What does back pain in the shoulder area say?

12 June 2021

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 the internal organs. Why is it necessary to consult a doctor and with which specialist to make an appointment? Effective methods to eliminate discomfort.

If you are worried about back pain in the shoulder blades, such a symptom may indicate diseases of the spine or shoulder girdle, nerve pathologies, somatic diseases. Careful collection of the patient's medical history and complaints allows you to determine the cause of the problem and decide on further treatment.

Often, back pain in the shoulder blades is the first signal of pathological changes in the body. And the definition of the provoking factor allows you to prevent exacerbation of the disease at an early stage. The symptom can appear in one half of the body or spread to the arm, appear by inhalation - all this is important in the diagnosis.

The causes of pain and its location

As a rule, discomfort occurs in the area of the shoulder blades when moving. For example, prolonged static body position, awkward bend. In this case, the pain under the shoulder blade signals damage.

Important!Unilateral localization of pain (left below the shoulder blade or right) is rare. This is due to the symmetrical arrangement of the nerve roots of the spinal cord.

Traumatic injury

Painful sensations can signal damage to muscles or bones. In this case, the symptom is diffuse and of varying intensity. The pain occurs abruptly and continues.
Injuries that can cause pain in the shoulder blades:

Fractures, cracks. Serious injury in which the pain is concentrated directly in the shoulder blade. The symptom worsens with minimal movement, so the patient cannot move.
Bruises. The discomfort is superficial, occurs due to damage to the muscular frame and is localized in the lower part of the shoulder blades. Examination may reveal signs of inflammation, swelling of the tissues. The symptoms persist for 14-21 days.
Subluxation or displacement of the vertebrae. Joint pain occurs under the shoulder blades or at their level. Discomfort may be exacerbated by compression of the nerve roots.

In injuries in the area of injury there is swelling of the soft tissues, the pain appears sharply. Often a crisis occurs when moving.

Protrusion and hernia of the spine

In this pathology, the spinal cord and nerve roots are compressed, which is accompanied by impaired sensitivity and sharp pain under the right and left shoulder blades.

Possible discomfort:

Back pain under the shoulder blade on the left or right. Shows lesions of 6-12 discs with possible involvement of the lumbar spine in the pathological process. As the latter is exposed 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. The discomfort becomes more pronounced when moving the head.
Between the shoulder blades. Pain is observed when 3-6 segments of the spine are affected. It becomes more pronounced with deep breathing, turning the body, abducting the upper limbs to the sides.

Note!With a bulge, the pain continues even at rest. This is due to compression of the nerve roots and muscle spasm.

Osteochondrosis

If the back hurts in the shoulder blades, the symptom may indicate osteochondrosis of the chest. 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 pronounced symptoms.

The area of discomfort is determined by the location of the lesion:

2-6 segments. The discomfort is localized at the level of the shoulder blades, irradiation of the arm and neck is possible. There may be an increase in intracranial pressure, dizziness due to squeezing of blood vessels.
6-12 segments. There is pain under the shoulder blade on the back left or right and extends to the lower back.

Note!In osteochondrosis, the pain is unilateral.

Spondyloarthritis

This pathology is also characterized by unilateral placement of the pain syndrome. In spondyloarthritis there is a violation of mobility, a feeling of stiffness due to damage to the intervertebral discs and facet joints.

The symptoms depend on the neglect of the pathological changes:

Destruction of cartilage tissue. It develops against the background of reduced blood circulation and disruption of connective tissue integrity. The cartilage element becomes brittle - it is quickly damaged and slowly renewed. The situation is aggravated by microtraumas due to intense physical activity. In this case, the pain radiates to the shoulders and lower back.
Deformation of the intervertebral disc. Thickening of the tissue is accompanied by impaired mobility, as well as pain in the shoulders and back. Against this background, destructive processes are intensifying.
The formation of bone growths. They appear in an advanced form of spondyloarthritis. They cause damage to blood vessels, muscle tissue, nerves, joints.

In spondyloarthritis, the pain occurs after exercise and can be localized in the area of the shoulder blades or between them. At rest, the symptom disappears.

Scoliosis

It is accompanied by 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 shoulder blade.

