Pain under the shoulder blade: causes, diagnosis, treatment (2023)

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Pain under the shoulder blade is a clinical sign of many pathological conditions, including gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology and others.

The pain symptom can be different in intensity and localization - under the right or left shoulder blade, and sometimes limit a person's motor activity. Pain under the scapula is most commonly associated with skeletal muscle spasms due to stress or with pain reflected from internal organs in the scapula region.

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Causes of pain under the shoulder blades

Regio scapularis is the so-called scapular region, limited to the lines - in the upper part of the body between the unpaired spinous process of the protruding seventh cervical vertebra and the clavicles, below - the medial-vertical line along the lower edge of the scapula, and also the line from the Armpits to the edge of the deltoid. The diagnosis of pain under the shoulder blade depends on the nature of the symptom, its localization and the accompanying clinical signs, since the shoulder blade region itself can hurt only with trauma - stroke, bruise.

The causes of pain under the shoulder blades can be:

1. LRS - skopulokostalny, scoop-rib syndrome, or muscle syndrome that raises the scapula. When the muscle attached to the transverse processes of the upper cervical vertebrae becomes hypothermic, traumatized, inflamed, or overworked, it is unable to perform its function normally—tilting the neck and raising the scapula. Symptomatically, LRS scapula rib syndrome manifests itself in the form of aching, sometimes intense pain in the shoulder, at the tip of the scapula and below. The sensation of pain often spreads to the shoulder, the lateral part of the breastbone. The most painful point is where the muscle attaches. When you press on it, the pain becomes acute and radiates up into the neck. In addition, a characteristic feature of the LRS is the crunch when moving with the shoulders and hands. Continuous dynamic loads, as well as static loads, can create a condition where pain under the shoulder blade becomes permanent and is aggravated by cold and drafts.
2. YABZH - peptic ulcer, as the most common cause, causing radiating pain under the shoulder blades. The symptom begins with dull, aching pain that builds up or decreases after taking medication, vomiting. The pain is directly related to eating, is seasonal, most often radiates to the left - from the epigastrium to the left shoulder blade, chest and back. The pain symptom of gastric ulcers is divided into hunger, late or early pain. In addition, JBW is usually accompanied by nausea at the peak of pain development, vomiting - in 75-80% of cases and heartburn.
3. Vegetative or, as they are often called, psychosomatic pains also come into the causes of pain under the shoulder blade. Such feelings are similar to the signs of angina pectoris, heart pain, because they cause a feeling of squeezing and burning in the chest, which intensifies and radiates into the arm, under the shoulder blade, under the collarbone, more often to the left, into the heart. The pain symptom can be both intense and painful and indefinite. The main differential sign of vegetative pain is the ineffectiveness after taking cardio preparations - they do not relieve pain or the feeling of pressure. As a rule, with a vegetative-vascular attack, sedatives, tranquilizers help.
4. Osteochondrosis of the thoracic or cervical spine can cause a unilateral, dull, persistent, aching pain that usually begins in the neck and spreads down under the shoulder blade. Pain can appear early in the morning, increase with static loads (sedentary work), with sudden movements of the body. This condition is accompanied by referred pain in the arm, under the shoulder blade, paresthesia of the limbs, dizziness, blurred vision. The symptom is eliminated by warm-up massages, ointments, a warm bath.
5. Intercostal neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and is manifested by paroxysmal, unilateral pain, surrounding the intense nature. The painful sensation spreads along the intercostal muscles, gaps and intensifies with deep breathing, coughing, sneezing, with prolonged physical exertion and walking. In the clinical sense, the intercostal syndrome is manifested by palpation of the site of innervation, which is uncharacteristic of heart disease, osteochondrosis. Due to the constant muscle tension, the pain can spread down - in the lower back, but more often it manifests itself as a shock sensation, burning under the shoulder blade.
6. The attack of angina begins with pain in the center of the chest (retrosternal space) that spreads rapidly, spreading to the left and giving way under the collarbone in the back under the left shoulder blade. Pain is not always stopped by taking nitroglycerin, vasodilator drugs that can serve as a signal for a myocardial infarction. In addition, a distinction is made between the causes of angina pectoris:
   • Severe, acute pain in the left chest area under the shoulder blade is characteristic of angina when a person is exposed to physical or psychoemotional stress.
   • Drawing, aching pain may indicate an attack of resting angina when there is no external, provocative cause of the pain symptom.
7. Causes of pain under the shoulder blade can be associated with a serious, life-threatening condition - perforation of the peptic ulcer, which is accompanied by severe, acute pain radiating under the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, the patient's posture - pressed hands, knees to the abdomen (embryo pose). This symptom requires immediate medical attention, as well as cardiac pain.
8. Symptom of Euret or a sign of inflammation in the pericardium accompanied by the release of exudate. The main manifestations of exudative pericarditis are chest pain, shortness of breath, high fever, fever. The pain is accompanied by the accumulation of effusions and stretching of the pericardium when coughing, the change in posture, the sensations can be loud, but more often they "shoot" in the nape area under the left shoulder blade. The exacerbation of the inflammatory process often causes a clinical picture of "acute abdomen".
9. Dissection of the aorta - stratification of the aortic wall (aneurysm). A life-threatening condition, accompanied by severe pain in the back, between the shoulder blades, or with a shift to one of them. Most often, the pain shifts to the left, gives up the arm and under the left shoulder blade, and spreads along the dissecting aorta. The most dangerous consequences of this symptom can be a stroke (when the blood flow of the carotid arteries is disturbed), myocardial infarction (with violation of blood flow of the coronary arteries), mesenteric thrombosis, paralysis of the legs (with a violation of the ilium arterial blood flow), spinal cord injury (with injury blood flow in the vertebral arteries).
10. Herniated disc in the thoracic spine. The disease is rarely diagnosed, since the thoracic region is quite stable in this sense. Constant, aching and growing pains in the area of ​​\u200b\u200bthe injury and the pathological focus gradually become more intense, often similar to the symptoms of diseases of the bronchopulmonary or cardiovascular systems. The main feature of the hernia can be muscle tension between the shoulder blades and the apparent curvature of the spine. The diagnosis is confirmed by X-ray studies, MRI.
11. LCB is cholelithiasis, colic can also manifest itself as paroxysmal, unbearable pain radiating to the right, under the shoulder blade and above.
12. The causes of pain under the shoulder blade can be caused by diseases of the respiratory tract - pneumonia or pleurisy. With pneumonia, the pain is localized in the tissues according to the pathological focus, if the process develops in the back, pain appears in the back, between the shoulder blades or below. Inflammation of the pleura is also accompanied by shooting pains between the shoulder blades, often under one of them. The pain increases with the cough reflex and breathing.
13. Myositis is an inflammatory process in the muscles as a result of hypothermia, acute respiratory viral infection or overexertion, less often due to bruises. Pain occurs suddenly in the acute course or develops gradually, has a pulling, aching character with chronic inflammation. The pain symptom is associated with movements, physical exertion, changes in posture, inclines.

