Pain under the scapula is a type of spinal pain that can occur against the background of muscle spasms, myofascial syndrome, chronic vertebrogenic diseases, as well as be a consequence of injuries and physical and mechanical damage to the musculoskeletal system. Localization of pain in the back from the back can indicate not only vertebral pathologies, but also indicate possible disturbances in the functioning of internal organs: the cardiac region and fundus of the stomach, spleen, peritoneum, and respiratory tract. Cardiac pathologies, for example, myocarditis, angina pectoris or myocardial infarction, can also manifest as pain under the scapula on the left side. In approximately 8.3% of cases, intense pain under the scapula on the left side is a surgical symptom and can occur when the spleen is ruptured (or one of its lobes is bent), as well as ischemic damage to the organ parenchyma as a result of occlusion of blood vessels and arteries.
Pain under the left shoulder blade from the back
A little anatomy
The scapula is a flat triangular bone adjacent to the chest at the back in the area from the 2nd to 7th ribs. Performs binding, protective, strengthening and motor functions.
The scapula connects the girdle of the upper limbs with the arms and sternum. It protects the shoulder joint and protects the lungs and aorta from mechanical stress. Certain muscles extending from the shoulder blades are designed to strengthen and support the shoulder joints. Thanks to these parts of the skeleton, mobility of the shoulder girdle is ensured; their functions extend even to the lower limbs. The bone is equipped with nerve roots emanating from the cervicothoracic region.
General anatomical information
So, if you look at the back from the back, you can see that the left shoulder blade is fixed on the ribs that make up the chest. Between each of them there is a nerve and blood vessels located in the recesses. The ribs are connected to each other by ligaments and muscles.
Closer to the center of the shoulder blade is the spine, inside which the spinal cord is located. All the nerves come from him. The back muscles surrounding the shoulder blade are quite well developed. Its purpose is to protect the left lung, heart, spleen, stomach and pancreas, as well as the thoracic aorta.
Classification
The reasons underlying pain in the area of the shoulder blades on the left side are quite varied. There may be pain;
- aching;
- like a dull pain;
- with increased intensity;
- sharp, when it takes your breath away;
- pulling;
- burning;
- permanent, not passing;
- piercing (lumbago);
- pressing;
- pulsating;
- pointwise.
Important! Often the cause of pain is prolonged stay of the body in an uncomfortable position, as well as muscle strain due to physical activity. They go away on their own and usually do not require medical intervention.
Prolonged pain syndrome, as well as its systematic nature, makes consultation with a specialist a necessity. Acute pain in the area of the left shoulder blade requires urgent medical intervention, because... the factor does not exclude the manifestation of angina pectoris, exacerbation of stomach ulcers, or activation of inflammatory processes in the pancreas.
Pain affecting the lower part of the left shoulder blade from the back is often a consequence of injuries, diseases of the musculoskeletal system and pathologies of the internal organs.
Types of pain
The following types of pain exist:
- reflected. It can be aching, deep, burning or dull, and is often combined with other symptoms. This type of pain is caused by diseases of the internal organs;
- somatic. It can be diffuse in nature, can be acute, aching, dull and responds adequately to the use of analgesics. Occurs in or near the affected area. The cause is diseases of the spine, bones, tendons;
- irradiating. The pain is acute, intense, accompanied by motor disturbances and does not respond to analgesics. This type of pain syndrome occurs as a result of disturbances in the functioning of the nervous system;
- dysfunctional. Pain sensations can occur in different places, as a result of malfunctions of the central nervous system, namely the areas responsible for susceptibility.
The nature of the pain can be: sharp, dull, pulling, burning, aching. In the chronic form of the disease, pain syndrome can be observed for a long period with moments of exacerbation and remission.
Musculoskeletal system
Pathologies of the musculoskeletal system are provoked by various injuries:
Why does my upper back hurt?
