Painful sensations under the shoulder blade - this symptom can be encountered by adults who suffer from diseases of the musculoskeletal system or pathology of internal organs, and children who simply did not calculate physical activity or were standing on the draft.
Self-administration of painkillers when subscapular pain occurs is absolutely unacceptable: such feelings of pain can be a sign of a life-threatening condition.
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 the accompanying symptoms help to suggest a particular disease. However, only a qualified doctor, based on the patient's complaints, will be able to understand which organ damage 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
The proximity of the lungs, heart, and spine, as well as the extensive network of nerve fibers, expand the list of possible causes of subscapularis pain. In this case, each disease is characterized by other specific signs, and the nature and duration of feelings of pain change.
Pathology of the musculoskeletal system and nerves
Diseases of the spine and muscular frame of the back are a common cause of subscapular pain on the left side. The pain of such diseases is often one-sided.
- Osteochondrosis - the formation of osteophytes in the thoracic or cervical spine causes traction on the left or right side, starting from the neck and upper back, and ending with radiation in the arm. The pain does not disappear at rest, it is often prolonged, but bearable.
- Intercostal neuralgia - accompanied by intense pain that spreads to the intercostal space and worsens by breathing, turning, sneezing / coughing. The sensitivity of the skin to the source of pain often changes with neuralgia. Neuralgia provokes paresthesias in the form of goose bumps, while numbness under the left shoulder blade often occurs in 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 shoulders, which radiates under the shoulder blade.
Bitan! The causes of pain under the left shoulder blade, which radiate to the arm and are depressive in nature - osteochondrosis and angina pectoris - have a characteristic feature. In angina pectoris the pain lasts up to 30 minutes, in osteochondrosis - several days. In addition, the attack of angina pectoris is stopped by nitroglycerin or other heart medications.
Sometimes subscapularis pain is caused by myositis (stiffness of movement and tension of certain muscle groups are observed at the same time), shoulder injuries (acute pain, always preceded by a fall, blow, etc. ) or oncology (pain may occur periodically, not intensely). Bone tuberculosis, or scapular defeat, cannot be ruled out.
Diseases of the heart and blood vessels
Cardiac pathology 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 start 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 area of the heart can be:
- Angina pectoris - pressing pain behind the sternum extends below the left shoulder blade and collarbone, into the jaw and arm. The intensity of the pain decreases at rest, but changing the position of the body does not bring relief. In scapular-costal (vertebrogenic) syndrome, the situation with increased pain is radically opposite. An attack of angina pectoris is eliminated by consuming nitroglycerin, with pain in the spine, manual therapy is excellent.
- Myocardial infarction is an acute, growing pain in the heart with characteristic radiation to the left (including below the scapula) that is not stopped by cardiac glycosides. The patient experiences strong fear, which is not the case with damage to the spine and nerve fibers. Urgent hospitalization required!
- Hypertensive crisis - often accompanied by pain in the heart radiating to the left shoulder blade. The cause of pain is easily determined by measuring a / d.
- Pericarditis - in this disease the pain subsides at rest and when the torso is bent forward. The pain occurs in the anterior part of the heart, radiates under the shoulder blade, but not as intense as in acute myocardial ischemia (angina pectoris, heart attack).
- Separation, aortic aneurysm is a dangerous condition characterized by pulsating pain under the shoulder blade. A sudden increase in pain requires an urgent call from the medical team.
Bitan! Both ischemic heart disease (angina pectoris, heart attack) and cervical osteochondrosis are characterized by numbness of the tongue on the left side.
Bitan! Vegetative-vascular dystonia often gives a symptomatic picture similar to cardiac pathology. At the same time, the demonstration of his serious condition (psychogenic factor) is clearly fake, the patient is often nervous, trembling, has a fever and a lump in his throat.
Respiratory tract diseases
Pain under the shoulder blade on the left side can cause the following lung diseases:
- Pneumonia - gives pain only when the focus of inflammation is near the pleural membrane. Painful feelings of low intensity occur periodically, have a localization point and intensify with breathing.
- Pleuritis - unlike pneumonia, the pain is sharp, a sting. Its intensity depends on the depth of breathing.
Accompanying pulmonary symptoms that accompany pain when inhaling under the left shoulder blade are shallow, rapid breathing, shortness of breath, fever. Hyperthermia may also occur in pericarditis. A mild increase in temperature is extremely rare in severe neuralgia, myositis.
Bitan! Unlike heart disease, with pathology of the respiratory tract, the pain is accompanied by night sweats and cough (in the initial phase of pneumonia and with pleurisy - dry).
Gastrointestinal tract pathology
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 meals), radiates to the scapula with nonspecific localization of the ulcerative process (posterior wall of the stomach or its heart part). The pain decreases after vomiting, taking acid-lowering medications. The perforation of the ulcer is accompanied by increased pain (like cutting with a knife), the patient presses his legs on his stomach and covers them with his hands.
- Pancreatitis - accompanied by severe pain of a lumbar nature (including under the left shoulder blade). Attack is always associated with dietary errors (fatty, salty, fried foods, alcohol, starvation). Vomiting does not bring relief.
Bitan! The 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 the anamnesis, the doctor pays attention to the relationship between pain and physical activity, food intake, stress, and states the accompanying chronic and recent illnesses.
Assessing the nature of pain, the presence of certain symptoms specific to diseases of various organs allows you to narrow the range of causes to a particular body system - heart, lungs, musculoskeletal system, gastrointestinal tract. Preliminary diagnosis is confirmed by the following studies:
- heart - a / d measurement, ECG, echocardiography and Doppler scan;
- lungs - chest X-ray;
- spine - X-ray of the cervical and thoracic region, CT or MRI.
A more detailed examination of the damaged organ may be needed in the future. Only then is the treatment of the established disease prescribed.
When and which doctor should I go to?
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 an ambulance - sharp pain of increasing intensity and rapid deterioration of the general condition;
- traumatologist - getting an injury that caused a pain syndrome;
- cardiologist - with accompanying chest pain (constant or periodic), shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the left shoulder blade, intensified by raising the arm, there is a clear link between the occurrence of pain and physical activity, previously diagnosed degenerative pathology of the spine;
- gastroenterologist - there is a link between pain and food intake, there are other signs of gastrointestinal diseases (nausea, vomiting, etc. );
- pulmonologist - pain under the shoulder blade accompanied by cough, shortness of breath;
- therapist - pain occurs without a clear cause, permanent or temporary.
It is the therapist who often diagnoses trivial VSD and finds confirmation of acute surgical pathology or oncological process. In the future, the doctor will appoint a consultation with a specialist of a narrow profile.
Preliminary treatment regimens
Depending on the diagnosis, the doctor chooses an effective treatment for the causative disease. An important point in complex therapy is the elimination of pain syndrome:
- Strong painkillers are most commonly used for neurological pain;
- Spinal and muscle pathology requires a course of nonsteroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires taking nitroglycerin (does not help with heart attack), validol acts only reflexively and in no way improves the condition of the heart muscle in ischemic disease;
- If you suspect gastrointestinal disease, it is recommended to take antispasmodics, acid-lowering drugs (for ulcers).
Only by eliminating the cause of the disease, the patient is relieved of pain under the shoulder blade. In acute conditions, urgent hospitalization and intensive treatment are sometimes required.
The radical nature of the treatment depends on the nature of the disease and the duration of its course, so at the first painful symptoms you should consult a doctor. Not only the outcome of the disease depends on it, but the chances of complete recovery increase.
In severe cases, timely medical care saves the patient's life.