Symptoms of pain under the shoulder blades

The symptoms of pain under the shoulder blades are so diverse that in clinical practice there is still no unified standard algorithm for differential diagnosis. Each medical specialty has its own patterns for collecting anamnesis, examination, tests and examinations, but there are often cases when the pain symptom is "masked" and does not indicate a true cause. Therefore, the patient must describe as accurately as possible the nature of the pain and all the circumstances under which it occurs. In addition, chronic pain, to which a person has "got used", often smears a diagnostic picture, as a result of which time is lost, and the therapeutic effect is much more difficult.

What symptoms of pain under the shoulder blade require immediate medical attention?

• Drawing, constant pain in the back with radiation under the shoulder blade, which does not go away in 2-3 days.
• Pain under the shoulder blade with static tension (sedentary work) in people over 50 years of age.
• Pain under the shoulder blade, growing at night or in a horizontal position.
• pain with fever.
• Pain accompanied by numbness in arm, shoulder.
• Tender pain, burning, starting from the middle of the chest.
• Pain that is not stopped by heart drugs, sedatives.
• Shining pain giving under scapula.
• Acute, severe pain with vomiting.

Symptoms of pain under the shoulder blades are most often described like this:

• Sharp pain in middle of back, giving under left shoulder blade. The pain appeared in the morning and intensifies with movements.
• Sharp, intense pain under the shoulder blades.
• Dull pain below shoulder blade, worse with raised arms.
• Drawing, aching pain under shoulder blade, spreading to waist.
• Pain under the left shoulder blade and a feeling of pressure in the chest.
• Pain under the shoulder blades in the form of a localized area, burning.
• When coughing, the pain intensifies.
• Pain under the shoulder blade is replaced by a burning sensation, numbness of the hand.
• Severe pain after vomiting.

Despite the variety of reasons that provoke a pain symptom under the shoulder blades, there are different signs - signs of danger that allow an experienced doctor to rule out relatively benign diseases associated with back pain. Disturbing symptoms that may accompany pain in the shoulder blade area are the following:

• Hyperthermia - 38-40 degrees.
• Spontaneous pain that aggravates and provokes the condition of the "acute abdomen".
• shortness of breath, cyanosis of the skin.
• swelling of the hands.
• Pain that doesn't go away with rest.
• Vomit.
• Falling blood pressure. Pulse.
• fainting.

Back pain under the shoulder blades

Back pain in the shoulder blade can be associated with many diseases, but most often it is caused by deformation of the spine, especially if it is accompanied by numbness in the limbs and tingling in the fingers.

In addition, pain in the back under the shoulder blades is provoked by such diseases and conditions:

• Curvature of the spine - kyphosis.
• Herniated disc in the chest area.
• Lateral curvature of the spine - kyphoscoliosis.
• cardiac ischemia.
• shoulder-shoulder periarthritis.
• intercostal neuralgia.
• The anterior curvature of the spine is scoliosis.
• Angina pectoris - tension or rest.
• Bulging (degeneration) of the intervertebral disc of the thoracic spine without rupture.
• YABZH - gastric ulcer.
• Cholecystitis.
• Hepatic colic with concomitant dyskinesia of the gallbladder.
• Dry pleurisy.
• Lung infection.
• Inflammation of the interblade muscles, tendons, supraspinous ligaments.

Pain under left shoulder blade

The pain symptom under the left shoulder blade can be associated with such diseases:

1. Periodic pain under the left shoulder blade may indicate a developing peptic ulcer. The pain grows rapidly, accompanied by nausea, and then vomiting, a symptom associated with eating or the lack of it - hungry pain. The pain begins in the epigastrium and extends sideways - to the right or left, most often under the left chest and under the left shoulder blade.
2. Vegetative crises are also characteristic of left-sided pain, massaged under cardiopathy. Pain under the left shoulder blade, the aching, aching character that often causes a feeling of anxiety, not being controlled by nitroglycerin and other heart drugs, is a typical sign of psychogenic conditions.
3. Myocardial infarction most often has symptoms that are clearly expressed in the clinical sense - burning in the middle of the chest, pain in the left side of the jaw, in the hand, under the left shoulder blade, numbness of the limbs, nausea.
4. Angina pectoris - attacks of pain can develop with stress, stress (angina pectoris) or as an exacerbation of a chronic form (resting angina).
5. Intercostal neuralgia is accompanied by acute pain, which often surrounds the character, giving it to the right or left under the shoulder blade. Symptom can be aggravated by changing posture, physical activity. The pain is eliminated by heating, relaxing muscles.
6. Osteochondrosis of the cervical and thoracic parts is also one of the reasons that provoke pain under the left shoulder blade. The pain symptom is accompanied by dizziness, nausea, numbness of the hands or one arm.
7. Perforation of the ulcer is an acute condition, manifested by very severe pain radiating to the area of ​​\u200b\u200bthe clavicle under the shoulder blade. In addition to severe pain, the patient is characterized by a pose with his knees pressed to his stomach, cold sweat, cyanosis, a drop in blood pressure, a pulse.

