Pain in the chest region at the level of the shoulder blades can indicate back problems, pain in the internal organs and a reflection of heart discomfort. To determine the cause, you need to clearly explain the complaints to the doctor and undergo an examination. Depending on the diagnosis, treatment is prescribed. You should also consider in detail ways to treat back pain under the shoulder blades.
chest anatomy
The scapular area belongs to the thoracic spine and is located at chest level. It is necessary to study the anatomy of this area in order to understand which organs can disturb the patient directly and indirectly.
The main anatomical elements include:
- The spine - consists of the spinal cord and vertebrae, intervertebral discs. It is an important part of the entire musculoskeletal system, protects the spinal cord from damage.
- The right and left shoulder blades belong to the bony structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bony structure has many pits and depressions. These are the places of attachment of ligaments, tendons and muscles. The blades have a high resistance, 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 the digestive organs.
- Ribs - perform a protective function of the chest. They 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 the collarbone. This is a paired bone of a triangular shape, to which the rhomboid and partially trapezius muscles are attached. These muscle groups make the upper shoulder girdle mobile. The shoulder blades are connected with the ribs to form a strong framework of the torso. 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 painful sensations is divided into several classifications:
- Pain and its character depending on the localization of unpleasant sensations - in the middle of the shoulder blades, on the left or on the right, whether there is radiation to the chest or between the ribs, the pain is felt higher or lower.
- By the nature of sensations - unpleasant sensations, feelings of tightness, sharp pain, moaning, radiation, pulsation.
- The duration of pain is episodic attacks, it is felt constantly, increases sharply, unpleasant sensations arise after physical activity.
Most often, pulling pains indicate spinal problems and rarely signal other related issues.
Main reasons
Symptoms of pain under the shoulder blades are due to such disorders:
- stomach pain (gastric ulcer, gastritis);
- digestive disorders (heartburn, esophageal reflux);
- disturbances in the work of the cardiovascular system (myocardial infarction, pericarditis);
- lung problems (bronchitis, pneumonia);
- degenerative disorders of the ridge, spine;
- trauma, inflammation, sprain, myositis;
- neurological disorders.
In 90% of cases, as statistics indicate, discomfort in the shoulder blades is caused by back pain. The human spine is responsible for upright walking, therefore it carries a significant load. A careful attitude towards one's own 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 strain. 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:
- Wound. It is characterized by superficial pain. Most often, superficial soft tissues, the upper muscle layer and subcutaneous fat suffer from bruising. Unpleasant sensations occur under the shoulder blades, and below, swelling and a locally localized inflammatory process appear. Usually, no specific treatment is needed. This pain goes away on its own within a few weeks.
- Fracture or crack - the pain is sharp and has no reflection and is concentrated at the site of injury. Even the slightest movement of the hand causes excruciating sensations. In such a situation, the patient is shown complete rest, so as not to aggravate the situation with a fracture.
- Dislocations, displacement of the vertebrae. In this case, the pain will be localized not only in the shoulder blade region, but also in the back in the chest 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 the movement, a crunch is felt, swelling of the tissue at the site of the bruise is observed.
Osteochondrosis
The classic manifestation of osteochondrosis of the thoracic region is interscapular pain at the level of the ridge. Unpleasant sensations arise due to pinched nerve endings. With a lesion of the chest region in the upper part of the patient, he feels a sharp pain in the shoulder, which radiates to the arm. The side depends on the specific nerve root injury. When squeezing blood vessels, there is an increase in pressure, headaches and dizziness.
If the lower part of the chest region is affected, the patient experiences unpleasant sensations in the lower back from the shoulder blade. Also gives to 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 period of rest. Difficult situation - the discomfort is felt around the clock, even at night. Often, against the background of osteochondrosis, protrusions 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 from the first years of school - children do not control the correct posture and do not understand why adults require them to sit evenly. Over time, abnormal movement patterns develop. A person sits in a position that is comfortable for him, but this position causes a static overload of the muscles and the development of an imbalance. If the spine remains in an analgesic position for a long time, a curvature occurs, which is fraught with consequences.
In adulthood, many people suffer from 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 chest region, the pain is localized in the region of the shoulder blades. Sometimes there is radiating discomfort in the cervical region. A characteristic difference in scoliosis is that one shoulder is higher than the other when standing and relaxed.
During the 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 relieve the painful condition, you need to establish a lifestyle, stop being nervous and start moving. Under stress, muscle tone may increase, which will lead to a deterioration in well-being. Massage helps a lot, it is also useful to carry out exercise therapy for the back.
Hernias and protrusions
The occurrence 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 hernia is protrusion. With protrusion, the disc is partially damaged and the annulus fibrosis is stretched. Hernias occur during intense physical exertion, due to carrying heavy loads. An important role in their appearance is played by the hereditary factor. If the family has close relatives with hernias or protrusions, then most likely they will occur with age in children.
If a hernia or protrusion is located in the chest region, then pain occurs in the region of the shoulder blades. There is also radiating pain to the arm or shoulder. The side depends on the specific pinched nerve roots. Painful shooting is explained by the defeat of nerve endings, which are pinched due to excessive compression in the back.
