Painful sensations under the shoulder blade - this symptom can appear in adults suffering from diseases of the musculoskeletal system or pathology of internal organs, and in children who simply did not calculate the physical activity or were in a draft.
Self-administration of pain relievers when subscapularis pain occurs is absolutely unacceptable: such pain sensations can be a sign of life-threatening conditions.
At the same time, attention and often emergency medical care deserves not only acute pain, but also a dull ache under the left shoulder blade.
The type of pain and the accompanying symptoms suggest a specific illness. However, only a qualified doctor can use the patient's complaints to identify which damage has caused the pain to which organ, prescribe the necessary diagnostic examination and, if necessary, provide immediate help.
Causes of pain under the left shoulder blade in the back from behind
The proximity of the lungs, heart, and spine, as well as an extensive network of nerve fibers, add to the list of possible causes of subscapular pain. In this case, each disease is characterized by different specific signs, and the nature and duration of the sensations of pain also change.
Pathology of the musculoskeletal system and nerves
Spine and back muscle disorders are a common cause of left lower shoulder blade pain. Pain in such diseases is often one-sided.
- Osteochondrosis - the formation of osteophytes in the thoracic or cervical spine provokes pulling pain on the left or right, starting on the neck and upper back and ending with radiation in the arm. The pain does not go away at rest, often persistent, but bearable.
- Intercostal neuralgia - accompanied by severe pain that spreads throughout the intercostal space and is aggravated by breathing, twisting, sneezing / coughing. With neuralgia, the sensitivity of the skin to the source of pain often changes. Neuralgia triggers paresthesia in the form of goose bumps, while numb pains under the left shoulder blade are common with myocardial infarction, angina pectoris.
- Scapula Rib Syndrome - is a "reward" for hard physical work or activities associated with prolonged stay in one position (office worker). Patients complain of non-intense dull pain localized between the neck and shoulder and radiating under the shoulder blade.
Important! The causes of pain under the left shoulder blade from behind, which radiate into the arm and are of an urgent nature - osteochondrosis and angina pectoris - have a peculiarity. With angina pectoris the pain lasts up to 30 minutes, with osteochondrosis - several days. In addition, nitroglycerin or other heart medication will stop an attack of angina pectoris.
Sometimes subscapular pain is caused by myositis (stiffness of movement and tension in certain muscle groups are observed at the same time), scapula injury (acute pain always preceded by a fall, blow, etc. ), or oncology (pain may occur periodically, not intensely). Bone tuberculosis, namely an injury to the shoulder blade, cannot be ruled out.
Heart and blood vessel disorders
Cardiac pathology is one of the most dangerous that can be diagnosed when a patient complains of subscapular pain. When this happens, heart disease pain doesn't always start in the front of the chest (behind or to the left of it). The cause of pain under the left shoulder blade in the area of the heart can be:
- Angina pectoris - tenderness behind the sternum extends below the left shoulder blade and collarbone, into the jaw and arm. The pain intensity decreases at rest, but changing posture does not bring any relief. In the scapular-costal (vertebrogenic) syndrome, the situation with increased pain is radically reversed. Angina attacks are balanced by taking nitroglycerin, and manual therapy is excellent for vertebral pain.
- Myocardial infarction is an acute, growing pain in the heart with a characteristic radiation to the left (including under the shoulder blade) that is not stopped by cardiac glycosides. The patient feels a great deal of fear, which is not the case with damage to the spine and nerve fibers. Immediate hospitalization required!
- Hypertensive crisis - often accompanied by oppressive heart pain radiating to the left shoulder blade. The cause of pain can easily be determined by measuring a / d.
- Pericarditis - in this disease, the pain subsides at rest and when the trunk is tilted forward. Pain occurs in the front of the heart, radiates under the shoulder blade, but not as intense as in acute myocardial ischemia (angina pectoris, myocardial infarction).
- Detachment, aortic aneurysm is a dangerous condition characterized by throbbing pain under the shoulder blade. The rapid increase in pain requires an urgent call from the medical team.
Important! In ischemic heart disease (angina pectoris, myocardial infarction) as well as in cervical osteochondrosis, numbness of the left tongue is characteristic.
Important! A symptomatic picture similar to cardiac pathology is often given by vegetative-vascular dystonia. At the same time, the evidence of his serious condition is clearly simulated (psychogenic factor), the patient is often nervous, trembles, has a fever and a feeling of lump in the throat.
