Pain under the shoulder blades from 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 a reflection of cardiac 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 disturb the patient directly and indirectly.

The main anatomical elements include:

1. The spinal column - consists of the spinal cord and vertebrae, 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 bone structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bone 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, 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 at the back of the back and are close to the humerus and collarbone. 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 together 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 nature according to the localization of unpleasant sensations - in the middle of the shoulder blades, on the left or right, whether there is irradiation to the chest or between the ribs, the pain is felt higher or lower.
2. By the nature of sensations - unpleasant, pulling sensations, acute 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.

Most often, pulling pains indicate problems with the spine and rarely signal 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 ridge, 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, so it bears a significant load. Careful attitude to one's own health helps to 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, pain under the shoulder blade may occur with movement or strain. In the acute period, 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 muscle corset.

Other types of traumatic injuries:

1. Injury. It is characterized by superficial pain. Most often, superficial soft tissues, the upper muscle layer and subcutaneous fat suffer from bruises. Unpleasant sensations occur under the shoulder blades and below, swelling and a locally localized inflammatory process appear. Usually no specific treatment is required. This pain goes away 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 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, which indicates damage to the intervertebral discs.

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

Osteochondrosis

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

If the lower part of the thoracic region is affected, then the patient has unpleasant sensations in the lower back from the scapula. Also gives to the left hand or right, 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 around the clock, even at night. Often, against the background of osteochondrosis, protrusions or hernias occur.

Scoliosis

Violation of posture is the most common disease of the spine that occurs at an early age. The first problems are observed already 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 static overload of the muscles and the development of imbalance. If the spine stays in an antalgic position for a long time, then 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 radiating discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in a standing, relaxed state.

At 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 alleviate the painful condition, you need to establish a lifestyle, 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 carry out exercise therapy for the back.

Hernias and protrusions

The appearance of an intervertebral hernia is a serious condition characterized by a protrusion of the spinal canal through the fibrous ring 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 heavy lifting. An important role in their appearance is played by the hereditary factor. If the family has close relatives with hernias or protrusions, then it is highly likely that they will occur with age in children.

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

When the lower back is affected, the backache is given to 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 tightness. With hernias and protrusions, 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 stoop of the upper shoulder girdle. One of the characteristic signs of the disease is a feeling of soreness in the interscapular zone in the presence of external signs of pathology. It hurts under the left shoulder blade or right, depending on the nature of the curvature. Usually the pain occurs on both sides and gives to the arms, neck. There are two main mechanisms for the formation of pathology:

1. Neurogenic. During the occurrence 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, which are given to the neck, collarbone or arm, less often to the shoulder joint.
2. Muscular. Constantly being in a concave state provokes muscle imbalance and overstrain. In the upper back, the muscles are clamped, which provokes their hypertonicity and severe pain. The rest of the back muscles also suffer. Hypotension may 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 in the work of internal organs. With such a patient, it is necessary to carry out complex work, including the services of a rehabilitator, exercise therapy.

Spondylarthrosis

Sometimes the development of spondylarthrosis indicates pain on the right or left 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 most pronounced in the morning.

Pathology manifests itself in several stages:

1. Deformation and destruction of cartilage. If blood circulation is impaired in this zone, then the integrity of the connective tissue is destroyed, due to which the articular disc becomes thinner. Restorative processes in the bone and connective tissue deteriorate significantly. Increased physical activity in this area leads to microtrauma.
2. Further deforming changes occur. Seals appear in the disc, mobility worsens, which leads to increased destruction of cartilage tissue. The patient may constantly feel soreness, even in a state of calm.
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 required.

A characteristic manifestation of spondylarthrosis at the initial stage is the appearance of pain only during physical exertion. Discomfort at rest subsides, as there is no traumatic factor.

Intercostal neuralgia

This condition refers to disorders of the vagus nerve. When a pathology occurs, a sharp pain appears, shooting into 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. Unpleasant sensations intensify on inspiration. The pain is accompanied by a feeling of constriction. If the patient thinks that he has angina pectoris, then after taking nitroglycerin, there is no relief.

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

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

Often, back pain indicates a heart disorder. Why back pain is a phenomenon of referred pain that indicates 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 diseases of the spine, you need to 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 aching pain in the region of the heart muscle. The causes of the pathology are associated with blockage of large arteries and veins by a thrombus. If the thrombotic plaque breaks off and blocks the 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 clotting.
2. Ischemic heart disease or angina pectoris. According to information from a medical article, an attack of coronary artery disease develops suddenly. There is a 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, you need to call an ambulance. In addition to discomfort in the heart, the patient's breathing comes true, shortness of breath occurs, which is aggravated by physical exertion.
3. Pain under the left shoulder blade from the back from the back may indicate the development of an attack of pericarditis. 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 often 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. Pleurisy. If the patient complained of severe chest pain with possible irradiation, cough, shortness of breath and fever, then the specialist must rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural layers, followed by the accumulation of liquid sputum in the pleural cavity. The disease is hard to bear. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is required.
3. Pneumonia. Often develops as a complication of SARS. Pneumonia is characterized by a severe course, accompanied by cough, shortness of breath, chest pain on inspiration and a strong fever. The disease is confirmed by a 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 reflected pain character. What problems may arise:

1. Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, then the patient feels unpleasant discomfort in the lower thoracic region (the bottom of the shoulder blades on both sides). It may seem 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 scapular 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 sensation 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. In symptomatic treatment, acid-reducing antacids based on magnesium and aluminum hydroxide are used.

Editorial opinion

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