Back pain in the area of the shoulder blades is a symptom characteristic not only of diseases of the spine, but also of pathologies of internal organs. Why is it necessary to consult a doctor and which specialist to make an appointment with? Effective methods of getting rid of discomfort.
If you are worried about back pain in the area of the shoulder blades, such a symptom may indicate diseases of the spine or shoulder girdle, nerve pathology, somatic diseases. Careful collection of anamnesis and patient complaints allows you to identify the cause of the problem and decide on further treatment.
Often, back pain in the area of the shoulder blades is the first signal of pathological changes in the body. And the definition of the provoking factor allows you to prevent the exacerbation of the disease at an early stage. The symptom can occur in one half of the body or spread to the arm, appear when inhaling - all this is important when making a diagnosis.
The causes of pain and its localization
As a rule, discomfort in the area of the shoulder blades appears when moving. For example, prolonged static position of the body, awkward turn. In this case, pain under the scapula signals damage.
Important!Unilateral localization of pain (on the left under the scapula or on the right) is rare. This is due to the symmetrical arrangement of the nerve roots of the spinal cord.
Traumatic injury
Painful sensations can signal muscle or bone damage. In this case, the symptom is diffuse and of varying intensity. The pain arises sharply and persists.
Injuries that can cause pain in the shoulder blades:
- Fractures, cracks. A serious injury in which pain is concentrated directly in the scapula. The symptom is aggravated with minimal movement, so the patient cannot move.
- Bruises. The discomfort is superficial, it occurs due to damage to the muscular frame and is localized in the lower part of the shoulder blades. On examination, it is possible to detect signs of inflammation, tissue swelling. Symptoms persist for 14-21 days.
- Subluxation or displacement of the vertebrae. Joint pain occurs below the shoulder blades or at their level. The discomfort can be exacerbated by compression of the nerve roots.
With injuries in the area of damage, soft tissue edema is observed, pain appears abruptly. Often a crunch appears when moving.
Protrusion and hernia of the spine
With this pathology, the spinal cord and nerve roots are compressed, which is accompanied by impaired sensitivity and sharp pain under the right and left scapula.
Possible discomfort placement:
- Back pain under the scapula on the left or right. Indicates a lesion of 6-12 discs with possible involvement of the lumbar spine in the pathological process. Since the latter is subject to increased stress, there is a high risk of developing spinal hernias.
- Above the shoulder blades. The protrusion is localized in the cervical spine or segment 1-3. Discomfort becomes more pronounced with head movement.
- Between the shoulder blades. Pain is observed when 3-6 segments of the spine are affected. It becomes more pronounced with a deep breath, turning the body, abducting the upper limbs to the sides.
Note!With protrusion, the pain persists even at rest. This is due to compression of the nerve roots and muscle spasm.
Osteochondrosis
If the back hurts in the area of the shoulder blades, the symptom may indicate osteochondrosis of the thoracic spine. The symptom occurs due to entrapment of the spinal cord or nerve roots and deformation of the intervertebral disc. The disease gradually progresses, causing more and more vivid symptoms.
The area of discomfort is determined by the localization of the lesion:
- 2-6 segments. Discomfort is localized at the level of the shoulder blades, irradiation to the arm and neck is possible. An increase in intracranial pressure, dizziness due to squeezing of blood vessels is possible.
- 6-12 segments. There is pain under the scapula on the back left or right and extends down to the lower back.
Note!With osteochondrosis, the pain is one-sided.
Spondyloarthrosis
This pathology is also characterized by unilateral placement of pain syndrome. With spondyloarthrosis, there is a violation of mobility, a feeling of stiffness due to damage to the intervertebral discs and facet joints.
Symptoms depend on the neglect of pathological changes:
- Destruction of cartilage tissue. It develops against the background of reduced blood circulation and a violation of the integrity of the connective tissue. The cartilaginous element becomes fragile - quickly damaged and slowly renewed. The situation is aggravated by microtraumas due to intense physical exertion. In this case, the pain radiates to the shoulder blades and lower back.
- Deformation of the intervertebral disc. The thickening of the tissue is accompanied by impaired mobility, as well as pain in the shoulder blades and back. Against this background, destructive processes are intensifying.
- Formation of bone growths. Appear in the advanced form of spondyloarthrosis. They lead to damage to blood vessels, muscle tissues, nerves, joints.
With spondyloarthrosis, pain occurs after exercise, it can be localized in the area of the shoulder blades or between them. At rest, the symptom disappears.
Scoliosis
It is accompanied by a curvature of the spine in the transverse direction due to the tension of the muscles that support the posture. In this case, the spinal cord and nerves are compressed, discomfort is observed under the scapula.
