Pain in the shoulder blades and below: discomfort may indicate

Pain in the shoulder blades and below can occur with nerve damage, diseases of the spine, shoulder ligaments, or somatic diseases. Etiology can be determined by clinical signs, presenting conditions for the syndrome, and medical history data.

Pain may be felt in the scab area when inhaled, felt in half of the body and or all over the arm. In some cases, such symptoms are the "first bell" of an exacerbation, which can be prevented after a trigger has been established.

Cause and localization

Pain below the shoulder blades often occurs with movement - before turning with difficulty, standing for a long time with the back arched. It signals a local failure that occurs for various reasons.

Unilateral pathologies, in which pain is only on the right or left side below the shoulder blade, are minimal - often the severity of symptoms is isolated. This is due to the symmetrical arrangement of nerve roots extending from the spinal cord.

Hurt

If the pain is below the right and left shoulder blades, this may be the result of bone and muscle damage. Symptoms do not have strict localization, severity depends on the traumatic factor. The clinic is often acute, with sudden onset and transition to the chronic phase.

Causes of pain due to trauma under the left or right shoulder blade are as follows:

1. Bruises - in such cases, the pain is superficial, often the muscles are damaged. Often the back muscles below the shoulder blades become painful, swollen, and develop local inflammation. After 2-3 weeks, the symptoms should disappear.
2. Fractures and fractures are more serious injuries, with pain concentrated in the shoulder blade area itself. With slight movement, it becomes stronger, the patient cannot move his arm or bend over.
3. Degeneration and displacement of the vertebrae - this leads to joint pain at the level of the shoulder blades and below, sometimes bony structures pressing on the nerve roots.

Trauma is characterized by severe pain below the right or left shoulder blade, which occurs spontaneously. During movement, there may be a crunch and swelling is often present.

Bone tumor

If the disease affects the thoracic spine, the patient may experience back pain near the shoulder blades and below. It is caused by a pinched nerve or spinal cord due to a deformed disc. Pathology develops gradually, and as the distance between the vertebrae decreases, the pathology clinic worsens.

The location of the pain depends on the area affected:

1. If osteonecrosis destroys the articular discs of the chest area 2 to 6, you will feel pain in the shoulder blades. It usually radiates to the neck and arms. When the vessels are compressed, dizziness occurs, there may be an increase in intracranial pressure.
2. When joints 6-12 segments are affected, the pain radiates below the left or right shoulder blade, radiating downward, down the half of the body and lower back, respectively.

The spinal roots of the thoracic region give rise to plexuses inside the arms and trunk. Therefore, when they are squeezed, pain spreads along their path.

With osteonecrosis, the discomfort is unilateral - pain in the right or left shoulder blade and below, depending on the deviation of the spine.

Scoliosis

This is a phenomenon in which the spine is curved in a horizontal direction due to overactivity of the muscles that support the posture. Leads to the roots and spinal cord being compressed, pain appears under the right or left shoulder blade. The disease is often accompanied by:

1. Respiratory failure - the spine deviates to one side, deforming the ribcage, affecting the functioning of the lungs, one of which is compressed, while the second takes over the lost function.
2. Violation of the work of the heart - the frequency of contractions and pulse changes, shortness of breath and pale skin appear.
3. The visible deformity of the ribcage is the main cause of pain under the right or left shoulder blade. The vertebrae, along with the ribs, are displaced to the side, so that on one side of the curvature, bony structures are displaced downwards and injuring the spinal cord and its branches.

If the spinal cord is compressed during scoliosis, the back often hurts between the shoulder blades and below, the center of gravity is severely restricted. If muscle spasms are involved, symptoms will spread to nearby structures.

kyphosis

It is characterized by a backward arching of the spine, forward displacement of the shoulders, and a gradual appearance of stooping. Pain above the shoulder blades - usually bilateral, in the arms and neck. The following mechanisms are involved in its formation:

1. Neurological causes - due to curvature, the distance between the vertebral bodies in the anterior parts is reduced, which causes compression of the branches of the spinal cord. Pain in the right and left shoulder blades, can radiate down the collarbone, neck and shoulder.
2. Muscles - misalignment of the spine leads to overactivity of the neck muscles, which can cause painful spasms in the shoulder blades and below.

