Pain under the shoulder blades from the back: causes, symptoms and treatment

Pain in the chest region at the level of the shoulder blades can indicate back problems, pain in internal organs, and a reflex of heart discomfort. To find out the cause, it is necessary 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 below the shoulder blades.

Chest anatomy

The scapular area 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 spine - 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 shoulder blades belong to the bony 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 attachment points for ligaments, tendons and muscles. The blades have high strength, so they can easily withstand constant static loads.
3. The collarbone 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 breastbone.

The nature of the 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 solid torso structure. 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 see a doctor immediately.

The variety of pain sensations is divided into several classifications:

1. Pain and its character according to the localization of unpleasant sensations: in the center of the shoulder blades, left or right, regardless of whether there is irradiation to the chest or between the ribs, the pain is felt higher or higher low.
2. By the nature of the sensations: unpleasant sensations, pulling, sharp pain, moaning, irradiation, pulsation.
3. The duration of pain consists of episodic attacks, is felt constantly, sharply increases, unpleasant sensations occur after physical activity.

Most often, pulling pains indicate spinal problems and rarely signal other related problems.

Main reason

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

• stomach pain (gastric ulcer, gastritis);
• digestive disorders (heartburn, oesophageal reflux);
• disturbances 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 the statistics indicate, discomfort in the shoulder blades is caused by back pain. The human spine is responsible for upright walking, so it bears a significant load. A careful attitude to one's 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, pain under the shoulder blade can occur with movement or exertion. In the acute period the pain is constant and is felt even at rest. Depending on the location of the lesion, 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. Wound. It is characterized by superficial pain. Most often, the 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. No specific treatment is usually required. This pain goes away on its own in a few weeks.
2. Fracture or crack: The pain is acute and has no reflexes and is concentrated at the site of the 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 shoulder blade region, 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 creak is felt, swelling of the tissue is observed at the site of the bruise.

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 experiences severe scapular pain that radiates to the arm. The side depends on the injury of the specific nerve roots. When the blood vessels are compressed, 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 from the shoulder blade. He also gives 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 experience discomfort not only during motor activity, but also during the rest period. Difficult situation: the discomfort is felt 24 hours a day, even at night. Often, protrusions or hernias occur against the background of osteochondrosis.

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 classes 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 comfortable position for him, but this position causes static overload of the muscles and the development of imbalance. If the spine remains in an analgesic position for a long time, a curvature occurs, which is fraught with consequences.

In adulthood, many people experience hypodynamy, 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, the pain is localized in the region of the shoulder blades. Sometimes there is radiant discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in an erect and relaxed state.

On initial examination, the therapist can see the disease. It is necessary to cure the disease for a long time and with the help of an integrated approach. To relieve the painful condition, it is necessary to establish a lifestyle, stop being nervous and start moving. Under stress, muscle tone can increase, causing a deterioration in well-being. The massage helps a lot, it is also useful for carrying out physical 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 the protrusion. With the protrusion, the disc is partially damaged and the fibrous ring is elongated. Hernias occur during severe 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, they are very likely to show up with age in children.

If a hernia or protrusion is found in the thoracic region, 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, back pain 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 relieving muscle tension. With hernias and protrusions, it is useful to carry out physical therapy, 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 with scoliosis the spine is curved to the right or left, then with kyphosis there is a pronounced curve of the upper shoulder girdle. One of the characteristic signs of the disease is a feeling of pain in the interscapular area in the presence of external signs of pathology. It hurts under the left or right shoulder blade, depending on the nature of the curvature. Pain usually occurs on both sides and extends 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 provoke pinching of the nerve roots of the spinal cord. There are aching pains in the region of the right and left shoulder blades, which are given in the neck, collarbone or arm, less often in the shoulder joint.
2. Muscular. Being constantly in a concave state causes muscle imbalance and overload. In the upper back, the muscles are blocked, 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, causing 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, physical therapy.

Spondyloarthrosis

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 area, the integrity of the connective tissue is destroyed, as a result of which the joint disc becomes thinner. Reparative processes in 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 greater destruction of cartilage tissue. The patient may experience pain constantly, even in a calm state.
3. The terminal stage is ossification, the formation of osteophytes. These growths damage adjacent joints, tendons, muscles, and ligaments. In this case, an operation will be required.

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

Intercostal neuralgia

This condition refers to disorders of the vagus nerve. When pathology occurs, sharp pain appears, affecting 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 heart region. Unpleasant sensations intensify on inspiration. The pain is accompanied by a feeling of constriction. If the patient thinks 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 pathological process. Given the specificity of the symptoms of the disease, the specialist will make a diagnosis without 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 from behind from the back - heart ailments

Often, back pain indicates a heart disorder. Because back pain is a referred pain phenomenon that indicates coronary artery disease, myocardial infarction, or pericarditis. If there is excruciating pain of a sudden nature, which increases with physical exertion, but there are no symptoms of diseases of the spine, it is necessary 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 heart discomfort, causing pain under the left shoulder blade from behind from the back:

1. Heart attack. In addition to irradiation, the patient feels aching 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 ruptures 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 main 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 from a medical article, a bout of coronary heart 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 manifest itself at the most unexpected moment. If the attack lasts more than a few hours and the drug does not help, an ambulance should be called. In addition to discomfort in the heart, the patient's breathing comes true, shortness of breath occurs, aggravated by physical exertion.
3. Pain under the left shoulder blade from behind 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 performed.

Diseases of the respiratory system

In the presence of prolonged respiratory disease, the patient may eventually experience radiating pain in the shoulder blade area. 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, an increase in body temperature occurs. The disease does not require specific therapy, it is enough to observe bed rest, drink more warm fluids. 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, the specialist should rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural sheets, followed by the accumulation of liquid sputum in the pleural cavity. The disease is difficult to bear. Comprehensive treatment with antibiotics and anti-tuberculosis 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 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

All disorders of the gastrointestinal tract that cause discomfort in the shoulder blade area have a reflex pain character. What problems can arise:

1. Gastritis or stomach ulcer. If there is a reflex of the pain syndrome, the patient feels unpleasant discomfort in the lower thoracic region (the lower part of the shoulder blades on both sides). It may feel like a 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 radiating to the scapular area. The cause of the pathology is the return of stomach contents into the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is an acid rash, the feeling of a lump in the throat. In rare cases, vomiting occurs. To prevent an attack, it is necessary to limit the consumption of fried, spicy and fatty foods. In symptomatic treatment, antacid antacids based on magnesium and aluminum hydroxide are used.

Editorial opinion

Unpleasant sensations in the scapular area are often associated with an exacerbation of diseases of the musculoskeletal system. Less often, heart ailments, problems in terms of neurology, stomach and respiratory diseases lead to discomfort. To learn more about the causes of back pain, we recommend that you study the corresponding article on our website.