Respiratory diseases
Pain under the left shoulder blade can cause the following lung diseases:
- Pneumonia - causes pain only when the focus of inflammation is near the pleural membrane. Painful sensations of low intensity occur periodically, have a punctiform localization and increase with breathing.
- Pleurisy - unlike pneumonia, the pain is sharp and stabbing. Its intensity depends on the depth of breathing.
Concomitant pulmonary symptoms that accompany painful inhalation under the left shoulder blade are shallow, rapid breathing, shortness of breath, fever. Hyperthermia can also occur with pericarditis. It is extremely rare that with severe neuralgia, myositis, there is a slight increase in temperature.
Important! In contrast to heart disease, with the pathology of the respiratory tract, pain is accompanied by night sweats and coughs (in the initial stages of pneumonia, and with pleurisy - dry).
Pathology of the gastrointestinal tract
Pain under the shoulder blade is often associated with gastrointestinal disorders. In this case, the symptomatic picture will be as follows:
- Gastric ulcer - severe cutting pain is always associated with food intake (occurs before or immediately after eating), radiates to the shoulder blade with unspecific localization of the ulcerative process (the back wall of the stomach or its part of the heart). The pain subsides after vomiting and takes acid-lowering medication. Perforation of the ulcer is accompanied by increased pain (like cutting with a knife), the patient presses his legs to the abdomen and covers them with his hands.
- Pancreatitis - accompanied by severe girdle pain (including under the left shoulder blade). An attack is always associated with nutritional deficiencies (fatty, salty, fried, alcohol, hunger). Vomiting does not bring any relief.
Important! The pathology of the gastrointestinal tract, which caused pain under the shoulder blade on the left side, is accompanied by other characteristic symptoms - flatulence, indigestion, vomiting, belching.
Diagnosis of subscapular pain
When taking the anamnesis, the doctor pays attention to the connection between pain and physical activity, food consumption, stress and also names chronic and current comorbidities.
Assessing the nature of the pain, the presence of certain symptoms specific to diseases of different organs, allows you to narrow down the range of causes to a particular body system - heart, lungs, musculoskeletal system, gastrointestinal tract. The preliminary diagnosis is confirmed by the following studies:
- Heart - measurement of a / d, EKG, echocardiography and Doppler scan;
- lungs - chest x-ray;
- Spine - X-ray of the neck and chest region, CT or MRI.
In the future, a more detailed examination of the damaged organ may be necessary. Only then is the treatment of the identified disease prescribed.
When and which doctor should I contact?
Depending on the intensity and type of painful sensations under the shoulder blade, accompanying symptoms, you should consult a doctor:
- urgent emergency call - severe pain with increasing intensity and rapid deterioration of the general condition;
- Traumatologist - got an injury that provoked a pain syndrome;
- Cardiologist - with simultaneous chest pain (constant or periodic), shortness of breath, cyanosis;
- Neurologist, orthopedist - pain under the left shoulder blade, aggravated by raising the arm, there is a clear link between the appearance of pain and physical activity, previously diagnosed degenerative pathology of the spine;
- Gastroenterologist - there is a relationship between pain and food intake, there are other signs of gastrointestinal disease (nausea, vomiting, etc. );
- Pulmonologist - pain under the shoulder blade is accompanied by cough, shortness of breath;
- Therapist - Pain occurs without a clear cause, permanently or temporarily.
It is the therapist who often diagnoses both a trivial VSD and confirms an acute surgical pathology or an oncological process. In the future, the doctor will appoint a consultation with a specialist with a narrow profile.
Preliminary treatment regimens
Depending on the diagnosis, the attending physician selects an effective treatment for the causative disease. An important point in complex therapy is the elimination of the pain syndrome:
- Strong pain relievers are most commonly used for neurological pain;
- The pathology of the spine and muscles requires treatment with nonsteroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires the use of nitroglycerin (does not help with a heart attack), validol only has a reflex action and in no way improves the condition of the heart muscle in ischemic disease;
- If a gastrointestinal disease is suspected, it is advisable to take anticonvulsant, acid-lowering medication (for ulcers).
Only by eliminating the causative disease will the patient get rid of the pain under the shoulder blade. In acute conditions, urgent hospitalization and intensive treatment are sometimes required.
The radical nature of treatment depends on the type of disease and the duration of its course, therefore, at the first painful symptoms, a doctor should be consulted. Not only does the outcome of the disease depend on this, the chances of a full recovery also increase.
In severe cases, timely medical care will save the patient's life.