Pain under the shoulder blades from the back - Causes, Symptoms and Treatment

Pain at the level of the shoulder blades in the chest region can indicate back problems, pain in the internal organs, and discomfort in the heart muscle. To find out the cause, the doctor must clearly explain the complaints and take over an examination. Depending on the diagnosis, therapy is prescribed. You should also consider in detail how to treat back pain under the shoulder blades.

Chest anatomy

The shoulder zone belongs to the thoracic spine and is located at chest level. The anatomy of this area needs to be studied to understand which organs can directly and indirectly disturb the patient.

The main anatomical elements are:

1. The spine - consists of spinal cord and vertebrae, intervertebral discs. It is an important part of the entire musculoskeletal system, protecting the spinal cord from damage.
2. The right and left shoulder blades belong to the bone structure of the upper shoulder girdle. They look like a triangle and have flat bones. There are many pits and depressions in this bone structure. These are the sites where the ligaments, tendons, and muscles attach. The blades are 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 functioning of the cardiovascular system, pumping blood through the veins and arteries.
5. The lungs are a pair of respiratory organs that are responsible for gas exchange processes.
6. Esophagus, stomach - belong to the digestive system.
7. Ribs - provide a protective function for the chest. These are flat bones that connect to the spine behind and in front of the sternum.

The nature of pain

The scapulae are located in the back of the back and are close to the humerus and clavicle. It is a triangular, paired bone to which the rhombus and partly trapezoidal muscles are attached. These muscle groups make the upper shoulder girdle movable. The scapulae are connected to the ribs to form a strong frame of the trunk. Any discomfort in this area can lead to significant discomfort and restricted movement of the upper back. Because of this, the pain is not tolerated and see a doctor immediately.

The diversity of pain sensations is divided into several classifications:

1. Pain and its nature according to the localization of discomfort - in the middle of the shoulder blades, on the left or right side, regardless of whether there is radiation between the chest or ribs, the pain can be felt higher or lower.
2. By the nature of the feelings - unpleasant, pulling feelings, acute pain, whining, irradiation, pulsation.
3. The duration of pain is episodic attacks, constantly felt, sharply increased, discomfort occurs after physical activity.

Most often, pulling pain indicates spinal problems and rarely other related problems.

Main reason

Symptoms of pain under the shoulder blades are caused by the following disorders:

• stomach pain (stomach ulcer, gastritis);
• indigestion (heartburn, esophageal reflux);
• disorders of the cardiovascular system (myocardial infarction, pericarditis);
• lung problems (bronchitis, pneumonia);
• spinal degenerative disorders of the spine;
• trauma, inflammation, sprain, 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 straight walking and therefore bears a significant load. A careful attitude towards our 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 as a result of movement or exertion. During the acute period, the pain is constant and can even be felt 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 bones or ligaments.

Other traumatic injuries:

1. Injury. It is characterized by superficial pain. Most commonly, superficial soft tissues, the upper muscle layer, and subcutaneous fat suffer from bruises. Unpleasant sensations occur below and below the shoulder blades, swelling and a locally localized inflammatory process occur. No special treatment is usually required. This pain will go away on its own within a few weeks.
2. Fracture or cracking - the pain is acute, has no reflection, and is concentrated at the site of injury. Even the slightest gesture makes you feel excruciating. In such a situation, the patient shows complete rest so as not to worsen the situation by breaking.
3. Displacements, movement of the vertebrae. In this case, the pain is localized not only in the shoulder region but also in the back at the level of the chest region. Often, the pain is due to compression of the nerve endings in the spinal canal, indicating damage to the intervertebral discs.

Trauma is easy to identify. During movement, cracking can be felt, swelling of the tissue can be observed at the site of bruising.

Osteochondrosis

The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the level of the spine. Unpleasant sensations occur due to pinching of nerve endings. In the upper part of the patient, if the chest region is altered, he feels sharp shoulder pain that radiates to the arm. The site depends on the changes in the particular nerve roots. When the blood vessels are constricted, pressure increases, headaches and dizziness occur.

If the lower part of the chest region is affected, the patient has discomfort in the lower back from the shoulder blade. It also gives to the left or right hand, depending on the location of the pinched nerve. Over time, the pain becomes more intense, and the patient feels uncomfortable not only during motor activity but also during rest periods. Difficult situation - the discomfort can be felt day and night, even at night. Bumps or hernias often occur in the background of osteochondrosis.

