Painful sensations under the shoulder blade - this symptom can be encountered by adults suffering from diseases of the musculoskeletal system or pathology of the internal organs, and children who simply did not calculate physical activity or remained in a bad copy.
Self-administration of painkillers when subscapular pain occurs is totally unacceptable - such pain sensations can be a sign of life-threatening conditions.
At the same time, attention and, often, emergency medical care, deserve not only acute pain, but also dull pain under the left shoulder blade.
The nature of the pain and associated symptoms help suggest a particular disease. However, only a qualified doctor, based on the patient's complaints, will be able to understand the damage to which organ caused the pain, prescribe the necessary diagnostic examination and, if necessary, provide emergency care.
Causes of pain under the left shoulder blade in the back from the back
The proximity of the lungs, heart and spine, as well as a large network of nerve fibers, expands the list of possible causes of subscapular pain. In this case, each disease is characterized by other specific signs, and the nature and duration of pain sensations also change.
Pathology of the musculoskeletal system and nerves
Diseases of the spine and back muscle structure are a common cause of left subscapular pain. Pain in such diseases is often one-sided.
- Osteochondrosis: The formation of osteophytes in the thoracic or cervical spine causes a pulling pain to the left or right, starting in the neck and upper back, and ending with irradiation in the arm. The pain does not go away at rest, often prolonged but bearable.
- Intercostal neuralgia - accompanied by intense pain spreading throughout the intercostal space and aggravated by breathing, turning around, sneezing / coughing. Often, with neuralgia, the sensitivity of the skin to the source of pain also changes. Neuralgia causes paresthesias in the form of goosebumps, while numb pain under the left shoulder blade often occurs with myocardial infarction, angina pectoris.
- Scapular Rib Syndrome - is a "reward" for hard physical work or activities associated with a long stay in one position (office workers). People complain of non-intense dull pain localized between the neck and shoulder, which radiates under the shoulder blade.
Important! The causes of pain under the left shoulder blade from the back from the back, radiating into the arm and pressing in nature - osteochondrosis and angina pectoris - have a distinctive feature. With angina pectoris, the pain lasts up to 30 minutes, with osteochondrosis - several days. Also, an attack of angina pectoris is stopped by nitroglycerin or other heart medications.
Sometimes subscapular pains are provoked by myositis (at the same time stiffness of movements and tension of some muscle groups are observed), scapula injuries (acute pain, always preceded by a fall, blow, etc. ) or oncology (pain may occur periodically, not intense). Tuberculosis of the bones, that is, the defeat of the scapula, cannot be excluded.
Diseases of the heart and blood vessels
Heart disease is one of the most dangerous, which can be diagnosed when a patient complains of subscapular pain. In this case, the pain in heart disease does not always begin on the front surface of the chest (behind or to the left of it). The cause of pain under the left shoulder blade in the heart area can be:
- Angina pectoris: Pressure pain behind the breastbone extends under the left shoulder blade and collarbone, into the jaw and arm. The intensity of the pain is reduced at rest, but the change in body position does not bring relief. With scapular-costal (vertebrogenic) syndrome, the situation with increased pain is radically opposite. The attack of angina pectoris is leveled by the intake of nitroglycerin, with vertebral pain, excellent manual therapy.
- Myocardial infarction is a sharp and increasing pain in the heart with a characteristic irradiation to the left (also under the scapula) not stopped by cardiac glycosides. The patient experiences severe fear, which is not the case with damage to the spine and nerve fibers. Immediate hospitalization required!
- Hypertensive crisis - often accompanied by pressing heart pain radiating to the left shoulder blade. The cause of the pain is easily determined by measuring a / d.
- Pericarditis: With this disease, the pain subsides at rest and when the trunk is tilted forward. Pain arises in the area of the heart in front, radiates under the scapula, but not as intense as in acute myocardial ischemia (angina pectoris, heart attack).
- The detached 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! Both for ischemic heart disease (angina pectoris, heart attack) and for cervical osteochondrosis, numbness of the tongue on the left is characteristic.
Important! Often, a symptomatic picture similar to cardiac pathology is given by vegetative-vascular dystonia. At the same time, the demonstration of his serious condition is clearly fake (psychogenic factor), the patient is often nervous, shivering, has a fever and a feeling of lump in the throat.