See also:Pain under left shoulder blade

Pain under the shoulder blade on the right

The pain symptom that manifests itself under the right shoulder blade is associated with such diseases:

• Biliary colic with spasm of bladder, ducts blocked by stones. The pain is sharp, cutting, localized under the right rib, and gives way under the shoulder blade.
• The pain under the right shoulder blade can be caused by a diaphragmatic abscess. The symptom is very acute, it intensifies when inhaling, not even deeply, and more often radiates to the right.
• Pyelonephritis in acute form begins with pain in the lumbar region, which later spreads upward and appears under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination and increased body temperature.
• Myofascial syndrome is also the cause of pain under the right shoulder blade. This is chronic muscle pain associated with irritation of certain trigger points.
• Among the factors that provoke a pain symptom under the right shoulder blade, sometimes there is also herpes - shingles. It is a viral disease that is not considered life-threatening, but causes very severe, painful pain and burning numbness. Herpes is typically a rash, itching, muscle pain that goes from under the shoulder blade.
• Osteochondrosis is one of the reasons that often provokes radiating pain under the shoulder blade, including the right one.
• Right-sided pneumonia. Pain in pneumonia most often manifests itself in the acute stage, can be fever, fever.

See also:Pain under right shoulder blade

When the pain goes under the shoulder blade

Any pain symptom that "gives away" is called radiation. The impulse of visceral pain can be so intense that the irritation of the primary nerve branch is quickly transmitted along the chain to the terminal branch, ie far away from the original source. Pain occurs under the shoulder blade most often from an organ affected by inflammation, which can be provoked by such causes:

• Increased pressure in the intestine with inflammation, ulcer process. The postbulbar department of the duodenum under the ulcer radiates to the right under the scapula.
• Biliary colic (gallbladder, liver).
• Sharp pains appear under the left shoulder blade and with an attack of angina, when there are feelings of pressure, compression.
• Pericarditis can also manifest as reflected pain under the shoulder blades.
• Stratification of the walls of the aorta (aneurysm) is manifested by severe retrosternal pain with radiation to the neck, to the left side, shoulder, under the scapula.
• Pneumothorax (spontaneous) - acute pain in the chest with a reflection under the shoulder blade in the area of ​​\u200b\u200bthe shoulder blade.
• worsening of pancreatitis.
• Renal colic.
• Acute musculoskeletal dorsalgia.
• Heart attack.
• Osteochondrosis of the cervical spine.

Reflected pain can be temporary, but it can also indicate that an acute condition is developing that requires immediate medical attention. If the pain appears under the shoulder blade and is not stopped by antispasmodic or cardiac drugs, you should consult a doctor who will conduct the examination and differential diagnosis and prescribe appropriate treatment.

Pain under the shoulder blades for inspiration

The pain symptom under the shoulder blade, increasing with inspiration, is a signal characteristic of the following pathologies:

• Dry pleurisy - an inflammatory process in the pleura, the lining of the lungs. The pain can increase with inclinations, movements, decrease horizontally or laterally. The accumulating fluid in the pleural cavity when inhaled provokes swelling and pain under the shoulder blade.
• Pericarditis is an inflammatory process in the pericardial sac, the disease manifests itself as weakness, chest pain, which intensifies with inspiration.
• Pain under the shoulder blades with a deep breath can testify to intercostal neuralgia, which manifests itself in the form of belt pain that seems to tighten the chest.
• Diseases of the gallbladder, spasms, colic can also be accompanied by a pain symptom associated with inhalation.
• Renal colic (pyelonephritis, renal abscess) can also be accompanied by pain in the hypochondrium, which is so severe that it spreads throughout the epigastric region, radiates under the scapula, and intensifies when inhaling.

pain under the shoulder blade

The aching pain under the shoulder blade is evidence of a chronic process both in muscle tissue, in the spine and in internal organs, which can signal their pathologies with reflected pain.

Spade Rib Syndrome - LRS is the most common cause of aching pain. This syndrome is characterized by vegetative pains - aches, pains, dull aches, often associated with weather conditions. In the clinical sense, aching pain under the shoulder blade is not a specific sign of a particular disease, therefore pain differentiation should be carried out by the method of excluding threatening conditions. Often the aching pain in the area of ​​\u200b\u200bthe shoulder blade can serve as the first signal of an attack of resting angina, such a symptom can also be a myocardial infarction, which does not always have a clearly expressed clinical picture. However, the main factors provoking aching pain are osteochondrosis, scoliosis, kyphosis and other degenerative, dystrophic pathologies of the spine.

In addition, aching pains under the shoulder blade can be caused by psychogenic factors, vegetative crises, fibromyalgia. The most alarming symptom is accompanied by nausea and vomiting, since this can be the beginning of an exacerbation of an ulcer of the stomach or duodenum.

Severe pain under the shoulder blade

Severe severe pain under the shoulder blade - left or right - is a reason to seek medical help, often such a pain symptom cannot be stopped independently, and it can also indicate life-threatening conditions. Severe pain under the shoulder blade can be provoked by such diseases:

