, and exercise therapy for the back is also useful.

Hernias and protrusions

The appearance of an intervertebral hernia is a serious condition characterized by the protrusion of the spinal canal from the fibrous ring of the disc. The previous condition of the hernia is a protrusion. With the protrusion, the disc is partially damaged and the fibrous ring stretches. Hernias are caused by lifting heavy loads during intense physical exertion. Heredity plays an important role in their appearance. If close relatives of the family have hernias or protrusions, then children are more likely to develop with age.

If the hernia or bulge is located at the level of the thoracic region, pain occurs in the area of the shoulder blades. There is also radiation of pain in the arm or shoulder. The side depends on specially compressed nerve roots. Painful shots are explained by the defeat of the nerve endings that are compressed due to excessive compression of the back.

When the lower back is affected, back pain is transmitted to the legs, and when a cervical hernia occurs, the pain spreads to the head. In any case, the hernia requires a complex treatment aimed at relaxing the back, relieving acute pain and relieving muscle tension. It is useful to conduct exercise therapy with hernias and protrusions, to participate in physiotherapy procedures. In rare and advanced cases, surgery is required.

Kyphosis

This is a curvature similar to scoliosis, but in the opposite direction. If the spine is bent to the right or left with scoliosis, there is an open curvature of the upper shoulder girdle with kyphosis. One of the characteristic symptoms of the disease is pain in the interscapular zone with the presence of external signs of pathology. Depending on the nature of the curvature, it hurts under the left shoulder blade or on the right. Usually the pain is on both sides and extends to the arms and neck. There are two main mechanisms of pathological formation:

1. Neurogenic. During the curvature, degenerative processes take place in the spine, which leads to compression of the nerve roots of the spinal cord. There is pain in the right and left back, neck, clavicle or arm, less pain in the shoulder joint.
2. Muscular. Constant concave position leads to muscle imbalance and excessive tension. The muscles in the upper back are constricted, which causes them to become hypertonic and in severe pain. The rest of the back muscles also suffer. Hypotension may occur in the lumbar region.

As a result, the vertebral artery constricts, leading to permanent disruption of cerebral circulation. Gradually, there is a deterioration in well-being, there are malfunctions of internal organs. It is necessary to carry out complex work with such a patient, including the services of a rehabilitator, exercise therapy.

Spondylarthrosis

Sometimes the development of spondylosis shows pain in 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, the most pronounced feeling of stiffness in the morning.

The pathology manifests itself in several stages:

1. Deformation and destruction of cartilage. If blood circulation is disrupted in this area, the integrity of the connective tissue is compromised, so the articular disc becomes thin. Regenerative processes in bone and connective tissue are significantly impaired. Increased physical activity in this area leads to microtrauma.
2. Additional deformation changes occur. Seals appear on the disc, mobility deteriorates, which leads to increased destruction of cartilage tissue. Even if the patient is in a calm state, he may feel constant pain.
3. The terminal stage is ossification, the formation of osteophytes. These growths damage adjacent joints, tendons, muscles and ligaments. In this case, surgery will be required.

The characteristic manifestation of spondylosis in the early stages is the appearance of pain only during physical exertion. As there is no traumatic factor, discomfort is reduced during rest.

Intercostal neuralgia

This condition is a disorder of the vagus nerve. When a pathology occurs, a sharp pain appears in the shoulder blade, ribs and chest. This type of pain is often confused with a heart attack. A characteristic difference is the lack of a clear localization in the region of the heart. Inspiration intensifies unpleasant feelings. The pain is accompanied by a feeling of tightness. If the patient thinks that he has angina pectoris, then there is no relief after taking nitroglycerin.

Pain under the right or left shoulder blade indicates innervation in certain areas. Complications and spasms are not characteristic 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 B vitamins for injection and myotropic drugs (muscle relaxants). Intercostal neuralgia should be treated by a neurologist.

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

Often, back pain is a sign of heart disease. Why back pain is a cited pain phenomenon indicating coronary artery disease, myocardial infarction or pericarditis. If you have sudden stabbing pain that increases with physical force, but there are no signs of spinal disease, you should see a cardiologist immediately. Self-medication or procrastination can lead to a critical condition.

The most common causes of heart pain that cause back pain behind the left shoulder blade are:

1. Myocardial infarction. In addition to radiation, the patient feels excruciating pain in the heart muscle area. The causes of the pathology are associated with thrombus occlusion of large arteries and veins. If the thrombotic plaque ruptures and obstructs the flow of blood around the heart, a heart attack will occur. In this case, the person must act quickly, otherwise the patient will die. The root cause of the pathology is atherosclerosis, agglutination of erythrocytes, platelets with increased clotting.
2. Ischemic heart disease or angina pectoris. According to the medical article, the onset of coronary artery disease develops suddenly. There is a dull pain that is paroxysmal in nature. Taking nitroglycerin stops the attack easily. The disease requires additional 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, an ambulance should be called. In addition to the feeling of anxiety in the heart, the patient is breathing, shortness of breath, which is aggravated by physical force.
3. Pain under the left shoulder blade in the back may indicate the development of a pericarditis attack. Pathology is characterized by accumulation of fluid 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 a previous infectious disease, including upper and lower respiratory tract infections. Long-term, complex therapy is carried out.

Diseases of the respiratory system

In the case of long-term respiratory diseases, the patient may eventually experience radiation pain in the area of the shoulder blades. Complications are often caused by the following diseases:

1. Chronic or acute bronchitis. In the early stages, the disease is characterized by a dry cough. Gradually, the irritation of the larynx increases and a wet cough occurs. If the disease develops against the background of SARS, then there is an increase in body temperature. The disease does not require special therapy, it is enough to observe bed rest, drink more warm fluids. In rare cases, antipyretics and antibiotics may be needed.
2. Pleurisy. If the patient complains of severe chest pain with possible radiation, cough, shortness of breath and fever, the specialist should rule out or confirm the disease. Pleurisy is characterized by inflammation of the pleural effusions, followed by accumulation of fluid in the pleural cavity. The disease is difficult to tolerate. Complex treatment with antibiotics and anti-tuberculosis drugs is required.
3. I have pneumonia. It often develops as a complication of SARS. Pneumonia is characterized by a severe course accompanied by cough, shortness of breath, chest pain during inspiration, and severe fever. The disease is confirmed by chest radiography and can be treated with antibiotics.

Diseases of the gastrointestinal tract

All disorders of the gastrointestinal tract, which cause discomfort in the area of the shoulder blades, are characterized by pain. What problems can arise:

1. Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, the patient feels an unpleasant discomfort in the lower thoracic region (the base of the shoulder blades on both sides). It can look like muscle pain. A burning sensation may be felt in the solar plexus in parallel with the attack of pain in the stomach. Diseases are treated in a complex way, drugs and therapeutic agents (proton pump inhibitors) are used to reduce acidity. If a bacterial pathogen is found, antibiotics are prescribed.
2. Esophageal reflux, heartburn. Anxiety develops in the chest area, often spreading to the scapula area. The cause of the pathology is the return of gastric contents to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour eructation, a lumpy feeling in the throat. Rarely, vomiting occurs. It is necessary to limit the consumption of fried, spicy and fatty foods to prevent the attack. Acid-reducing antacids based on magnesium and aluminum hydroxide are used in symptomatic treatment.

Editorial opinion

Unpleasant sensations in the scapular area are most often associated with exacerbation of diseases of the musculoskeletal system. Less commonly, heart disorders, neurological problems, and diseases of the stomach and respiratory system are of concern. To learn more about the causes of back pain, it is recommended to read the relevant article on our website.