What does back pain in the shoulder blade area mean?

12 June 2021

Back pain in the area of the shoulder blades is a characteristic symptom not only of diseases of the back, but also of pathologies of internal organs. Why is it necessary to consult a doctor and which specialist to make an appointment? Effective methods to get rid of discomfort.

If you are worried about back pain in the area of the shoulder blades, such a symptom may indicate back or shoulder girdle disease, nerve pathology, somatic disease. Careful collection of the patient's medical history and 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 provocative factor allows you to prevent the aggravation of the disease at an early stage. Symptoms can occur in one half of the body or spread to the arm, appearing when inhaling - all of which is important when making a diagnosis.

Causes of pain and its localization

As a rule, discomfort in the area of the shoulder blades appears when moving. For example, an extended static body position, a difficult turn. In this case, the pain under the shoulder signals injury.

Important!Unilateral localization of pain (on the left below the shoulder 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 may signal muscle or bone damage. In this case, the symptoms are diffuse and of varying intensity. The pain arises sharply and continues.
Injuries that can cause pain in the shoulder blades:

Fractures, cracks. A serious injury in which the pain is concentrated directly on the shoulder. The symptom worsens with minimal movement, so the patient cannot move.
Bruising. The discomfort is superficial, it occurs due to damage to the muscular frame and is localized to the bottom of the shoulder blades. During the examination, it is possible to detect signs of inflammation, swelling of the tissues. Symptoms persist for 14-21 days.
Subluxation or displacement of the vertebrae. Joint pain occurs below or at shoulder level. Discomfort can be exacerbated by compression of the nerve roots.

With lesions in the area of injury, soft tissue edema is observed, the pain appears suddenly. Often a crisis occurs when moving.

Spinal protrusion and hernia

With this pathology, the spinal cord and nerve roots are compressed, which are associated with impaired sensitivity and sharp pain under the right and left shoulder.

Possible concern placement:

Back pain under the shoulder on the left or right. Shows an injury of 6-12 discs with possible involvement of the lumbar spine in the pathological process. Since the latter is subject to increasing stress, there is a high risk of developing spinal hernias.
Above the shoulder blade. The outlet is located in the spine of the uterus or in segment 1-3. The discomfort becomes more pronounced with the movement of the head.
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, grabbing the upper limbs sideways.

Note!With prolongation, 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 area of the shoulder blades, the symptoms may indicate osteochondrosis of the thoracic spine. Symptoms occur due to blockage of the spinal cord or nerve roots and deformity of the intervertebral disc. The disease gradually progresses, causing more and more vivid symptoms.

The area of concern is determined by the location of the wound:

2-6 segments. Discomfort is localized at shoulder level, radiation to the arm and neck is possible. An increase in intracranial pressure is possible, dizziness due to squeezing of blood vessels.
6-12 segments. There is pain under the shoulder of the left or right back and extends to the lower back.

Note!With osteochondrosis, the pain is one-sided.

Spondyloarthritis

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

Symptoms depend on neglect of pathological changes:

Destruction of cartilage tissue. It develops against the background of reduced blood circulation and a violation of the integrity of connective tissue. The cartilaginous element becomes brittle - it is damaged quickly and regenerates slowly. The situation is exacerbated by microtraumas due to intense physical exertion. In this case, the pain radiates to the shoulders and lower back.
Deformation of the intervertebral disc. Tissue thickening is associated with impaired movement as well as pain in the shoulders and back. Against this background, destructive processes are intensifying.
Formation of bone growths. They appear in the advanced form of spondyloarthritis. They lead to damage to blood vessels, muscle tissue, nerves, joints.

With spondyloarthritis, the pain occurs after physical exertion, and can be localized in the area of the shoulder blades or between them. At rest, the symptoms disappear.

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 shoulder.

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. Because of this, back pain is noticed on the left below the shoulder or on the right.
Respiratory disorder. Due to the deformity of the chest, lung dysfunction is observed - one of them is congested, the second is trying to compensate for the gas exchange deficit.
Violation of cardiac activity. Due to the sloping back, shortness of breath is present, the skin becomes pale, the heartbeat changes.

Note!Scoliosis is characterized by compression of the spinal cord, so the discomfort is localized between the shoulder blades or below them. The pathological focus has clear outlines and can spread to nearby areas only with muscle spasms.

kyphosis

Kyphosis is a curvature of the back of the spine, in which the shoulder girdle is pulled forward, a curvature appears. In this case, the pain is localized on the shoulders, has a bilateral nature, radiates to the neck, arm.

Mechanisms of pain formation in kyphosis:

Muscular. Bending of the spine leads to overload of the muscles of the collar area and their spasm, which is accompanied by pain over the shoulder blades.
Neurogenic. Against the background of curvature of the spine, the distance between the vertebrae is reduced. This leads to damage to the branches of the spinal cord and the appearance of pain in the area of the shoulder blades, which can spread to the neck, collar bone, shoulder.

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

Radiculitis

The pathology is characterized by constriction of the lumbar roots that form the sciatic nerve. With the defeat of the upper section, the pain is localized below the shoulder and below. The discomfort is bilateral, it becomes more pronounced with sudden movements.

If left untreated, sciatica is associated with other symptoms:

burning pain in the back (below the shoulder blades and in the lower back) - indicates tightening of the spinal roots;
lumbago with foot radiation;
convulsions;
violation of sensitivity in the buttocks, lower back;
numbness along the nerve (can be noticed in the lower leg, thigh, foot).

Neuralgia

Inflammation of nerve fibers in this anatomical region can provoke pain below the shoulder blades. A common cause of pathology is hypothermia.