• Daggering, sharp, stabbing pains that increase during inspiration and are reflected in the shoulder can be a sign of spontaneous pneumothorax. Other clinical symptoms of pneumothorax are rapidly developing shortness of breath, tachycardia, drop in arterial pressure, slowing of the pulse, enlargement of (compensating) veins in the neck.
• Severe pain radiating from under the shoulder blade and accompanied by hypertension indicates an exacerbation of osteochondrosis of the thoracic spine. Simultaneous pain in the back under the shoulder blade, headache, and skyrocketing blood pressure are a clear symptom of an injury to nerve endings in the neck or chest. The pain can be aggravated by twisting the body, shooting when tilting or moving, and is not stopped by heart drugs, sedatives.
• Severe pain under the shoulder blade can be associated with perforation of the epigastric ulcer. If the perforation progresses rapidly, the pain intensifies with every minute, the general clinical picture of the ulcer is typical - acute pain when irradiated, possible vomiting, cold sweat, cyanosis of the face, characteristic postures - podzhatye knees to the chest.
• Hepatic colic (biliary colic) is also manifested by severe pain that gives way to the top right, under the shoulder blade, in the neck and even in the area of ​​the right eye. Painful symptom is associated with blockage of the bile duct after ingestion of fried, fatty foods.
• Purulent process in the area between the diaphragm and the underlying organs, subdiaphragmatic abscess is an acute condition that requires immediate medical attention. The development of a bacterial infection in this form can provoke general intoxication, sepsis. In fact, we are talking about purulent peritonitis, limited by a diaphragm and manifested by severe pain in the hypochondrium with irradiation to the right - the shoulder under the scapula. Typical hyperthermia is also up to 40 degrees, fever, nausea.

It is not recommended to tolerate a strong radiating pain symptom for more than an hour, if it cannot be stopped by available means, it is necessary to call emergency help.

Dull pain under shoulder blade

The type of pain under the shoulder blades can vary from painful, dull to very intense and acute. Dull pain under the shoulder blade suggests that the cause is most likely related to the muscles, tendons, and ligaments.

In clinical practice there are data that are confirmed by long-term observation:

• 85-90% of all pain symptoms in the back and shoulder area are due to inflammation, stretching, muscle damage and tendon-ligament apparatus. Usually this pain is dull and aching.
• 5-7% pain symptoms in the back, under the shoulder blades, in the shoulder blade area are associated with neurological pathologies (radicular syndrome). This intense, acute pain.
• 3-4% due to other causes - diseases of the respiratory system, heart, gastric tract, biliary pathology. The pain is usually intense, acute and requires immediate medical attention.

Dull pain under the shoulder blade is most often a reflex, vertebrogenic syndrome, for which signs are such signs:

• The pain has a clear localization - under the right or left shoulder blade, in the middle of the back between the shoulder blades.
• The pain does not radiate to the limbs, other parts of the body.
• The pain is dull, aching.
• The pain symptom is aggravated by physical stress on the damaged muscles and ligaments.
• The pain site is painful when palpated.
• Absence of symptoms of disc deposition and compression (radicular syndrome).
• Absence of vegetative-vascular disorders.

Typical causes that provoke whimpering, dull pain under the shoulder blades are the degenerative process of the intervertebral discs (osteochondrosis) of the neck region in the C5-C7 zone. In addition, dull pain can be a consequence of the inflammatory process in the intervertebral joints, a signal of the developing severe pathology - Bechterew's disease (ankylosing spondylitis). Often the stupidity of pain is a sign of arthrosis, a hidden trauma to the intervertebral joints, spondylosis, scoliosis.

Among the reasons that provoke a painful symptom under the shoulder blade of a dull, dull character, there are diseases of the internal organs:

• Pleurisy.
• Bronchitis in chronic form.
• Chronic pneumonia.
• Atonia of the gallbladder is dyskinesia of the hypotonic type.
• Chronic pyelonephritis (sclerotic process of kidney tissue).
• The oncological process in the liver, pancreas in the initial stages.
• Also, dull pain under the left shoulder blade often signals a developing cardiovascular pathology - pericarditis, myocarditis.
• The pain symptom gradually grows, increases in stressful situations, with concomitant infectious and viral diseases. Also often manifested and hidden bronchitis in the atypical form, pneumonia, when the pain increases only with coughing, or when falling asleep on the "unhealthy" side.

Sharp pain under the shoulder blade

The sharp pain in the area of ​​​​the shoulder blade below indicates a serious, sometimes life-threatening condition.

The reasons for severe pain under the shoulder blade can be as follows:

• The dividing wall of the thoracic aorta (aneurysm). The pain is sharp, intense, radiating down the spine, most often to the left, to the shoulder, under the shoulder blade.
• The initial stage of pleurisy. Pain sharp, acute, intermittent, often localized under the right or left shoulder blade in the zone of fluid accumulation in the pleura. If pleurisy is accompanied by intercostal neuralgia, the pain takes on a shingles character.
• Spontaneous pneumothorax, manifesting as a sharp pain under the shoulder blade (reflecting off the chest). The condition is characterized by severe shortness of breath, acrocyanosis.
• Attack of acute pancreatitis. The disease is accompanied by a sudden sharp pain in the epigastrium with a reflection to the left in the chest, shoulders, heart area, under the shoulder blade.
• Myocardial infarction is most commonly characterized by increasing pain, but may present with sharp, intense, rapidly spreading chest pain that radiates to the left shoulder, jaw, under the shoulder blade, and down the back.

pain behind the shoulder blades

The pain behind the shoulder blades between them, as a rule, is not intense, so the person does not pay attention to the symptom, since it is transient and transient. Untimely determination of the cause, the factor provoking such pain, can lead to the development of chronic, difficult-to-treat diseases.

Persistent, persistent pain between the shoulder blades below is most often caused by muscle tension, which, in turn, is explained by professional peculiarities - sedentary work in the office, behind the sewing machine, behind the wheel of the car and so on. Usually the pain behind the shoulder blades is not associated with life-threatening pathologies and even with dystrophic changes in the spine, since the thoracic region is not mobile, it is stable enough and stable. More often disorders, changes, less often - inflammation affects the muscles of the interleaf area, ligaments and tendons can also be stretched.

Pain of this type, associated with the muscles, is characterized by a feeling of gravity and tension, which quickly passes with active movements (exercises), massage or warming up.