As a result of kyphosis, the vertebral artery is compressed, cerebral circulation is disturbed. The work of internal organs gradually deteriorates.

Spondylolisthesis disease

If the right or left shoulder blade is painful, one of the reasons could be spondylolisthesis - damage to the facet joints and discs. Accompanied by loss of mobility, stiffness, most pronounced in the morning.

The clinical picture changes as the disease progresses: >

1. Destruction of cartilage - with a lack of blood circulation, the integrity of the connective tissue is violated, the articular disc becomes fragile, suffers more damage and recovers more slowly. At this stage, exertion leads to injury, pain appears and radiates down the shoulder blade and below.
2. Deformation of the articular disc - the appearance of pads that interfere with mobility. This stimulates new destruction, causing the regeneration processes to be slowed down, the patient feels pain in the back and shoulder blades.
3. The appearance of bony growth is characteristic of the advanced stage of the disease. Fibroids damage joints, muscles, blood vessels, and nerves.

With spondylolisthesis, the back can be painful between the shoulder blades or below – a bout that often precedes physical activity. At rest, symptoms subside because the bone growth does not damage surrounding tissues.

Protrusion and hernia

In these conditions, acute pain under the left and right shoulder blades, arising from compression of the spinal cord or its roots, is worrisome. As a result of compression, sensitivity along the nerve fibers is disturbed.

Localize symptoms as follows:

1. Pain in the shoulder blades or more - protrusion or hernia in the cervical region or when 1-3 thoracic segments are affected. Symptoms increase when you try to tilt your head, turn to the side.
2. Pain in the intervertebral region - in this case, the midsections may be affected, 3 to 6. Discomfort increases when bringing both hands to the side, taking a deep breath or turning.
3. Severe pain under the right and left shoulder blades - the discs of the joints 6 to 12 are affected, the lower back can be associated with pathology. In this case, there is a risk of developing a hernia because this part of the spine is more loaded than the previous parts.

Unlike spondylolisthesis, pain from hernia and protrusion does not go away for a long time with rest. The reason is that the nerve is constantly compressed, the muscle spasm becomes worse.

Tooth decay

This is the compression of the lumbar roots, which is focused on a strong sciatic nerve. If its upper part is affected, the patient feels pain below the collarbone and below, bilateral pain, aggravated by bending and sudden movements.

As the disease progresses, other symptoms may appear: >

1. There is back pain that radiates to the lower extremities - an electric shock sensation along the path of the nerve.
2. Burning pain in the back, lumbar region or below the shoulder blades indicates prolonged compression of the spinal roots in the lumbar region.
3. Cramps and loss of sensation usually occur in the lower back, buttocks, sometimes there is numbness along the nerve fibers in the thighs, legs and feet.

Periarthritis of shoulder-fish scale

This condition is understood as a condition in which the shoulder joint and surrounding tissues become inflamed, appear stiff, only disappear after warming up.

The pain is concentrated in the right or left shoulder blade area and down depending on the development of motor skills of the hemisphere (right or left hand). First, it appears after exercise, and then at rest. Along the way, other symptoms emerge:

• headache;
• hand numbness;
• violation of the mobility of the spine.

With periarthritis, the clinical manifestations are increased when the arm is raised - pain in the right or left shoulder blade, shoulder blade. Gradually, the range of motion decreases, progressive stiffness.

