Pain in the thoracic region at the level of the shoulder blades can indicate back problems, pain in Organs internal organs and a reflex of cardiac discomfort. To find out the cause, you need to clearly explain the complaints to the doctor and undergo an examination. Depending on the diagnosis, therapy is prescribed. You should also consider in detail ways to treat back pain under your shoulder blades.
chest anatomy
The scapular zone belongs to the thoracic spine and is located at the level of the chest. It is necessary to study the anatomy of this area to understand which organs can directly and indirectly bother the patient.
Key anatomical elements include:
- The spinal column - consists of the spinal cord and vertebrae, intervertebral discs. It is an important part of the entire musculoskeletal system, it protects the spinal cord from damage.
- The right and left scapula belong to the bony structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bone structure has many holes and depressions. These are the attachment sites for ligaments, tendons, and muscles. The blades have high strength, so they can easily withstand constant static loads.
- The collarbone is the bone that connects the shoulder blade to the chest.
- Heart - responsible for the functionality of the cardiovascular system, pumps blood through veins and arteries.
- The lungs are a paired respiratory organ responsible for gas exchange processes.
- Esophagus, stomach - belong to Organs digestive organs.
- Ribs - provide a protective function of the breast. These are flat bones attached to the spine behind and in front of the sternum.
the nature of pain
The shoulder blades are located at the back of the back and are close to the humerus and collarbone. This is a paired, triangular-shaped bone, to which the rhomboid and partially trapezius muscles are attached. These muscle groups make the upper shoulder girdle mobile. The shoulder blades are connected to the ribs to form a strong torso structure. Any discomfort in this area can lead to significant discomfort and limited upper back mobility. For this reason, the pain cannot be tolerated and you should immediately consult a doctor.
The variety of pain sensations is divided into several classifications:
- Pain and its character according to the location of unpleasant sensations - in the middle of the shoulder blades, on the left or right, if there is irradiation in the chest or between the ribs, the pain is felt more or less.
- By the nature of the sensations - unpleasant sensations, pulling, sharp pain, whimpering, irradiation, pulsation.
- The duration of pain is episodic attacks, it is felt constantly, it sharply increases, unpleasant sensations occur after physical activity.
Most of the time, pulling pains indicate spinal problems and rarely signal other related problems.
main reasons
Symptoms of pain under the shoulder blades occur due to such disorders:
- stomach pain (gastric ulcer, gastritis);
- digestive disorders (heartburn, esophageal reflux);
- disorders in the work of the cardiovascular system (myocardial infarction, pericarditis);
- lung problems (bronchitis, pneumonia);
- degenerative disorders of the ridge, spine;
- trauma, inflammation, sprains, myositis;
- neurological problems.
In 90% of cases, as statistics indicate, discomfort in the shoulder blades is caused by back pain. The human spine is responsible for walking upright, so it bears a significant load. A careful attitude to one's health helps to improve well-being when physical inactivity and poor posture cause discomfort. The situation worsens with age.
injuries
If the patient has a bruise or sprain, pain under the shoulder blade may occur with movement or tension. In the acute period, the pain is constant and is felt even at rest. Depending on the location of the injury, the pain occurs on the left or right side of the shoulder blades. The most common types of damage are bone or muscle corset.
Other types of traumatic injuries:
- Loss. It is characterized by superficial pain. Most of the time, the superficial soft tissues, the upper muscle layer and the subcutaneous fat are bruised. Unpleasant sensations occur under the shoulder blades and below, swelling and a locally localized inflammatory process appear. No specific treatment is usually required. This pain goes away on its own in a few weeks.
- Fracture or crack - the pain is sharp and has no reflex and is concentrated at the site of injury. Even the slightest movement of the hand causes excruciating sensations. In this situation, the patient remains in absolute rest, so as not to worsen the situation with a fracture.
- Dislocations, displacement of vertebrae. In this case, the pain will be located not only in the region of the shoulder blade, but also in the back at the level of the thoracic region. Often, the pain occurs due to compression of the nerve endings in the spinal canal, which indicates damage to the intervertebral discs.
Trauma is easy to identify. During movement, a crisis is felt, tissue swelling is observed at the site of the bruise.
osteochondrosis
The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the ridge level. Unpleasant sensations arise due to pinched nerve endings. With injury to the thoracic region in the upper part of the patient, he feels a sharp scapular pain that radiates to the arm. The side depends on the specific nerve root injury. When squeezing the blood vessels, there is an increase in pressure, headache and dizziness.
If the lower part of the thoracic region is affected, then the patient will have unpleasant sensations in the lumbar region of the scapula. It also fits the left or right hand, depending on the location of the pinched nerve. Over time, the pain becomes more intense, the patient begins to feel discomfort not only during motor activity, but also during the rest period. Difficult situation - discomfort is felt 24 hours a day, even at night. Often, against the background of osteochondrosis, bulges or hernias occur.