Pain caused by damage, stretching of the tendons is felt differently, it causes a feeling of pain under the shoulder blades, often a pain symptom is reflected in the heart area. Also, a person complains of numbness in the hands, tingling, "crawling". Neutralizing this pain with heart medication is not possible, but you can get rid of it and it's very simple:

• Change your posture regularly, preferably every half hour. If the work is seated, then you need to get up, walk around, make circular movements with your hands and shoulders, bringing the shoulder blades together and expanding them.
• It is advisable to give 20-30 minutes a day for stretching exercises of the muscles of the interloparous zone and for the general muscle tone of the body. Regular exercise will prevent muscle spasms and pain behind the shoulder blades.
• It is necessary to regularly massage the shoulder lobe zone, the collar zone.
• Periodically, you can do the following exercise: put a small (tennis) ball on the floor, lie on its back and "ride" the ball, passing it vertically and between the shoulder blades.

If the symptom of pain on the side of the back under the shoulder blades is accompanied by cough, subfebrile temperature, pain increases with breathing, a cough reflex, the doctor should be consulted to exclude the diseases of the bronchopulmonary system .

Drawing pain under the shoulder blades

The aching nature of the pain is most often due to increased muscle tone due to nerve root injury. Myofascial syndrome and osteochondrosis of the cervical spine, less often herniated disc with a bulge, can be the cause of the drawing pain under the shoulder blades.

Degenerative changes that reduce the height of the intervertebral openings and provoke the displacement of the vertebrae to the right or left are accompanied by the inevitable damage to nerve endings. Unlike intercostal neuralgia, characteristic acute symptoms, shingles, dystrophic pathologies of the spine develop more slowly and are accompanied by aching, pulling, constant pain.

In addition, the pulling pain under the shoulder blades can be caused by scapulostenal scapular rib syndrome - LRS. In addition to painful sensations, a person clearly hears a specific sound - a crunch. LRS is also characterized by reflex pain that spreads to the shoulder, neck, and often to the nape of the neck. The course of the disease is long, it is repetitive, but the prognosis is quite favorable.

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Pain under the shoulder blade when moving

Strong, intense pain that increases with movement or breathing indicates compression of the nerve roots. Compression is caused by muscle spasms, hernias, protrusions and causes pain under the shoulder blade when moving.

The causes of such pain are most often associated with diseases and conditions:

• Neuropathy of the thoracic and suprathiopathic nerves as a result of overexertion (sport), trauma, viral disease.
• Intercostal neuralgia, typical signs of it are sharp, constricting pains, aggravated by movement, affecting breathing, inclinations. The pain is paroxysmal unilateral, during the peak of the pain a person "freezes", it is difficult for him to breathe. Intercostal neuralgia is the result of neglected, timely osteochondrosis of the thorax. The thoracic zone of the spine is stable, the deformation of the intervertebral discs develops for a long time and is accompanied by unspoken periodic dull pains, which can also increase with movement. Due to the nonspecific symptoms, unexpressed pain, osteochondrosis of the sternum is often "masked" for the symptomatology of other diseases - cardiac, bronchopulmonary. The acute stage of the disease is compression of the intercostal nerves, in which the intensity of the pain depends on the position of the body and motor activity.

Any reflected pain increases with movement. Radiation pain is associated with diseases of the lungs, heart, gastrointestinal tract, and gallbladder. Similar symptoms require a differential diagnosis.

Constant pain under the shoulder blade

If the pain is persistent, this is a direct indication of the developing inflammatory process, either in the musculoskeletal tissue or in internal organs.

Causes that cause constant pain under the shoulder blade:

• Osteochondrosis of the cervical spine, which is accompanied by a constant, dull, unilateral pain. The feeling of aching pain begins in the lower part of the occiput, flows to the middle of the back and shifts to the deformed vertebrae, reflected under the shoulder blade, less often in the arm. The pain may periodically subside when warming up, massaging.
• The onset of intercostal neuralgia may not be typical and is not accompanied by acute symptoms. Constant sensation of pain, burning under the shoulder blade may indicate osteochondrosis of the thoracic region, which at the stage of exacerbation passes into intercostal neuralgia, that is, compression of the nerve roots.
• Muscle hypertonia due to chronic static loading also manifests itself as persistent back pain, below the shoulder blades. This symptom is typical for many professions associated with monotonous movements or poses - drivers, office workers, students.
• Constant pain under the shoulder blade may indicate inflammation of the hollow organ located in the area of ​​\u200b\u200bthe shoulder blade. Such pain is often the first signal about the peptic ulcer, perigastritis.
• Constant intense, enveloping pain, reflected under the shoulder blade, is also characteristic of herpes zoster - herpes zoster, herpes. The pain begins with the chest and continues until the underlying cause is neutralized.

Pain under the shoulder blade when coughing

• Pain when coughing under the shoulder blade, in the back is a typical sign of bronchopulmonary diseases.
• Pleuropneumonia is a complex pathology, which, depending on the stage of development, is accompanied by severe or aching pain. The pain increases with a cough reflex.
• Tracheitis (inflammatory process in the mucous membrane of the trachea). The pain begins with the upper, middle part of the chest, can be radiated in the back under the shoulder blades when coughing. The nature of the pain symptom is sharp, stabbing, when the cough subsides, the symptom also becomes less intense.
• Tuberculosis is the infectious pathology of the bronchopulmonary system, in which the symptoms can develop both long-term and rapidly. The main visible sign of tuberculosis is persistent cough within 1-1.5 months with sputum production, hyperthermia and chest pain. If the disease is unilateral, the pain when coughing is worse and is reflected in the back under the shoulder blade.
• Oncological process in the lungs, malignant tumor. Pain is evidence of a late stage in the process, often fatal. Pain reflection can be in the shoulder girdle, neck, back and under the shoulder blade. Painful sensations increase with coughing and deep breathing.
• Pain when coughing under the shoulder blade can accompany and croupous pneumonia - acute, life-threatening condition, in which there is a very high body temperature, sharp pains, cough, lack of air.

