Pain in the shoulder and lower blades: what discomfort may be indicated

Pain in the shoulder and lower blades can occur with nerve damage, spinal disease, shoulder girdle, or somatic pathology. The cause can be determined by clinical signs, conditions for manifestations of the syndrome, and anamnestic data.

Pain in the scapular area can be felt while inhaling, felt on half of the body and or on the whole arm. In certain cases, such symptoms are the "first bell" of the exacerbation period, which can be prevented after the provoking factors have been established.

Causes and localization

Pain under the shoulder blades usually appears during movement - it is preceded by an awkward round, long standing with a bent back. It signifies local damage that appears for a variety of reasons.

Pathology with unilateral lesions, where it is only painful on the right or left side below the scapula, is slight - usually the severity of symptoms is individual. This is due to the symmetrical arrangement of nerve roots extending from the spinal cord.

injuries

If there is pain under the right and left shoulder blades, this may be due to damage to the bones and skeletal muscles. Symptoms do not have strict localization, severity depends on traumatic factors. The clinic is usually acute, starts abruptly and gets a chronic course.

The causes of traumatic pain under the left or right shoulder blade are as follows:

1. Bruising - in such cases, the pain is superficial, often muscle damage. Usually the back muscles below the shoulder blades and lower back pain, swelling and local inflammation develop. After 2-3 weeks, the symptoms disappear.
2. Fractures and fractures are more serious injuries, the pain being concentrated in the scapula itself. At slight movements, it becomes stronger, the patient cannot move his arms or bend.
3. Subluxation and displacement of the vertebrae - this leads to joint pain at the level of the shoulder blades and down, sometimes the bone structure compresses the nerve roots.

The injury is characterized by severe pain under the right or left shoulder blade, which appears spontaneously. During movement, irritation may occur, and swelling often appears.

Osteochondrosis

If the disease affects the thoracic spine, the patient experiences back pain near the shoulder blades and lower back. This is due to pinching of the nerve or spinal cord due to deformation of the articular disc. The pathology develops gradually, and as the distance between the vertebrae decreases, the clinical pathology worsens.

Localization of pain depends on the affected area:

1. If osteochondrosis destroys the articular discs of the thoracic region from 2 to 6, pain is felt in the scapula. It usually radiates to the neck and arms. When vessels are squeezed, dizziness appears, intracranial pressure may increase.
2. When the 6-12 segment joints are affected, the pain radiates under the left or right shoulder blade, spreading downwards, to the corresponding half of the body and the lower back.

The spinal roots in the thoracic region give rise to plexuses that invade the arms and body. Therefore, when they are squeezed, the pain spreads throughout their journey.

With osteochondrosis, the discomfort is one -sided - it is painful in the shoulder blades on the right or left and below, depending on the inclination of the spine.

Scoliosis

This is the curvature of the spinal space in the transverse direction due to overstrain of the muscles that support the posture. This leads to pinching of the roots and spinal cord, the appearance of pain under the shoulder blades on the right or left side. Pathology is usually accompanied by:

1. Respiratory failure - unilateral skew of the spine changes the shape of the chest, which affects lung function, one of which is compressed, and the second takes over the lost function.
2. Violation of the work of the heart - the frequency of contractions and changes in the pulse, shortness of breath and pale skin appear.
3. The appearance of visible chest deformities is a major cause of pain under the right or left shoulder blade. The vertebrae, together with the ribs, are displaced laterally, as a result of which, on the side of curvature, the bone structure is shifted downward and damages the spinal cord with its branches.

If the spinal cord is compressed during scoliosis, the back is usually sore between the shoulder blades and lower back, focus is limited. If muscle spasms merge, symptoms spread to neighboring structures.

Kyphosis

It is characterized by flexion of the back of the spine, forward displacement of the shoulder girdle, and a gradual bending appears. There is pain in the shoulder blades - usually bilateral, giving to the arms and neck. The following mechanisms are involved in its formation:

1. Neurogenic - due to curvature, the distance between the vertebral bodies in the anterior part decreases, this gives rise to pinching of the spinal cord branches. There is excruciating pain in the right and left shoulder blades, which can radiate to the collarbone, neck and shoulders.
2. Muscles - deflection of the spinal column leads to muscle tension of the collar zone, which can cause painful spasms in the shoulder area and below.

As a result of kyphosis, the vertebral arteries are compressed, cerebral circulation is disrupted. The work of internal organs gradually worsens.

Spondylarthrosis

If the right or left shoulder blade hurts, one of the reasons may be spondylarthrosis - damage to the facet joints and intervertebral discs. It is accompanied by loss of mobility, stiffness appears, most noticeable in the morning.