Scoliosis
Violation of posture is the most common disease of the spine that occurs at an early age. The first problems are observed already from the first grades of school - children do not control the correct posture and do not understand why adults demand that they sit evenly. Over time, abnormal movement habits develop. A person sits in a position that is comfortable for him, but this position causes static overload of the muscles and the development of imbalance. If the spine remains in an antalgic position for a long time, a curvature occurs, which is fraught with consequences.
In adulthood, many people experience hypodynamia - a state of low physical activity, when a person leads an exclusively sedentary lifestyle. The result is persistent back pain due to muscle weakness. If there is a curvature in the thoracic region, the pain is located in the region of the shoulder blades. Sometimes there is radiating discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in a relaxed, standing state.
On initial examination, the therapist can see the disease. It is necessary to treat the disease for a long time and with the help of an integrated approach. To alleviate the painful condition, you need to establish a lifestyle, stop being nervous, and start moving. Under stress, muscle tone can increase, which will cause a deterioration in well-being. Massage helps a lot, it is also helpful to perform back exercise therapy.
hernias and bumps
The appearance of an intervertebral hernia is a serious condition characterized by a protrusion of the spinal canal through the fibrous ring of the disc. The previous condition of the hernia is protrusion. With protrusion, the disc is partially damaged and the annulus fibrosus is stretched. Hernias occur during intense physical exertion, due to heavy lifting. An important role in your appearance is played by the hereditary factor. If the family has close relatives with hernias or bulges, it is highly likely that they occur with age in children.
If a hernia or protrusion is located at the level of the thoracic region, then pain will occur in the region of the shoulder blades. There is also radiating pain in the arm or shoulder. The side depends on the specific compressed nerve roots. Painful shootings are explained by the defeat of nerve endings, which are compressed due to excessive compression on the back.
When the lower back is affected, the back pain is given to the leg, and when a cervical hernia occurs, the pain radiates to the head. In any situation, a hernia requires complex treatment aimed at relaxing the back, relieving acute pain, and eliminating muscle tightness. With hernias and protrusions, it is useful to carry out exercise therapy, participate in physical therapy procedures. In rare and advanced cases, surgery is necessary.
kyphosis
This is a curvature similar to scoliosis, but in the opposite direction. If with scoliosis the spine is curved to the right or left, then with kyphosis there is a pronounced slope of the upper shoulder girdle. One of the characteristic signs of the disease is a sensation of pain in the interscapular zone in the presence of external signs of pathology. It hurts under the left or right shoulder blade, depending on the nature of the curvature. Usually the pain occurs on both sides and goes into the arms, neck. There are two main mechanisms for the formation of pathology:
- Neurogenic. During the occurrence of curvature, degenerative processes occur in the spine, which causes the nerve roots of the spinal cord to be pinched. There are aching pains in the region of the right and left scapula, which are given to the neck, collarbone or arm, less often to the shoulder joint.
- muscular. Constantly being in a concave state causes muscle imbalance and overload. In the upper back, the muscles are tight, which causes hypertonicity and severe pain. The rest of the back muscles also suffer. Hypotension can occur in the lower back.
As a result, the vertebral artery is compressed, which causes a persistent violation of cerebral circulation. Gradually, there is a deterioration of well-being, there are malfunctions in the work of internal organs. With such a patient, it is necessary to carry out complex work, including the services of a rehabilitator, exercise therapy.
spondylarthrosis
Sometimes the development of spondylarthrosis indicates right or left pain in the region of the shoulder blades. The disease is characterized by damage to facet joints and intervertebral discs. With the development of the disease, there is a loss of mobility, there is a feeling of stiffness, which is more pronounced in the morning.
The pathology manifests itself in several stages:
- Deformation and destruction of cartilage. If blood circulation is impaired in this zone, the integrity of the connective tissue is destroyed, due to which the articular disc becomes thinner. Restorative processes in bone and connective tissue deteriorate significantly. Increased physical activity in this area leads to microtrauma.
- Other deforming changes occur. Seals appear on the disc, mobility worsens, which leads to increased destruction of cartilaginous tissue. The patient may feel pain constantly, even in a calm state.
- The terminal stage is ossification, the formation of osteophytes. These growths injure adjacent joints, tendons, muscles, and ligaments. In this case, an operation will be required.
A characteristic manifestation of spondylarthrosis in the initial stage is the appearance of pain only during physical exertion. Discomfort at rest decreases as there is no traumatic factor.
intercostal neuralgia
This condition refers to vagus nerve disorders. When a pathology occurs, a sharp pain appears, shooting in the shoulder blade, ribs and chest. This type of pain is often mistaken for a heart attack. A characteristic difference is the lack of a clear location in the heart region. Unpleasant sensations intensify on inspiration. The pain is accompanied by a feeling of constriction. If the patient thinks he has angina, after taking nitroglycerin, there is no relief.