Stitching pains under the shoulder blade

The feeling of sharp pains in the back under the shoulder blade is most often due to the inflammatory process in the pleura, especially when the interpleural ligament is shorter than normal. Cough in the syndrome is common, mild, but persistent. Cough, as well as stabbing pains under the shoulder blade in this condition, increase, sometimes slightly, during a conversation, deep inhalation or exhalation, as well as with loads. The pain-tingling symptom may increase with prolonged walking while running.

Most often, the character of the sensations is not considered a sign of serious pathologies, often such pains pass independently without treatment. However, a systematic tingling under the shoulder blade that does not go away within 2-3 weeks is the reason for a visit to the doctor.

Stabbing pains, as a rule, are not caused by diseases of the bone or muscular system, are not associated with the spine. The most common cause of such signs are bronchopulmonary, cardiac and neurological diseases. In addition, the following pathologies can be the factors that cause tingling in the shoulder blade area:

• Incipient perforation of the gastric ulcer.
• Vegetative-vascular Syndrome.
• Osteochondrosis of the cervical spine with damage to the nerve roots without protrusion, hernia.
• Intercostal neuralgia in the initial stages.
• Atypical development of myocardial infarction.
• Spasmodic bile ducts.
• Atypical course of pyelonephritis.

Lancinating pain under the shoulder blade requires careful differential diagnosis, so the pain, accompanied by nausea, hyperthermia and irregular blood pressure should not be ignored. It is necessary to undergo complex diagnostics and find out the cause of the pain.

Pain and burning under the shoulder blade

Burning is a characteristic sign of a deformed spine, since back pain is most often (80-90%) related to the musculoskeletal system.

• One of the most common causes that provoke pain and burning under the shoulder blade is osteochondrosis of the cervical spine, less often the thoracic spine. The pain begins in the neck and spreads down in the form of a burning, aching sensation, often under the shoulder blade area. This is due to the compression of the nerve roots by the offset processes of the vertebrae. The pain is usually not intense, constant, and varies with body position and movements.
• In addition, a burning sensation under the shoulder blade can be caused by an attack of biliary colic (hepatic colic) and blockage of the bile ducts.
• Renal colic, exacerbation of pyelonephritis often radiate under the scapula and are accompanied by acute, burning pains. Such symptoms are very intense, especially with a drop in blood pressure, and therefore require emergency treatment.
• Pain and burning under the shoulder blade - this is one of the signs of reflux esophagitis at the stage of exacerbation.
• Intercostal neuralgia is often accompanied by a feeling of tingling, burning in the injury zone, girdles with pain, sagging in the heart, in the back.

Pain with a sigh under the shoulder blade

The symptom of pain, which increases with inhalation and is localized under the shoulder blade, can be caused by such diseases:

• Stretching of the muscles, ligaments of the interleaf area, pain from overexertion.
• Renal colic, which often manifests itself as a throbbing pain that worsens with deep breathing. Most often, such a symptom develops in the right hypochondrium zone, spreads, and then returns, returns.
• Pain when inhaling under the shoulder blade is a typical sign of intercostal neuralgia, when the character of the pain is so severe that the person literally freezes. Every breath brings an unbearable, stabbing pain.
• Pain that occurs when breathing deeply, often when inhaling, radiating to the back, in the area of ​​​​the scapula, may indicate an exacerbation of cholecystitis, biliary colic.
• Often a factor causing such pain can be trauma, both visible and hidden. A broken rib is not always accompanied by severe pain, often a bruise is accompanied by a fracture, but a person experiences discomfort. The only sign of latent damage to the rib that gives way under the shoulder blade may be pain when breathing in and coughing.

Tinea pain under the shoulder blades

Paroxysmal shingles under the shoulder blades is a typical symptom of intercostal neuralgia. Compression injury of nerve endings with deformed vertebrae (intervertebral discs) causes severe pain, which begins on one side of the body and can move along the intercostal spaces, as if along a circle. The symptom is reflected in the lower back, in the back, accompanied by difficulty breathing and aggravated by an uncomfortable curve, inclination, physical activity. Pain can also build up under stress.

The shroud radiating in the back, shoulder blade pain can serve as a signal of an exacerbation of pancreatitis. This condition is characterized by severe pain, fever, cold sweats, and cyanosis of the skin.

A perforation (perforation) of the stomach ulcer (part of the wall of the heart) usually radiates the pain to the collarbone area, but can often present as shingles.

It should be noted that there are no exact diagnostic criteria for spinal pain, therefore any pain, especially acute, lasting several hours, requires urgent medical attention.

Burning pain under the shoulder blade

Burning pain under the shoulder blade is a sign of osteochondrosis, injury, compression of the nerve roots. Such pains often disguise themselves as cardialgia, in particular, they resemble restless stenocardia or clinical manifestations of myocardial infarction.

How to distinguish what the burning pain under the shoulder blade means?

Attack of angina pectoris:

• The pain is pressing, compressing, spastic.
• The pain symptom is most often localized in the chest area, on the left it can spread higher, reflected under the shoulder blade, in the arm, in the jaw, in the neck.
• An objective external cause that provokes pain is stress, emotional tension, physical stress.
• Pain rarely lasts more than 15 minutes.
• The pain symptom is stopped by taking nitroglycerin, other heart drugs (after 5-10 minutes).
• The pain can calm down with rest.
• The pain does not depend on the movement.

Burning pain under the shoulder blade in injury is directly related to movement, activity, posture and does not subside after the use of heart drugs. It is stopped by nonsteroidal anti-inflammatory drugs, spinal straightening or other means.

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Pain in the spine under the shoulder blades

Most often, the pain in the spine under the shoulder blades is not really related to diseases of the bone system, that is, the spine. The most common causes of such pain are caused by neuralgia, myalgia. A number of compression ischemic conditions, diseases of the peripheral nervous system, intercostal neuralgia and other factors are the main cause of painful sensations under the shoulder blades in the spine.