The clinical picture changes as the pathology develops: >

1. Cartilage destruction - with a lack of blood circulation, the integrity of connective tissue is violated, the articular disc becomes brittle, more damaged and recovers more slowly. At this stage, vigorous physical effort leads to microtrauma, pain occurs, which radiates to the shoulder blade area and down.
2. Deformation of the articular disc - a sealant appears that impedes movement. This provokes new destruction, which slows down the regeneration process, the patient feels pain in the back and shoulder blades.
3. The appearance of bone growth is characteristic of the advanced stages of the disease. Neoplasms injure joints, muscles, blood vessels and nerves.

With spondylarthrosis, the back may ache between the shoulder blades or below - the attack is usually preceded by physical activity. During rest, symptoms subside, as bone growth does not injure the surrounding tissue.

Protrusion and hernia

In this condition, acute pain under the left and right shoulder blades, which appears as a result of compression of the spinal cord or its roots, is alarming. As a result of pinching, the sensitivity along the nerve fibers is disturbed.

The localization of symptoms is as follows:

1. Pain in the shoulder blades and above - protrusion or hernia in the cervicothoracic area or when 1-3 segments of the thorax are affected. The symptoms get stronger when you try to tilt your head, turn it to the side.
2. Pain in the interscapular area-in this case, the middle part may be affected, from 3 to 6. Discomfort increases when both hands are moved to the side, inhaled deeply or twisted.
3. Severe pain under the right and left shoulder blades - articular discs from 6 to 12 are affected, the lower back may be involved in the pathology. In this case, there is a risk of developing a hernia, because this part of the spine is loaded more than the previous one.

Unlike spondylarthrosis, hernia and protrusion pain do not disappear for a long time during rest. This is due to constant compression of the nerve, which is exacerbated by muscle spasm.

Radiculitis

This is a pinch of the lumbar root, which is collected in a strong sciatic nerve. If the upper part is affected, the patient feels pain below the scapula and below, it is bilateral, exacerbated by sudden flexion and movement.

As the disease progresses, additional symptoms may appear: >

1. There is back pain that spreads to the lower limbs - a sharp stab pain is felt as an electric shock along the nerve travel.
2. Burning pain in the back, in the lumbar region or under the shoulder blades indicates prolonged pinching of the spinal roots in the lumbar region.
3. Cramps and loss of sensation usually occur in the lumbar region, buttocks, sometimes there is numbness along the nerve fibers in the thighs, lower legs and feet.

Periarthrosis of the shoulder-scapula

This condition is understood as inflammation of the shoulder joints and surrounding tissues, stiffness occurs, which disappears only after warming up.

Pain is concentrated in the right or left and lower scapular area, depending on the development of hemispheric motor skills (right or left hand). First, it appears after exercise, and then rest. Along the way, additional symptoms appear:

• Headache;
• numb hands;
• violation of spinal column mobility.

With humeroscapular periarthrosis, the clinical manifestations increase when the arm is lifted - it is painful in the area of the right or left shoulder, the shoulder blade. Gradually, the range of motion decreases, stiffness develops.

Neuralgia

The next cause of pain under the right or left shoulder blade is inflammation of the nerves in this area. The disease is caused by hypothermia, drafts. Often affected:

1. Suprascapular and supraspinous nerves - there is pain in the right or left shoulder blade from behind, concentrated mainly in the clavicle. Sometimes the discomfort spreads to the shoulders, which indicates the defeat of the skin branches of this area.
2. The subscapular and infraspinatus nerves - in this case, it is painful on the right or left side under the scapula, depending on the side of the lesion. If a muscle of the same name is involved, the clinical manifestations worsen when the arm moves downward, abducted behind the back.
3. Intercostal nerve - usually 1-4 pairs. These branches run along the lower edge of the ribs, the pain occurs not only in the area of the shoulder blades and below, but also on the side of the chest, sometimes in the anterior part.

Symmetry is not typical for neuralgia - if the left half of the body is exposed to drafts, then pain is observed in the neck, chest and shoulder blades from this side.

Heart disease

Branches from the parasympathetic trunk, which connect to the spinal cord and its roots, go to the heart. That is why heart disease can trigger pain in the scapula and below. Usually mild forms of myocardial infarction are latent. It may be accompanied by the following symptoms:

1. A dull pressing or burning pain is felt in the back of the sternum or under the left shoulder blade - can last for hours, increases when walking, but disappears slightly during rest.
2. Shortness of breath - accompanies pain, can manifest within a few days.
3. Tachycardia - an increase in heart rate, sometimes rhythm disturbances occur.
4. Other symptoms are increased pressure, dizziness, nausea and vomiting.

Problems with the gastrointestinal tract

Similar to the previous mechanism, pain spreads along nerve fibers. Clinical signs can be bilateral, but in most cases there is a specific pattern in which symptoms appear according to the location of internal organs.

Pain below the left shoulder blade from behind from behind occurs with the following diseases:

• pancreatitis;
• gastric;
• stomach ulcer.