Other symptoms of scoliosis:

Chest deformity. There is a displacement of the ribs and vertebrae, which leads to damage to the spinal cord and its branches. Therefore, back pain is observed on the left under the shoulder blade or on the right.
Respiratory disorder. Due to the deformation of the chest, there is a dysfunction of the lungs - one of them is compressed, the second tries to compensate for the deficit of gas exchange.
Cardiac dysfunction. Due to the curved spine there is shortness of breath, the skin becomes pale, the pulse changes.

Note!Scoliosis is characterized by compression of the spinal cord so that discomfort is localized between or below the shoulder blades. 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, bending occurs. In this case, the pain is localized above the shoulder blades, has a bilateral nature, radiates to the neck, arm.

Mechanisms of pain formation in kyphosis:

Muscular. The curvature of the spine leads to overexertion of the muscles of the collar area and their spasm, which is accompanied by pain over the shoulders.
Neurogenic. Against the background of the curvature of the spine, the distance between the vertebrae decreases. This leads to disruption of the branches of the spinal cord and the appearance of pain in the shoulder blades, which can spread to the neck, clavicle, shoulder.

In kyphosis, the vertebral artery is compressed, which leads to deterioration of cerebral circulation, dysfunction of internal organs.

Sciatica

The pathology is characterized by pinching of the lumbar roots, which form the sciatic nerve. With the defeat of the upper part, the pain is localized under the shoulder blade and below. The discomfort is bilateral, it becomes more pronounced with sudden movements.

If left untreated, sciatica is accompanied by other symptoms:

burning pain in the back (under the shoulder blades and in the lower back) - shows pinching of the spinal roots;
lumbago with radiation in the legs;
convulsions;
impaired sensitivity in the buttocks, lower back;
tingling in the nerve (can be seen in the lower leg, thigh, foot).

Neuralgia

Inflammation of the nerve fibers in this anatomical area 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 on 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 extending to its anterior sections.
Supraspinatus and suprascapular nerves. It is 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.
Infraspinatus and subscapular nerve. Discomfort is felt under the shoulder blade on the left or right. When the inflammation spreads to the muscles, the pain increases when you move your arms.

Note!In neuralgia, the pain is often unilateral - 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.

In humeroscapular periarthrosis, there is discomfort at the level of the shoulder blades and below. In the initial stage it appears after intense physical activity, with the progression of the disease - at rest. Other symptoms of pathology:

tingling in the upper limbs;
headache;
reduced mobility of the spine.

Cardiac pathology

Pain under the shoulder blades may indicate heart disease. This is due to the fact that the branches of the parasympathetic trunk, connected to the spinal cord and nerve roots, go to the organ. If there is pain under the left shoulder blade from behind, the symptom may indicate a mild form of myocardial infarction. It can last for several days, increase with movement and decrease at rest.

Pain under the shoulder blade and pressing pain behind the sternum with heart disease

Other signs of pathology:

burning, pressing pain behind the sternum;
heart rhythm disorder;
palpitations;
dyspnea;
dizziness;
nausea, vomiting;
high blood pressure.

Diseases of the digestive system

The mechanism of pain is similar to the previous cause - the spread of nerve fibers. The location of the symptom depends on the affected organ, less often the discomfort is bilateral.

If the back hurts on the left under the shoulder blade, development is possible:

inflammation of the gastric mucosa;
pancreatitis (inflammation of the pancreas);
stomach ulcer.

In addition, in such pathologies there is nausea, vomiting, heartburn, belching, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, there is pale skin, decreased blood pressure, weakness, dark stools.

The feeling of discomfort under the right shoulder blade may indicate such diseases:

duodenal ulcer;
hepatitis;
cirrhosis of the liver;
cholelithiasis.