Inflammation can affect structures such as:

Nerves between the ribs. Affect 1-4 pairs located along the lower edge of the ribs. The pain is localized below the shoulder blades and below, in the lateral parts of the chest, it rarely extends to its anterior parts.
Supraspinatus and Suprascapular Nerves. It is characterized by the appearance of pain in the area of the shoulder blades from the back to the area of the clavicle. Sometimes the symptoms extend to the shoulders.
Nerves infraspinatus and subscapularis. Discomfort is felt under the shoulder on the left or right. When inflammation spreads to the muscles, the pain increases when the hands move.

Note!With neuralgia, the pain is often unilateral in nature - the symptoms are localized to the part that has undergone hypothermia.

Periarthrosis shoulder-shoulder

It is characterized by inflammation of the shoulder joint and surrounding tissues. It is accompanied by impaired movement, which can only be removed 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, while the disease progresses - at rest. Other symptoms of the pathology:

numbness of the upper limbs;
headache;
reduced spinal mobility.

Heart pathology

Pain under the shoulder blades can 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 from the back to the back, the symptoms may indicate a mild form of myocardial infarction. It can continue for several days, increase with movement and decrease at rest.

Pain under the shoulder and oppressive pain behind the sternum with heart disease

Other signs of pathology:

burning, oppressive pain behind the breast bones;
heart rhythm disturbance;
heartbeats;
dyspnea;
dizziness;
nausea, vomiting;
increased blood pressure.

Diseases of the digestive system

The mechanism of onset of pain is similar to the previous reason - it spreads 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 below the shoulder, development is possible:

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

Moreover, with such pathologies, there is nausea, vomiting, heartburn, numbness, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, there is pale skin, decreased blood pressure, weakness, darkening of the stools.

Feeling of discomfort under the right shoulder may indicate such diseases:

duodenal ulcer;
hepatitis;
liver cirrhosis;
cholelithiasis.

Other causes of the symptom

The following factors may also provoke pain in the shoulder blade area:

Unsuitable 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 are stuck.
Vegetative-vascular dystonia. It is accompanied by drop in blood pressure, shortness of breath, impaired cardiac activity and sometimes back pain in the area of the shoulder blades.
Poliomyelitis. An infectious disease in which the pain in the shoulder blades is neurogenic.
Pleurit. With inflammation of the pleura, the symptoms occur due to the rubbing of its leaves against each other. The peak of pain occurs with a deep breath.
Kidney pathology. It is characterized by excruciating, stabbing pain under the right shoulder. Moreover, there is a change in the color of the urine, the discharge of urine.
Dehja. 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. Accompanied by chills, muscle aches, fever.
Subphrenic abscess. Pain under the shoulder blades is noticed when you inhale, arises from the accumulation of pus in the upper abdominal cavity.
Mental disorders. Sometimes mental disorders are associated with disorders in the spine, but the mechanism of its development has not yet been studied.

Types of pain

The nature of the pain in the shoulder girdle area may vary. Depending on this criterion, it is possible to assume a possible illness and determine the cause of the concern:

Shooting, sharp, that arises when the body turns or moves. Typical of embedded nerves. This feature 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 pain, dull with varying intensity. May indicate neuralgia, joint inflammation.
Beating, pain 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 may become more pronounced.
Choking pain at the level of the shoulder blades or below. Typical of a spinal hernia. 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 schedule an appointment with a neurologist. The doctor will perform an examination, make a diagnosis, and determine treatment tactics. In case of detection of pathologies of internal organs, he will be referred to a specialist of narrow profile - a gastroenterologist, cardiologist, orthopedist (depending on the alleged diagnosis).

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

Clinical studies of blood, urine. They show inflammatory changes, help diagnose somatic diseases.
X-ray examination, CT. They allow you to discover the curvature of the spine, their injuries and consequences, osteochondrosis.
Ultrasound. Used to identify pathologies of internal organs.
ECGInformative in case of suspected heart disease.
MRI. Reflects the condition of the spine, shoulder girdle, internal organs. The area of investigation is determined by the doctor depending on the proposed diagnosis.

Note!Pain under 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 characteristics

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

Medical treatment. To relieve pain, medications from a number of analgesics and anti-inflammatory medications are used. Depending on the cause of the symptom, antibacterial agents, diuretics, gastro-protectors, etc. may be used.
Physiotherapy. Helps to accelerate healing from somatic pathologies, to strengthen the spine. To eliminate pain in the shoulder girdle area, electrophoresis, UHT and heating procedures are used.
Massage. Helps to remove muscle spasms, improve posture, relieve painful sensations. It is prescribed for back problems. Sometimes the intervention of an osteopath or chiropractor is required.
Gymnastics. Appears during the recovery period. A set of exercises is selected for each patient separately, depending on the diagnosis made.

How to prevent discomfort in the shoulder blade area?

Each patient who has undergone a course of treatment is then recommended to follow a number of preventative measures. They are needed to prevent recurrence of the disease.
Importers it is important to follow these rules:

create favorable sleeping conditions - choose an orthopedic pillow and a mattress with moderate stability to support the physiological position of the back;
look at your attitude;
follow the principles of proper nutrition;
try to prevent the worsening of chronic pathologies;
give up addictions (smoking, drinking alcohol);
Visit your doctor regularly for preventative examinations.

Shoulder pain can be caused by somatic and neurological causes. In the latter case, the symptoms arise sharply and is pronounced. With a somatic origin, the pain gradually increases 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 the sensations 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 therapeutic course after a thorough examination.