- fractures and cracks caused by impacts, falls, road accidents, etc. The aching pain intensifies when a person makes movements. Also, the damaged area swells, a bruise appears, and mobility decreases;
- dislocations, which are observed in rare cases and occur when there is a strong pull on the arm or a blow to the shoulder blade. In this case, the bone rotates, shifts, and takes on an abnormal position. Its lower edge is compressed between the ribs.
The muscles connecting the scapula and spine are subject to excessive stress, causing stretching and possible rupture.
Pain in the area of the left shoulder blade on the back caused by injury occurs immediately after the injury and only goes away as the patient recovers.
In addition to injuries, pain in the area of the shoulder blade from the back is often caused by diseases of the musculoskeletal system.
Pain syndrome under the scapula, which is a consequence of cervical osteochondrosis (dystrophic-degenerative processes in the intervertebral discs of the spine), is spontaneous and can be aching and pulling. Increased pain is observed when a person remains in a sitting position for a long time and during physical exertion. Taking medications does not bring relief.
A pinched, inflamed intercostal nerve causes unbearable pain in the sternum, in the area where it lies. The syndrome intensifies as a person moves, when he coughs, sneezes, inhales deeply, and changes body position. Constant or paroxysmal pain syndrome is sharp, strong, shooting in nature. Sometimes pain manifests itself in the heart area, in the lower back, and affects the neck and arms. It can also affect the shoulder blade.
Manifestations of intercostal neuralgia are similar to symptoms caused by cardiac problems, cholecystitis, angina pectoris, and pleurisy. Only a qualified specialist can make a correct diagnosis
When there is inflammation in the shoulder tendon and capsule of the shoulder joint without damage to the joint and cartilage itself (humeral periarthritis), pain affects the shoulder joint, sometimes the area between the shoulder blades and the bone itself. They are sharp and intensified at night. The disease is accompanied by slight swelling of the shoulder, elevated temperature in the range of 37–37.4ºС, and limited circular movements of the shoulder. The pathology is widespread and is diagnosed as a consequence of injuries, bruises, and increased loads on the shoulder joint.
With inflammation of the cervical muscles (myositis), caused by overstrain or infection, severe pain affects the entire cervical-brachial region, radiating to the scapula, occipital region, and arms.
Muscle pain in the scapula area occurs due to physical strain or impact on the bone.
Pain due to malignant lesions of the bone structure or soft tissues refers to the initial manifestation of the disease. At first, they do not differ in intensity and appear periodically, which makes timely diagnosis difficult. The development of pathological processes leads to an increase in the severity of negative sensations that haunt a person even at rest, mainly at night. Not eliminated by non-narcotic analgesics. Next, the bone becomes deformed, the surrounding tissues swell, the skin over the malignant focus changes, and fractures occur that are not associated with trauma.
In the presence of an inflammatory process in the bone (osteomyelitis) caused by streptococci, staphylococcus, salmonella, E. coli and other infectious agents, the patient is exposed to high fever, chills, and increased heart rate. There are complaints of back pain in the scapula and muscles, which decrease when the abscess is opened.
Please note! Painful manifestations under or above the left shoulder blade and in the bone area are inherent in congenital anomalies. These include aplasia (absence of an organ), hypoplasia (insufficient bone development), pterygoid scapula, and Sprengel's disease. At the same time, a person often suffers from cosmetic defects and limited motor activity.
Intervertebral hernia and protrusion of the discs of the cervical spine lead to compression of the nerve roots by bone formations, which causes pain when moving, especially when tilting the head.
Heart and blood vessels
Back pain below the left shoulder blade is often the result of problems in the cardiovascular system.
Substernal pain in the central part or to the left, with extension to the upper part of the body, signals myocardial infarction. At the same time, a strong burning sensation may be observed under the left shoulder blade from the back. It is impossible to clearly characterize the pain syndrome. It can be aching, or it can manifest itself in an acute form.
Lack of blood supply to the myocardium causes an attack of angina, characterized by pressing or squeezing retrosternal pain, often radiating to the left shoulder blade, arm, and lower jaw. At the same time, blood pressure may increase, sweating and pallor may appear.