Other causes of the symptom

The following factors can also provoke pain in the shoulder blades:

Inconvenient place to sleep. 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 pinch.
Vegetovascular dystonia. It is accompanied by a drop in blood pressure, shortness of breath, irregular heartbeat and sometimes back pain in the shoulder blades.
Polio. An infectious disease in which the pain in the shoulder blades is neurogenic.
Pleurisy. In inflammation of the pleura, the symptom occurs due to the friction of its leaves against each other. The peak of pain occurs with deep breathing.
Renal pathology. It is characterized by pain piercing pain under the right shoulder blade. In addition, there is a change in urine color and urine output.
Intoxication. Discomfort occurs when the body accumulates excess toxins or breakdown products on the background of a cold or due to severe poisoning. It is accompanied by chills, muscle aches, fever.
Subphrenic abscess. Pain under the shoulder blades is observed on inhalation, arising from the accumulation of pus in the upper abdominal cavity.
Mental disorders. Sometimes mental disorders are accompanied by back discomfort, but the mechanism of its development has not yet been studied.

Types of pain

The nature of the pain in the shoulder blades can vary. Depending on this criterion, it is possible to suggest a possible disease and determine the cause of the discomfort:

Shooting, sharp, occurring when turning the body or movement. Typical of pinched nerves. This characteristic makes it possible to distinguish it from pain in gallstone disease - in this diagnosis the discomfort is constant and does not depend on movements.
Cutting, dull pain of varying intensity. May indicate neuralgia, inflammation of the joints.
Pulsating, painful or burning. Such pain in the shoulder blades indicates diseases of the internal organs. The symptom develops as a result of compression of the nerve roots, with movement may become more pronounced.
Choking pain at the level of the shoulder blades or below. Typical of spinal hernias. Often accompanied by tingling in the hands or feet, lumbago.

Which doctor should I go to?

If you experience painful sensations in the shoulder blades, you should make an appointment with a neurologist. The doctor will perform an examination, make a diagnosis and determine the tactics of treatment. In case of detection of pathologies of the internal organs, he will turn to a specialist with a narrow profile - gastroenterologist, cardiologist, orthopedist (depending on the presumed diagnosis).

Research

To determine the cause of shoulder blade pain, patients are assigned the following diagnostic procedures:

Clinical tests 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 spine, injuries and their consequences, osteochondrosis.
Ultrasound. It is used to identify pathologies of the internal organs.
ECG. Informative in case of suspicion of heart disease.
NMR. Reflects the condition of the spine, shoulder girdle, internal organs. The field of examination is determined by the doctor depending on the proposed diagnosis.

Note!Pain under the shoulder blades is often an indicator of neurological abnormalities. Therefore, CT and MRI are the "gold standard" in determining the cause of a symptom.

Features of treatment

The goal of treatment is not only to eliminate the pain, but also to eliminate the factor that leads to its occurrence. At the same time, seeking medical help relieves the pain syndrome, as well as the appointment of etiological treatment aimed at eliminating the underlying disease.
The therapeutic program may include the following methods:

Medical treatment. A number of analgesics and anti-inflammatory drugs are used to relieve pain. Depending on the cause of the symptom, antibacterial agents, diuretics, gastroprotectors, etc. may be used.
Physiotherapy. Helps to accelerate recovery from somatic pathologies, to strengthen the spine. Electrophoresis, UHT and heating procedures are used to relieve pain in the shoulder blades.
Massage. Helps to eliminate muscle spasms, improve posture, relieve pain. It is prescribed for problems with the spine. Sometimes the intervention of an osteopath or chiropractor is needed.
Gymnastics. Displayed during the recovery period. A set of exercises is chosen for each patient individually, depending on the established diagnosis.

How to prevent discomfort in the shoulder blades?

Subsequently, each patient undergoing treatment is recommended to follow a number of preventive measures. They are needed 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 with moderate firmness to maintain the physiological position of the spine;
watch your posture;
follow the principles of proper nutrition;
try to prevent exacerbation of chronic pathologies;
quit addictions (smoking, drinking alcohol);
See your doctor regularly for preventive check-ups.

Scapular pain can be caused by somatic and neurological causes. In the latter case, the symptom occurs abruptly and is very pronounced. Of somatic origin, the pain increases gradually and lasts a long time, regardless of body movements.
Analgesics may be used to relieve the unpleasant symptom. However, in order to completely eliminate the sensation of pain, it is important to undergo a full course of treatment aimed at getting rid of the underlying pathology. Only a doctor can develop the right course of therapy after a complete examination.