Pain under the right or left shoulder blade indicates innervation to specific areas. Numbness and spasm are not typical for this pathological process. Given the specificity of the symptoms of the disease, the specialist will make a diagnosis without problems. Treatment consists of injectable B vitamins and myotropic (muscle relaxant) drugs. Intercostal neuralgia therapy should be treated by a neurologist.
Causes of pain under the left shoulder blade behind the back - heart disorders
Often, back pain indicates a heart disorder. Why back pain is a referred pain phenomenon that indicates coronary artery disease, myocardial infarction or pericarditis. If there is excruciating pain of a sudden nature, which increases with physical exertion, but there are no symptoms of spinal disorders, you need to urgently visit a cardiologist for an appointment. Self-treatment or procrastination can bring the situation to a critical state.
The most common causes of heart discomfort causing pain under the left shoulder blade behind the back:
- Myocardial infarction. In addition to irradiation, the patient feels painful pain in the region of the heart muscle. The causes of the pathology are associated with the blockage of large arteries and veins by a thrombus. If the thrombotic plaque ruptures and blocks vascular flow around the heart, a heart attack will occur. In this state, one must act quickly, otherwise the patient will die. The root cause of the pathology that arose is atherosclerosis, agglutination of erythrocytes, platelets with increased clotting.
- Ischemic heart disease or angina pectoris. According to information from a medical article, an attack of coronary artery disease develops suddenly. There is a dull pain, which is paroxysmal in nature. The attack is easily stopped by taking nitroglycerin. The disease requires more medical follow-up, as it can occur at the most unexpected time. If the attack lasts longer than a few hours and the medication doesn't help, you need to call an ambulance. In addition to the discomfort in the heart, the patient's breathing becomes reality, shortness of breath occurs, which is aggravated by physical exertion.
- Pain under the left shoulder blade behind the back could indicate the development of an attack of pericarditis. The pathology is characterized by the accumulation of fluid with an inflammatory lesion of the serous membrane of the heart. Diagnosis includes tests for inflammatory markers, including rheumatic tests. Pericarditis is often a complication of a previous infectious disease, including upper and lower respiratory tract diseases. Long-term complex therapy is carried out.
Respiratory system diseases
In the presence of prolonged respiratory illnesses, the patient may eventually experience radiating pain in the area of the shoulder blades. Most often, complications are caused by such diseases:
- Chronic or acute bronchitis. In the early stages, the disease is characterized by a dry cough. Gradually, irritation of the larynx increases and a wet cough occurs. If the disease has developed against the background of SARS, there is an increase in body temperature. The disease does not require specific therapy, it is enough to observe bed rest, drink more warm liquid. Rarely, antipyretics and antibiotics may be needed.
- Pleurisy. If the patient has complained of severe chest pain with possible radiation, cough, shortness of breath, and fever, the specialist should rule out or confirm this illness. Pleurisy is characterized by inflammation of the pleural laminae, followed by accumulation of liquid sputum in the pleural cavity. The disease is hard to bear. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is required.
- Pneumonia. It often develops as a complication of SARS. Pneumonia is characterized by a severe course, accompanied by cough, shortness of breath, chest pain on inspiration, and strong fever. The disease is confirmed by a chest X-ray and can be treated with antibiotics.
Diseases of the gastrointestinal tract
All disorders of the gastrointestinal tract that cause discomfort in the area of the shoulder blades have a reflected pain character. What problems can arise:
- Gastritis or stomach ulcer. If there is a reflex of the pain syndrome, then the patient will feel unpleasant discomfort in the lower thoracic region (the lower part of the shoulder blades on both sides). It may feel like muscle pain. With an attack of stomachache, a burning sensation in the solar plexus can be felt in parallel. Diseases are treated in a complex way, drugs are used to reduce acidity, healing agents (proton pump inhibitors). If a bacterial pathogen is found, antibiotics are prescribed.
- Esophageal reflux, heartburn. Discomfort occurs in the chest area, often radiating to the scapular area. The cause of the pathology is the return of stomach contents to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour belching, a lumpy feeling in the throat. In rare cases, vomiting occurs. To prevent an attack, you need to limit your consumption of fried, spicy and fatty foods. In symptomatic treatment, acid-reducing antacids based on magnesium and aluminum hydroxide are used.
editorial opinion
Unpleasant sensations in the scapular area are most often associated with an exacerbation of diseases of the musculoskeletal system. Less often, heart disorders, problems in terms of neurology, diseases of the stomach and respiratory system lead to discomfort. To learn more about the causes of back pain, it is recommended to study the corresponding article on our website.