Other symptoms of scoliosis:
- Deformation of the chest. There is a displacement of the ribs and vertebrae, which leads to damage to the spinal cord and its branches. Because of this, back pain is observed on the left under the scapula or on the right.
- Breathing disorder. Due to the deformation of the chest, dysfunction of the lungs is observed - one of them is compressed, the second is trying to make up for the deficit of gas exchange.
- Violation of cardiac activity. Due to the skewed spine, shortness of breath is present, the skin becomes pale, the heart rate changes.
Note!Scoliosis is characterized by compression of the spinal cord, so the discomfort is localized between the shoulder blades or under them. The pathological focus has clear outlines and can spread to nearby areas only with muscle spasms.
Kyphosis
Kyphosis is a backward curvature of the spine, in which the shoulder girdle is pulled forward, a stoop appears. In this case, the pain is localized above the shoulder blades, is bilateral in nature, radiates to the neck, arm.
Mechanisms of pain formation in kyphosis:
- Muscular. Curvature of the spine leads to overstrain of the muscles of the collar zone and their spasm, which is accompanied by pain over the shoulder blades.
- Neurogenic. Against the background of the curvature of the spinal column, the distance between the vertebrae decreases. This leads to infringement of the branches of the spinal cord and the occurrence of pain in the area of the shoulder blades, which can spread to the neck, collarbone, shoulder.
With kyphosis, the vertebral artery is compressed, which leads to a deterioration in cerebral circulation, dysfunction of internal organs.
Radiculitis
Pathology is characterized by pinching of the lumbar roots that form the sciatic nerve. With the defeat of the upper section, the pain is localized under the scapula and below. Discomfort is bilateral, it becomes more pronounced with sudden movements.
If untreated, sciatica is accompanied by other symptoms:
- burning pain in the back (under the shoulder blades and in the lower back) - indicates pinching of the spinal roots;
- lumbago with irradiation in the leg;
- convulsions;
- violation of sensitivity in the buttocks, lower back;
- numbness along the nerve (can be observed in the lower leg, thigh, foot).
Neuralgia
Inflammation of nerve fibers in this anatomical region can provoke pain under the shoulder blades. A common cause of pathology is hypothermia.
Inflammation can affect structures such as:
- Intercostal nerves. 1-4 pairs located along the lower edge of the ribs are affected. The pain is localized under the shoulder blades and below, in the lateral parts of the chest, less often extends to its anterior sections.
- Supraspinatus and suprascapular nerves. Characterized by the appearance of pain in the area of the shoulder blades from the back in the area of the clavicle. Sometimes the symptom extends to the shoulders.
- The infraspinatus and subscapularis nerves. Discomfort is felt under the scapula on the left or right. When the inflammation spreads to the muscles, the pain increases when you move your hands.
Note!With neuralgia, the pain is often one-sided in nature - the symptom is localized in the part that has undergone hypothermia.
Shoulder-scapular periarthrosis
It is characterized by inflammation of the shoulder joint and surrounding tissues. It is accompanied by impaired mobility, which can be removed only after warming up the muscles.
With humeroscapular periarthrosis, discomfort is observed at the level of the shoulder blades and below. In the initial stage, it occurs after intense physical activity, as the disease progresses - at rest. Other symptoms of pathology:
- numbness of the upper limbs;
- headache;
- decreased mobility of the spine.
Heart pathology
Pain under the shoulder blades may indicate heart disease. This is due to the fact that branches of the parasympathetic trunk connected with the spinal cord and nerve roots go to the organ. If there is pain under the left scapula from behind from the back, the symptom may indicate a mild form of myocardial infarction. It can persist for several days, increase with movement and decrease at rest.
Other signs of pathology:
- burning, pressing pain behind the sternum;
- heart rhythm disorder;
- heart palpitations;
- dyspnea;
- dizziness;
- nausea, vomiting;
- increased blood pressure.
Digestive system diseases
The mechanism of the onset of pain is similar to the previous reason - spread along the nerve fibers. The localization of the symptom depends on the affected organ, less often the discomfort is bilateral.
If the back hurts on the left under the scapula, development is possible:
- inflammation of the gastric mucosa;
- pancreatitis (inflammation of the pancreas);
- stomach ulcer.
Additionally, with such pathologies, there is nausea, vomiting, heartburn, belching, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, there is pallor of the skin, a decrease in blood pressure, weakness, darkening of feces.
A feeling of discomfort under the right shoulder blade may indicate such ailments:
- duodenal ulcer;
- hepatitis;
- cirrhosis of the liver;
- cholelithiasis.
Other causes of the symptom
The following factors can also provoke pain in the area of the shoulder blades:
- Inconvenient sleeping place. In particular, a collapsed mattress and sleeping on the left side can cause pain on the opposite side, as the spine bends and the roots are pinched.