Scoliosis

Posture disorder is the most common disease of the spine that occurs at an early age. The first problems can be seen from the first grade of school - children can’t control the correct posture and don’t understand why adults require them to sit evenly. Over time, abnormal movement habits develop. A person sits in a comfortable posture, but this position causes static overload and imbalance in the muscles. If the spine remains in an analgesic position for a long time, curvature will occur, which is fraught with consequences.

In adulthood, many people experience hypodynamics - a state of low physical activity when a person is living a sedentary lifestyle only. The result is persistent back pain due to muscle weakness. If there is curvature in the chest region, the pain is localized in the region of the shoulder blades. Sometimes there is a radiant discomfort in the neck region. The characteristic difference of scoliosis is that in the standing, relaxed state, one shoulder is higher than the other.

During the initial examination, the therapist may see the disease. The disease should be treated for a long time and with an integrated approach. To alleviate the painful condition, you need to develop a lifestyle, stop nervousness, and start moving. Stress can increase muscle tone, causing deterioration. Massage helps a lot, back movement therapy is also useful.

Hernias and protrusions

The onset of intervertebral hernia is a severe condition characterized by protrusion of the spinal canal through the fibrous ring of the disc. The previous condition of the hernia is the prominence. Upon protrusion, the plate is partially damaged and the fibrous ring is tensioned. Hernias occur during strenuous physical exertion due to heavy lifting. The hereditary factor plays an important role in their appearance. If the family has close relatives with hernias or protrusions, they are more likely to occur in children as they age.

If a hernia or protrusion is at the level of the chest region, there is pain in the area of the shoulder blades. Irradiation of pain also occurs in the arm or shoulder. The side depends on the specific pinched nerve roots. The painful shooting is explained by the defeat of the nerve endings, which are constricted by excessive compression of the back.

In case of involvement of the lower back, the back pain is given to the foot, in case of a neck hernia, the pain radiates to the head. A hernia in any situation requires complex treatment aimed at relaxing the back, relieving acute pain, and relieving muscle tension. It is useful to perform practical therapy with hernias and protrusions, to participate in physiotherapy procedures. Rare and advanced cases require surgery.

Kyphosis

It has a curvature similar to scoliosis, but in the opposite direction. If the spine is curved to the right or left in the case of scoliosis, the upper shoulder girdle has a pronounced curvature in the case of kyphosis. One characteristic sign of the disease is the feeling of pain in the interscapular zone in 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 side. Usually the pain occurs on both sides and adds to the arms and neck. There are two main mechanisms for the development of pathology:

1. Neurogenic. During the occurrence of curvature, degenerative processes occur in the spine, which cause pinching of the nerve roots of the spinal cord. There are painful pains around the right and left shoulder that affect the neck, collarbone or arm, less commonly the shoulder joint.
2. Muscular. The continuous concave state causes muscle imbalance and overexertion. The muscles in the upper back are compressed, which provokes hypertension and severe pain. The rest of the back also suffers. Hypotension may occur in the lumbar region.

As a result, the vertebral artery is compressed, causing permanent damage to the cerebral circulation. Welfare is gradually deteriorating, and the functioning of internal organs is disturbed. Complex work has to be done with such a patient, including the services of a rehabilitator, gymnastics.

Spondylarthrosis

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

The pathology manifests itself in several stages:

1. Deformation and destruction of cartilage. If blood circulation in this zone is damaged, the integrity of the connective tissue is destroyed, causing the articular disc to become thinner. Restorative processes in bone and connective tissue are significantly impaired. Increased physical activity in this area leads to microtrauma.
2. Further deforming changes occur. Seals appear in the disc, mobility is impaired, leading to increased destruction of cartilage tissue. The patient may continue to feel pain, even at rest.
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 needed.

The characteristic manifestation of spondylarthrosis in the initial stage is the appearance of pain only during physical exertion. Resting discomfort is reduced because there is no traumatic factor.