The list of possible factors associated with stretching of the tendons, muscles, neuritis:

• Plexitis is a neuropathy of the brachial nerve. This inflammatory process in the nerve plexus, which requires the destruction of the muscle tissue of the interphalangeal area, reduces the sensitivity of the skin on the surface of the shoulder, the median nerve. Clinically, the nerve of the brachial plexus is manifested in paresis, peripheral partial paralysis of the hand due to atrophy of the internal humerus, deltoid muscle and biceps, the arm can hang like a whip, the pain is spontaneous, stabbing, giving under the shoulder blade.
• Intercostal neuralgia, which is typical of a sharp pain belt, most often unilateral, spreading around the chest. Pain in the spine under the shoulder blades is often the climax of the disease, it is so intense that the patient finds it difficult to breathe.
• Compression of the dorsalis scapulae - the dorsal nerve of the scapula that innervates the rhomboids, the muscle that controls movement of the shoulders and scapula.

Check for yourself what caused the pain in the spine under the shoulder blades is quite difficult, but the primary differentiation can be done. A typical sign of neurological diseases of the interloparous area is a painful feeling in the "pose of Napoleon" - crossing your arms in front of your chest. If the pain is accompanied by an increase in temperature, a drop in blood pressure, tachycardia, a general serious condition, do not self-diagnose and treat, you should immediately call a doctor.

Pain in the muscles under the shoulder blade

To determine what is causing the pain in the muscles under the shoulder blade. It is necessary to accurately describe the nature of the pain and all the accompanying symptoms. Muscle pain in the upper back is usually characterized by depth, pulling and aching character. Any sharp pain is a sign of nerve root injury and not inflammation of muscle tissue. The muscular symptom can appear spontaneously without visible explanatory reasons, but more often it develops against the background of fatigue, after physical exertion or static tension of the body. The reason that can be a factor provoking pain in the muscles under the shoulder blade:

• Muscle strain between the blades. This is a typical occupational syndrome associated with monotonous work or static posture. Drivers, office workers, students, everyone who is forced to sit in the same position during the day, perform repetitive actions with one hand (painters, builders), sooner or later struggle with muscle pain in the back and between the shoulder blades. A similar sign can also appear in pregnant women, whose spine is subjected to increased loads due to changes in posture (enlargement of the abdomen) and weight gain.

Myositis is an inflammatory disease accompanied by muscle pain. The cause of myositis can be such factors:

• Drafts, severe hypothermia of the back, neck.
• Chronic muscle tension of a professional nature.
• Injury to the back, including covert (bruising).
• Acute respiratory infections (ARI, ARI).
• Overexertion due to increased training (sport), uneducated load distribution, improperly performed pre-warm-up training.

Myositis is one of the most harmless causes of pain in the shoulder blade, a symptom of pain during massage, hot rubbing, taking anti-inflammatory drugs. Myositis is more dangerous, accompanied by a purulent process in the muscles, this is associated with an acute infection, which can provoke an abscess, an abscess in a certain area of ​​\u200b\u200bthe back. This condition is characterized by an increase in body temperature, severe pain, redness, swelling at the site of accumulation of pus. Purulent myositis is treated with both conservative methods and minor surgical interventions.

Pulsating pain under shoulder blade

Ripples in the back, under the shoulder blades, can be associated with non-life-threatening causes, but can also be a sign of a serious illness developing. Periodic pulsating pain under the shoulder blade is most often due to the bulging of the intervertebral disc, its loss from the contours of the contour of the vertebral body and the developing compression of the nerve endings. It should be noted that the protrusion is the initial stage of intervertebral hernia, when the fibrous ring remains intact, does not collapse, but the process of its destruction has already begun. The herniated disc, which can be stopped and prevented from developing, is characterized by intermittent stabbing pains or pulsations in the part of the back where the displacement occurs. The bulging of the vertebrae of the thoracic spine, PMD (protrusion of intervertebral discs) can eventually turn into a herniated disc, which in turn manifests itself with severe pain and more severe symptoms. The etiology of protrusions is associated with degenerative processes in the spine with osteochondrosis, and the factors contributing to the development of deformations are known to many of us:

• A sedentary lifestyle, physical inactivity, static tension of the body.
• Occupational risks - sports, specialization features.
• Age over 50 years.
• Irrational nutrition (excess salts).
• overweight of the body.
• Harmful harmful habits - alcohol abuse, smoking.
• PMD - protrusion of the intervertebral discs of the thoracic region is manifested by pulling pains at the initial stage, with the development of the disease the pain becomes intense, radiating to the area of ​​\u200b\u200bthe scapula, causing a feeling of pulsation.

Pulsating pain under the shoulder blade is the beginning of radiating pain, when the transmission of a nerve impulse occurs pointwise and gradually. Painful sensations are tolerable, but require differential diagnosis, since the pulsation can be accompanied by an atypical development of pathological processes in the internal organs - lungs, heart, stomach, gallbladder.

Pain under the shoulder blade after vaccination

Prophylactic vaccinations are one of the most harmless causes of back pain in the shoulder blade area.

Pain under the shoulder blade after vaccination is usually associated with vaccination against diphtheria. Often the injection site swells, the skin is hyperemic, the area under the shoulder blade hurts. However, this condition does not last longer than 2-3 days, and all symptoms have usually subsided by the second day.

Pain under the shoulder blade after vaccination is due to the body's reaction to the introduced strains, viruses and bacteria, which are used to teach the immune system resistance to harmful microorganisms. The introduced vaccines consist of weakened active substances, so you should not fear any complications. Local reaction in the form of pain under the shoulder blade - this is an absolutely normal phenomenon, indicating that the process of "dating" has taken place. Do not grind, do not moisten the area in the scapula, do not lubricate it with anesthetics or use warming procedures. As a rule, before vaccination, the doctor conducts educational work and informs the person in detail about possible unpleasant complications and measures to be taken in such cases.

Pain under the shoulder blade during pregnancy

The period of pregnancy is often accompanied by atypical feelings for the expectant mother. These conditions are caused by hormonal changes, as well as an increase in the size of the uterus and displacement of the surrounding organs. Also, the cause that can cause pain under the shoulder blade during pregnancy is often excessive load on the spine. If a woman had a history of osteochondrosis before conception, then pregnancy will only aggravate the deformation of the intervertebral discs and provoke periodic pain in the back under the shoulder blades.