- Vegetovascular dystonia. It is accompanied by drops in blood pressure, shortness of breath, impaired cardiac activity, and sometimes back pain in the area of the shoulder blades.
- Polio. An infectious disease in which pain in the shoulder blades is neurogenic.
- Pleurisy. With inflammation of the pleura, the symptom occurs due to the friction of its sheets against each other. The peak of pain occurs with a deep breath.
- Kidney pathology. Characterized by aching, stabbing pain under the right shoulder blade. Additionally, there is a change in the color of urine, urine output.
- Intoxication. Discomfort occurs when an excess of toxins or decay products accumulate in the body against the background of a cold or due to serious poisoning. It is accompanied by chills, muscle pain, fever.
- Subphrenic abscess. Pain under the shoulder blades is observed when inhaling, arises from the accumulation of pus in the upper abdominal cavity.
- Mental disorders. Sometimes mental disorders are accompanied by discomfort in the back, but the mechanism of its development has not yet been studied.
Types of pain
The nature of the pain in the area of the shoulder blades may differ. Depending on this criterion, it is possible to assume a possible disease and determine the cause of the discomfort:
- Shooting, sharp, arising when turning the body or moving. Typical for pinched nerves. This characteristic makes it possible to distinguish it from pain in gallstone disease - with this diagnosis, the discomfort is constant and does not depend on movements.
- Cutting, boring pain of varying intensity. May indicate neuralgia, joint inflammation.
- Throbbing, aching, or burning. Such pain in the area of the shoulder blades indicates diseases of the internal organs. The symptom develops as a result of compression of the nerve roots, with movement it can become more pronounced.
- Choking pain at the level of the shoulder blades or below. Typical for a hernia of the spine. Often accompanied by numbness of the arms or legs, lumbago.
Which doctor should I go to?
If painful sensations appear in the area of the shoulder blades, you should make an appointment with a neurologist. The doctor will conduct an examination, establish a diagnosis and determine the treatment tactics. In case of detection of pathologies of internal organs, he will refer to a narrow-profile specialist - a gastroenterologist, cardiologist, orthopedist (depending on the alleged diagnosis).
Survey
To establish the cause of the onset of pain in the area of the shoulder blades, patients are assigned the following diagnostic procedures:
- Clinical studies of blood, urine. They show inflammatory changes, help in the diagnosis of somatic diseases.
- X-ray examination, CT. They allow you to detect curvature of the spinal column, injuries and their consequences, osteochondrosis.
- Ultrasound. It is used to identify pathologies of internal organs.
- ECG. Informative in case of suspicion of cardiac diseases.
- MRI. Reflects the condition of the spinal column, shoulder girdle, internal organs. The area of investigation is determined by the doctor depending on the proposed diagnosis.
Note!Pain below the shoulder blades is often indicative of neurological abnormalities. Therefore, CT and MRI are the "gold standard" in determining the cause of a symptom.
Treatment features
The goal of treatment is not only to remove pain, but also to eliminate the factor that leads to its appearance. When seeking medical help, pain relief is simultaneously carried out, as well as the appointment of etiological treatment aimed at eliminating the underlying disease.
The therapeutic program may include the following methods:
- Medication. To relieve pain, drugs from a number of analgesics and anti-inflammatory drugs are used. Depending on the cause of the symptom, antibacterial agents, diuretics, gastroprotectors, etc. can be used.
- Physiotherapy. Helps to speed up recovery from somatic pathologies, to strengthen the spine. To eliminate pain in the area of the shoulder blades, electrophoresis, UHT, and heating procedures are used.
- Massage. Helps to remove muscle spasms, improve posture, relieve painful sensations. It is prescribed for problems with the spine. Sometimes the intervention of an osteopath or chiropractor is required.
- Gymnastics. Shown during the recovery period. A set of exercises is selected for each patient individually, depending on the established diagnosis.
How to prevent shoulder blade discomfort?
Each patient who has undergone a course of treatment is subsequently recommended to follow a number of preventive measures. They are necessary to prevent recurrence of the disease.
It is important to follow these rules:
- create favorable conditions for sleep - choose an orthopedic pillow and a mattress of moderate firmness to support the physiological position of the spine;
- watch your posture;
- follow the principles of proper nutrition;
- try to prevent exacerbation of chronic pathologies;
- give up addictions (smoking, drinking);
- Visit your doctor regularly for preventive examinations.
Pain in the shoulder blades can be caused by somatic and neurological causes. In the latter case, the symptom arises sharply and is pronounced. With a somatic origin, the pain grows gradually and persists for a long time, does not depend on body movements.
Analgesics can be used to relieve an unpleasant symptom. However, in order to completely eliminate pain sensations, it is important to undergo a full course of treatment aimed at getting rid of the underlying pathology. Only a doctor can develop the correct therapeutic course after a complete examination.