Usually, with this disease, patients complain of dyspeptic disorders, nausea and vomiting. If internal bleeding occurs, pale skin, dark color of stool, decrease in pressure and weakness are observed.

Pain under the right shoulder blade from behind from behind accompanies:

• cholellitis;
• hepatitis;
• liver cirrhosis;
• ulcerative lesions of the duodenum.

Another reason

In addition to these factors, pain under the shoulder blades can trigger:

1. Uncomfortable mattress - if it fails and you sleep on your right side, in the morning you may feel pain under the left shoulder blade from behind from behind, as the curved spine pinches the root of the spine.
2. Pleurisy - pain in the scapular area occurs when breathing due to friction of the sheets against each other, reaching a peak on the deep breath.
3. Poliomyelitis - a pathology accompanied by neurological symptoms, back pain often appears.
4. Intoxication - severe poisoning or the common cold can be manifested by muscle aches, chills, and fever.
5. VVD - vegetovascular dystonia is accompanied by changes in pressure, disturbances in the work of the heart and shortness of breath, and sometimes discomfort in the back.
6. Kidney disease - such pathology is characterized by painful or stabbing pain under the right shoulder blade, discoloration of diuresis and urine, and general symptoms.
7. Subdiaaphragmatic abscess - if pus is observed in the upper level of the abdominal cavity, when inhaled, pain under the shoulder blades, fever and symptoms of intoxication will be felt.
8. Mental disorders - in some cases, pain in the shoulder blades and down may be caused by the disorder. The exact mechanism of occurrence has not been studied.

The nature of pain

Pain in the shoulder blade area and below can be different, by its nature it is possible to assume a specific group of pathologies, sometimes the provoking factors can be established:

1. For pinched nerves, lumbago is characteristic - a sharp stabbing pain that appears with a sharp round of the body, lifting the arms. This is the main difference from cholelithiasis, in which symptoms do not roll away from movement.
2. Pain, throbbing or burning pain indicates pathology of internal organs. The latter option occurs when squeezing the root of the spinal cord, but it increases with movement and can turn into a suture.
3. Severe narrowing pain in the shoulder and lower blade area is characteristic of a hernia. Sometimes it is preceded by lumbago, numbness of the limbs.
4. Cutting pain with varying intensity is characteristic of neuralgia, drilling often accompanies inflammation of the joints.

Which doctor treats shoulder pain?

If you are experiencing pain in the scapula and below, you will need to make an appointment with a neurologist. If there are no pinched nerves, the specialist will direct you to a consultation with an orthopedist, cardiologist, gastroenterologist or urologist, depending on the suspected disease.

Diagnostics

To identify the cause of discomfort in the scapular area and below, laboratory and instrumental examinations are performed:

1. X -ray or CT - using this method, you can detect osteochondrosis, curvature of the spine and the consequences of injury.
2. MRI >- spinal columns, shoulder joints or internal organs are examined, depending on the suspected pathology.
3. ECG - helps identify heart disease.
4. Blood and urine tests are informative for several somatic pathologies, inflammation of muscles and joints.
5. Ultrasound - prescribed for somatic diseases, if it is impossible to undergo an MRI.

Usually, pain under the shoulder blades occurs due to neurology. Therefore, CT and MRI are considered the "gold standards" in diagnostic protocols.

General principles of treatment

The main task is to eliminate the symptoms and provoking factors. First, the patient’s well -being is stabilized, then the underlying pathology is treated.

Therapy programs include:

1. Medications - Analgesics are usually prescribed to relieve pain and inflammation. Then funds are set depending on the underlying disease - antibiotics, gastroprotectors, diuretics.
2. Physiotherapy - strengthens the spine, treats somatic diseases. Drug electrophoresis was used in the shoulder blade area, warm -up procedure, SWT.
3. Massage - warming is done with damage to the spine. From such a procedure, the muscles above and below the shoulder blades relax, posture improves. In this case, you need professional help from a chiropractor or osteopath.
4. Gymnastics - is carried out after the elimination of pain, the program is arranged, depending on the disease suffered by a physiotherapist, a rehabilitation specialist.

Prevention

After successful treatment, patients are advised to follow a preventive program that will prevent recurrence of the pathology:

• pay attention to your posture;
• choose mattresses with moderate hardness and orthopedic pillows;
• twice a week, massage in the shoulder area and lower back;
• follow a low -calorie diet for obesity;
• get rid of bad habits;
• carry out prophylaxis of somatic pathology (if present in the anamnesis);
• visit a doctor every six months.

Pain in the shoulder blades and down can be neurological or somatic in nature. When nerves are damaged, the symptoms are acute and sudden, appearing spontaneously.

Pathology of internal organs and joints is characterized by gradual and prolonged pain, the clinic is always accompanied by additional symptoms. In the early stages, analgesics are prescribed, after diagnosis, the program is supplemented with etiological therapy and strengthening procedures.