In addition, the factors provoking pain in the shoulder blade region can be:

• Intercostal neuralgia, worsening against the background of catarrhal diseases, stress, physical activity.
• Hidden pneumonia or pleurisy.
• Stretching of the ligament apparatus, which is associated with increased production of a certain hormone - relaxin.
• The shift of the center of gravity forward (the abdomen increases), the tightening of the muscles.
• Rarely - exacerbation of pyelonephritis.

It should be noted that the temporary pulling pain under the shoulder blade during pregnancy is often not a threatening symptom, since each woman undergoes a comprehensive examination before registration, and then undergoes constant follow-up care. Pre-recorded ultrasound, X-ray or fluorography, blood, urine tests, etc. allow the gynecologist to foresee possible complications and take early action. As a rule, after the 20th week of pregnancy, implicit pulling back pain under the shoulder blade appears, in other cases a woman should consult a doctor and undergo additional diagnostics to avoid unnecessary anxiety.

Sharp pain under the shoulder blade

Acute pain symptoms appear suddenly and differ in intensity, increase in pain. Acute pain under the shoulder blade can be accompanied by such diseases:

• Biliary colic, an attack of acute cholecystitis. The pain "starts" on the right side under the ribs, carries an acute belt and is reflected in the right shoulder, under the scapula, in the neck, often in the lower back. The symptom is caused by a narrowing of the bile ducts, their obstruction by an advancing stone. The cause of this condition can be both the ingestion of fatty, fried foods, and infections, nervous or physical overstrain.
• Acute pain under the shoulder blade can progress to a penetrating peptic ulcer ("covert" perforation) with spikes that spread into the pancreas. Accompanying the disease is a constant pain, periodically increasing acute pain, often girdling, which settles up under the shoulder blade or down in the lower back.
• Intercostal neuralgia, which is characterized by acute pain, belting and shooting. The pain is aggravated by movement, inclines, and physical exertion.

Diagnosis of pain under the shoulder blade

Diagnosing pain under the shoulder blade is a complex and complex task, since this symptom is not specific and can indicate a number of similar clinical manifestations of diseases.

The main steps that involve the differential diagnosis of pain under the shoulder blade:

• Anamnese.
• Determining the nature of the pain from the patient's words and objectively.
• Measurement of blood pressure, pulse.
• Palpation of the back, interscapular area.
• Carrying out orthopedic examinations.
• Recognition of accompanying symptoms.
• Exclusion of acute conditions, life-threatening diseases.
• Exception or confirmation of the psychogenic etiology of pain.
• Referral to a specialist for additional examinations - X-ray of the chest, spine, CT, MRI, ultrasound of the heart, cardiogram, bronchoscopy, FGD, blood, urine and so on, depending on the specific disease.

It should be remembered that the diagnosis of pain under the shoulder blade is the prerogative of the doctor, not a single reference book, the source cannot help a person to accurately determine the source of the pain symptom, establish its specific cause in the absence.

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Treatment of pain under the shoulder blade

The task that solves the treatment of pain under the shoulder blade is not limited to relieving pain symptoms. Of course, acute pain requires anesthesia, cupping, as well as life-threatening conditions - perforation of the ulcer, myocardial infarction, spontaneous pneumothorax and others.

However, the main goal of therapy is to eliminate the underlying cause, therefore the treatment of pain under the shoulder blade directly depends on the diagnostic results, the patient's condition, his age and concomitant pathologies.

Due to the lack of specific recommendations below this article for treating under shoulder blade pain, the amount of self-help that could be applied at home is very limited.

If the pain in the area of ​​\u200b\u200bthe shoulder blade is accompanied by myalgia and muscle overstrain, then it can be removed at home with a reasonable load, performing a set of exercises, warming up and warming up the muscles.

All other conditions caused by diseases of the internal organs require the presence of a doctor who will select the method and method of treating pain under the shoulder blade and the underlying disease. Therapy can be both conservative and surgical, for example in the case of ulcer perforation or bile duct obstruction. In addition, various procedures can be prescribed, such as B. foot reflexology, massage, warming, possibly stretching of the spine.

It is necessary to pay attention to the alarming, menacing symptoms that indicate urgent conditions. This includes:

• Angina pectoris.
• Gastrointestinal erosive processes.
• Broncho-pulmonary diseases.
• Heart attack.
• All Cardiopathology.
• Pyelonephritis, renal colic.
• Spontaneous pain under the shoulder blade, acute nature.
• Pain behind the breastbone, giving way in the back, in the shoulder blade area, does not stop when taking heart medication.
• Painful loss of consciousness.
• All syndromes accompanied by high fever, vomiting, irregular blood pressure, shortness of breath, slowing or speeding of the pulse.

Treatment of pain under the shoulder blade can be quite successful with timely diagnosis and compliance with all medical prescriptions.

Prevention of pain under the shoulder blade

Specific recommendations for the prevention of pain under the shoulder blades cannot be given, since such symptoms of pain can accompany several diseases. Accordingly, the prevention of pain under the shoulder blade are all possible measures that prevent the underlying disease, which is diagnosed by a doctor.

In fact, the task of preventive measures is to prevent flare-ups of pain and reduce the risk of exacerbation of the pathology revealed.

If the symptom is associated with a neurological factor, muscle spasms and the prevention of pain under the shoulder blade are simple rules:

• Controlling static tension, performing a variety of exercises that help relieve muscle tension.
• Regular exercise, maintaining a muscular corset in one tone.
• Avoiding hypothermia, drafts.
• Visiting massage sessions, physiotherapeutic procedures.

Pain caused by osteochondrosis is also prevented by adequate motor load, performing complex exercise therapy, taking certain drugs that restore the structure of bone and cartilage tissue.