Intercostal neuralgia

This condition refers to disorders of the vagus nerve. If a pathology occurs, there is a sharp pain that shoots into the shoulder blades, ribs and chest. This type of pain is often confused with a heart attack. A characteristic difference is the lack of clear localization in the heart region. As a result of inspiration, unpleasant feelings intensify. The pain is accompanied by a feeling of contraction. If the patient thinks they are suffering from angina pectoris, there is no relief after taking nitroglycerin.

Pain under the right or left scapula indicates innervation of certain areas. Numbness and convulsions are not characteristic of this pathological process. Due to the specifics of the symptoms of the disease, it will be diagnosed without any problems by a specialist. Treatment involves the use of injectable B vitamins and muscle relaxants. Treatment of intercostal neuralgia should be treated by a neurologist.

Causes of pain under the left shoulder from behind to back - heart disease

Back pain is often an indication of heart disease. Why back pain is a referenced phenomenon of pain that indicates coronary artery disease, myocardial infarction, or pericarditis. If you experience sudden stabbing pain that is exacerbated by physical exertion but there are no symptoms of spinal disease, a cardiologist should be consulted immediately. Self-handling or procrastination can put the situation in a critical state.

The most common causes of heart discomfort that cause pain under the left shoulder blade, from behind, from behind:

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 blockage of the large arteries and veins by the thrombus. If the thrombotic plaque breaks down and blocks the flow of blood around the heart, a heart attack occurs. In this condition, action must be taken quickly, otherwise the patient will die. The cause of the pathology is atherosclerosis, agglutination of erythrocytes, increased coagulation of platelets.
2. Ischemic heart disease or angina pectoris. According to a medical article, an attack of coronary artery disease develops suddenly. Dull pain occurs that is paroxysmal in nature. The attack can be easily stopped by taking nitroglycerin. 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 doesn’t help, you need to call an ambulance. In addition to the discomfort of the heart, the patient's breathing becomes real, shortness of breath occurs, which is exacerbated by physical exertion.
3. Pain in the back and back of the left shoulder blade may indicate the onset of an attack of pericarditis. The pathology is characterized by the accumulation of fluid with inflammatory changes in the serum membrane of the heart. Diagnosis includes examination of inflammatory markers, including rheumatic tests. Pericarditis is often a complication of a previous infectious disease, including upper and lower respiratory tract diseases. They perform long-term, complex therapy.

Diseases of the respiratory system

In the case of prolonged respiratory disease, the patient may eventually experience radiant pain in the shoulder blades. The most common complications are caused by such diseases:

1. Chronic or acute bronchitis. In the early stages, the disease is characterized by a dry cough. There is a gradual increase in laryngeal irritation and a wet cough. If the disease develops in the background of SARS, body temperature rises. The disease does not require special therapy, it is enough to observe bed rest, consume more warm fluids. Rarely, antipyretics and antibiotics may be needed.
2. Pleurisy. If the patient has complained of severe chest pain, including possible radiation, cough, shortness of breath, and fever, the disease should be ruled out or confirmed by a specialist. Pleurisy is characterized by inflammation of the pleural cavities, followed by accumulation of fluid in the pleural cavity. The disease is hard to bear. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is needed.
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 on inhalation, and severe fever. The disease is confirmed by a chest x-ray and can be treated with antibiotics.

Diseases of the gastrointestinal tract

Any disorder of the gastrointestinal tract that causes discomfort in the shoulder blades is of a reflective pain nature. What problems might occur:

1. Gastritis or stomach ulcer. If pain syndrome is reflected, the patient feels uncomfortable discomfort in the lower chest region (the bottom of the shoulder blades on both sides). It can look like muscle pain. A burning sensation can be felt in the solar plexus in parallel with the onset of pain in the stomach. Diseases are treated in a complex way, with drugs that reduce acidity and healing agents (proton pump inhibitors). If a bacterial pathogen is found, an antibiotic is prescribed.
2. Esophageal reflux, heartburn. The discomfort occurs in the chest area, often radiating to the shoulder area. The pathology is caused by the return of stomach contents to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour rash, a feeling of dumplings 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 in symptomatic treatment.

Editorial Review

Discomfort in the shoulder blade zone is most often associated with exacerbation of musculoskeletal disorders. Less commonly, heart disease, neurological problems, and gastrointestinal disorders lead to discomfort. To learn more about the causes of back pain, we encourage you to study the appropriate article on our site.