When the lower back is affected, back pain is transmitted 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 tension. With hernias and protrusions, it is useful to carry out exercise therapy, attend physiotherapy 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 bent to the right or to the left, then with kyphosis there is a pronounced curvature of the upper shoulder girdle. One of the characteristic signs of the disease is a feeling 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 gives to the arms, neck. There are two main mechanisms for the formation of pathology:
- Neurogenic. When curvature occurs, degenerative processes occur in the spine, which cause pinching of the nerve roots of the spinal cord. There are aching pains in the region of the right and left scapula, which are transmitted to the neck, collarbone or arm, less often to the shoulder joint.
- Muscle. Being constantly in a concave state causes muscle imbalance and overexertion. In the upper back, the muscles are tight, which causes their hypertonicity and severe pain. The rest of the back muscles also suffer. Hypotension may occur in the lumbar region.
As a result, the vertebral artery is compressed, which causes a persistent violation of cerebral circulation. Gradually there is a deterioration in well-being, there are malfunctions in the work of internal organs. With such a patient, it is necessary to perform complex work, including the services of a rehabilitator, exercise therapy.
Spondylarthrosis
Sometimes the development of spondylarthrosis indicates pain on the right or left in the region of the shoulder blades. The disease is characterized by damage to the 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 area, the integrity of the connective tissue is destroyed, which has the effect of thinning the articular disc. Restorative processes in bones and connective tissues deteriorate significantly. Increased physical activity in this area leads to microtrauma.
- Other distorting changes occur. Seals appear in the disc, mobility worsens, which leads to increased destruction of cartilage tissue. The patient may constantly feel pain, even in a state of calm.
- 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 necessary.
A characteristic manifestation of spondylarthrosis in the initial stage is the appearance of pain only during physical exertion. Discomfort at rest subsides, because there is no traumatic factor.
Intercostal neuralgia
This condition refers to disorders of the vagus nerve. When pathology occurs, sharp pain appears, penetrating into the scapula, ribs and chest. This type of pain is often mistaken for a heart attack. A characteristic difference is the absence of a clear localization in the region of the heart. Unpleasant feelings intensify on inspiration. The pain is accompanied by a feeling of constriction. If the patient thinks he has angina, then after taking nitroglycerin there is no relief.
Pain under the right or left shoulder blade indicates innervation in specific areas. Numbness and spasms are not typical of this pathological process. Given the specificity of the symptoms of the disease, the specialist will make a diagnosis without any problems. Treatment consists of the use of injectable B vitamins and myotropic drugs (muscle relaxants). Treatment of intercostal neuralgia should be done by a neurologist.
Causes of pain under the left shoulder blade from behind from behind - heart disorders
Often, back pain indicates a heart condition. Why back pain is a referred pain phenomenon that indicates coronary heart disease, myocardial infarction or pericarditis. If there is a shooting pain of a sudden nature, which increases with physical exertion, but there are no symptoms of spinal disease, you should urgently consult a cardiologist for consultation. 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 from behind from behind:
- Myocardial infarction. In addition to radiation, the patient feels aching 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 breaks off and blocks vascular flow around the heart, a heart attack will occur. In this state, it is necessary to act quickly, otherwise the patient will die. The root cause of the pathology that has arisen is atherosclerosis, clumping of erythrocytes, platelets with increased coagulation.
- Ischemic heart disease or angina pectoris. According to information from a medical article, an attack of coronary heart disease suddenly develops. There is a dull pain, which is paroxysmal in nature. The attack is easily stopped by taking nitroglycerin. The disease requires additional medical supervision, as it can occur at the most unexpected time. If the attack lasts more than a few hours and the medicine does not help, you need to call an ambulance. In addition to heart discomfort, the patient's breathing becomes reality, shortness of breath occurs, which is aggravated by physical exertion.
- Pain under the left shoulder blade from the back of the back may 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 testing for inflammatory markers, including rheumatic testing. Pericarditis is often a complication of a previous infectious disease, including respiratory diseases of the upper and lower respiratory tract. Long-term complex therapy is carried out.
diseases of the respiratory system
In the presence of prolonged respiratory diseases, the patient may possibly feel radiating pain in 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, the irritation of the larynx increases and a wet cough appears. If the disease developed against the background of SARS, then there is an increase in body temperature. The disease does not require specific treatment, it is enough to observe bed rest, drink more warm liquids. Rarely, antipyretics and antibiotics may be needed.
- Pleurisy. If the patient complains of severe chest pain with possible radiation, cough, shortness of breath and fever, the specialist should exclude or confirm this disease. Pleurisy is characterized by inflammation of the pleural leaflets, followed by the accumulation of liquid sputum in the pleural cavity. The disease is hard to bear. Comprehensive treatment with antibiotics and anti-TB drugs is required.
- Pneumonia. 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 high 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 shoulder blades have a character of reflected pain. What problems can arise:
- Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, the patient feels unpleasant discomfort in the lower chest region (the bottom of the shoulder blades on both sides). It may feel like muscle pain. With an attack of pain in the stomach, 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 radiates to the scapular region. The cause of the pathology is the return of stomach contents into the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour belching, a feeling of a lump in the throat. In rare cases, vomiting occurs. To prevent an attack, you should limit the consumption of fried, spicy and fatty foods. In the symptomatic treatment, acid-reducing antacids based on magnesium and aluminum hydroxide are used.
Editorial notice
Unpleasant sensations in the scapular area are most often associated with an exacerbation of diseases of the musculoskeletal system. Less often, heart disorders, neurological problems, 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.