Angina attacks usually occur in stressful situations or from increased physical activity. They are treated with nitroglycerin. When the duration of pain exceeds 20 minutes or medications do not provide relief, the presence of myocardial infarction can be assumed.
High blood pressure or atherosclerotic lesions lead to aneurysm (enlargement) or dissection of the aorta (incomplete rupture or tear of the endothelium with subsequent spread of blood between the layers of the vessel wall).
Small aneurysms do not manifest themselves in any way. As they increase, a person begins to feel a dull pain in the back. A dissecting aneurysm is characterized by a pronounced clinical picture. When a tear occurs, the pain sensation is sharp and short-lived. It affects the chest and back, leading to a reflex decrease in blood pressure and fainting. After a certain period of time, a person feels a burning pain in the chest, arms, neck, under the left shoulder blade. The syndrome cannot be eliminated using available medications. In this condition, death is very possible, so urgent medical attention is necessary.
Pain below the left shoulder blade is caused by:
- ischemia – lack of blood supply to the heart;
- pericarditis – inflammatory processes in the pericardium;
- endocarditis - an inflammatory disease of the inner lining of the heart;
- myocarditis – inflammation of the heart muscle.
Disturbances in the autonomic nervous system cause vegetative-vascular dystonia. The disease is characterized by numerous manifestations, including pain under the left shoulder blade, similar to heart pain. In addition, the person suffers from irritability, memory impairment, increased sweating, etc.
Respiratory system
Pain under the left shoulder blade is not excluded due to respiratory diseases.
With left-sided pneumonia, mild chest pain or under the left shoulder blade is observed - dull, aching in nature, intensifying during movement or with deep breathing. Associated symptoms include fever to critical levels, shortness of breath, difficulty breathing, etc.
When necrotic cavities form in the left lung, accompanied by inflammatory processes and the formation of pus, pain is observed in the chest area, in some cases radiating to the scapula. The pathology is accompanied by a cough with purulent sputum, shortness of breath, and lack of air during breathing.
Diagnosis of left-sided pleurisy (accumulation of fluid in the pleural cavity) is carried out on the basis of the following symptoms: acute chest pain, sometimes radiating under the shoulder blade, fever, shortness of breath, dry cough and other manifestations.
Important! Almost all diseases of the respiratory system, accompanied by pain, are characterized by a cough of various types.
The occurrence of pain under the left shoulder blade is also possible due to acute bronchitis, tracheitis or tracheobronchitis.
Gastrointestinal tract
Pain in the area of the left shoulder blade is often inherent in pathologies of the gastrointestinal tract and requires urgent medical intervention.
Ulcerative lesions of the stomach and duodenum are characterized by paroxysmal pain. They are caused by prolonged fasting. They may appear immediately after eating or later.
Perforated ulcers cause acute unbearable pain, accompanied by fever, nausea, vomiting, etc. Failure to provide assistance to the patient within 12 hours from the onset of the disease leads to acute intoxication and can cause death of the patient.
Acute inflammation of the pancreas provokes pain in the upper, middle or left side of the abdomen. In some cases they extend under the shoulder blade. The pathology causes nausea, vomiting, bloating, and other digestive system disorders.
Some injuries cause the spleen to rupture. This does not lead to immediate internal bleeding, but causes a dull pain under the left shoulder blade. In such cases, delaying treatment can cost the patient his life.
In addition, esophageal spasm, calculous cholecystitis, gastroesophagitis and reflux are to blame for pain in the area of the left shoulder blade.
Methods for diagnosing the disease
The appearance of pain under the shoulder blade of unknown origin is an indication for a visit to a neurologist. To make a correct diagnosis you may need:
- urine and blood tests;
- X-ray examination;
- Ultrasound (kidneys, gallbladder);
- cardiogram;
- CT or MRI, etc.
Depending on the specifics of the identified problem, different specialized specialists can treat pain under the scapula: cardiologist, orthopedist, traumatologist, pulmonologist, neurologist.