Respiratory diseases
Pain under the shoulder blade on the left can cause the following lung diseases:
- Pneumonia - gives pain only when the inflammatory focus is located near the pleural membrane. Painful sensations of low intensity arise periodically, have a punctual localization and intensify with breathing.
- Pleurisy: Unlike pneumonia, the pain is sharp, stabbing. Its intensity depends on the depth of breathing.
Concomitant pulmonary symptoms accompanying pain when inhaling under the left shoulder blade are shallow, rapid breathing, shortness of breath, fever. Hyperthermia can also occur with pericarditis. It is extremely rare that a slight increase in temperature occurs with severe neuralgia, myositis.
Important! Unlike heart disease, with pathology of the respiratory tract, pain is accompanied by night sweats and cough (in the initial stage of pneumonia, and with pleurisy - dry).
Pathology of the gastrointestinal tract
Pain under the shoulder blade often accompanies gastrointestinal diseases. In this case, the symptomatic picture is as follows:
- Peptic ulcer - severe cutting pain is always associated with food intake (occurs before or immediately after eating), radiates to the scapula with non-specific localization of the ulcerative process (the posterior wall of the stomach or its heart part) . The pain subsides after vomiting, taking acid-lowering drugs. Perforation of the ulcer is accompanied by increased pain (like cutting with a knife), the patient presses his legs to the stomach and covers them with his hands.
- Pancreatitis - accompanied by severe pain of a girdle nature (including under the left shoulder blade). An attack is always associated with food errors (fatty, salty, fried foods, alcohol, hunger). Vomiting brings no relief.
Important! Pathology of the gastrointestinal tract, which caused pain under the shoulder blade on the left side, is accompanied by other characteristic symptoms: bloating, indigestion, vomiting, belching.
Diagnosis of subscapular pain
When collecting anamnesis, the doctor pays attention to the relationship of pain with physical activity, food intake, stress, and also specifies chronic and recent concomitant diseases.
Assessment of the nature of pain, the presence of some specific symptoms of diseases of different organs allows you to narrow the range of causes to a specific system of the body: heart, lungs, musculoskeletal system, gastrointestinal tract. The preliminary diagnosis is confirmed by the following studies:
- heart - measurement of a / d, ECG, echocardiography and Doppler scan;
- lungs - chest x-ray;
- spine - X-rays of the cervical and thoracic regions, CT or MRI.
In the future, a more detailed examination of the damaged organ may be required. Only then is the treatment of the identified disease prescribed.
When and which doctor should I contact?
Depending on the degree of intensity and the nature of the painful sensations under the shoulder blade, the accompanying symptoms, you should consult a doctor:
- urgent call for emergency care - acute pain with increasing intensity and a rapid deterioration of the general condition;
- traumatologist - getting an injury that resulted in the pain syndrome;
- cardiologist - with concomitant (constant or periodic) chest pain, shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the left shoulder blade, aggravated by lifting the arm, there is a clear connection between the onset of pain and physical activity, previously diagnosed degenerative pathology of the spine;
- gastroenterologist - there is a connection between pain and food intake, there are other signs of gastrointestinal diseases (nausea, vomiting, etc. );
- pulmonologist - pain under the shoulder blade is accompanied by cough, shortness of breath;
- therapist: pain occurs without a clear, permanent or temporary cause.
It is the therapist who often diagnoses both a trivial DIV and is confirmed by an acute surgical pathology or an oncological process. In the future, the doctor appoints a consultation with a narrow-profile specialist.
Pre-treatment regimes
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 pain syndrome:
- For neurological pain, strong pain relievers are often used;
- Pathology of the spine and muscles requires a course of non-steroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires taking nitroglycerin (it does not help with a heart attack), Validol has only a reflex effect and in no way improves the condition of the heart muscle in ischemic disease;
- If you suspect a gastrointestinal disease, it is advisable to take antispasmodics, drugs that lower acidity (with an ulcer).
Only by eliminating the causative disease, the patient gets rid of pain under the shoulder blade. In acute conditions, urgent hospitalization and intensive treatment are sometimes required.
The radicality of the treatment depends on the nature of the disease and the duration of its course, therefore it is necessary to consult a doctor at the first painful symptoms. Not only does the outcome of the disease depend on it, but the chances of a full recovery increase.
In severe cases, prompt medical assistance saves the patient's life.