Nerve pain

The next cause of pain under your right or left shoulder blade is an inflammation of the nerve in this area. Illness due to hypothermia, wind and cold. Most commonly affected:

1. The supraclavicular and supraclavicular nerves - pain is felt in the right or left shoulder blade from behind, concentrated mainly in the clavicle. Sometimes discomfort spreads to the shoulder, which indicates a defeat of the skin branches of this area.
2. Subchondral and subchondral nerves - in this case, it's painful on the right or left side below the shoulder blade, depending on the side of the lesion. If the muscles of the same name are involved, clinical manifestations are aggravated when the arm is brought down, abducted behind the back.
3. Intercostal nerves - usually 1-4 pairs. These branches pass along the lower border of the ribs, pain occurs not only in the shoulder blades downward but also on the sides of the ribcage, sometimes in the anterior segments.

Atypical symmetric neuralgia - if the left half of the body is exposed to drafts, pain will be noted in the neck, chest and shoulder blades from this side.

Heart disease

Branches from the parasympathetic trunk, which are connected to the spinal cord and its roots, go to the heart. That is why heart diseases can cause pain in the shoulder blades and below. Usually a mild form of myocardial infarction will be latent. It may be accompanied by the following symptoms:

1. A dull ache or burning pain behind the breastbone or below the left shoulder blade - can last for hours, increases with walking, but disappears a bit with rest.
2. Shortness of breath - accompanied by pain, which may manifest itself within a few days.
3. Tachycardia - increased heart rate, sometimes arrhythmias occur.
4. Other symptoms are increased pressure, dizziness, nausea, and vomiting.

Digestive tract problems

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

Pain under the left shoulder blade from the back from the back appears with the following diseases:

• pancreatitis;
• gastritis;
• stomach ulcers.

Often, with these diseases, patients complain of digestive disorders, nausea and vomiting. If internal bleeding, pale skin, dark stools, decreased pressure, and weakness are noted.

Pain below the right shoulder blade from the back with:

• gallstones;
• Hepatitis;
• cirrhosis;
• duodenal ulcer lesions.

Other reasons

In addition to these factors, pain below the shoulder blades can cause:

1. The mattress is uncomfortable - if it's broken and you sleep on your right side, in the morning you may feel pain under your left shoulder blade from behind from behind, due to the curved spine pressing on the spinal roots.
2. Pleurisy - pain in the squamous area that occurs when breathing due to the friction of the plates against each other, reaching a peak when taking a deep breath.
3. Pulpitis - a disease accompanied by neurological symptoms, back pain often appears.
4. Intoxication - severe poisoning or a cold can be manifested by muscle pain, chills and fever.
5. VVD - vegetative dystonia is accompanied by changes in pressure, interruption of cardiac activity and shortness of breath, and sometimes discomfort in the back.
6. Kidney disease - these are characterized by aching or sharp pain below the right shoulder blade, changes in diuresis and urine color, and general symptoms.
7. Diaphragm Abscess - If pressure is felt in the upper abdominal cavity, when inhaling, you will feel pain below the shoulder blades, fever and symptoms of intoxication.
8. Psychiatric disorders - in some cases, pain in the shoulder blades and below can be the result of such disorders. The exact mechanism of occurrence has not yet been studied.

The nature of pain

Soreness in the shoulder blade area and below can be different, in essence, it is possible to presuppose a specific group of pathologies, sometimes a provoking factor can be established:

1. For the pinched nerve, characteristic of low back pain - sharp pain occurs when turning, raising the arm. This is the main difference from cholelithiasis, in which the symptoms do not curl up with movement.
2. Aching, throbbing or burning pain indicates a pathology of internal organs. The second option occurs with compression of the roots of the spinal cord, but it increases with movement and may convert to sutures.
3. Severe cramping pain in the shoulder blade area and below is characteristic of a hernia. Sometimes preceded by low back pain, numbness in the limbs.
4. Cutting pain of varying intensity is characteristic of neuralgia, often associated with arthritis.

Which doctor treats shoulder pain?

If you feel pain in your collarbone and below, you need to make an appointment with a neurologist. If there is no pinched nerve, the specialist will refer you to an orthopedist, cardiologist, gastroenterologist, or urologist, depending on the suspected pathology.

Diagnose

To determine the cause of discomfort in the scapula and below, a laboratory and instrumental examination is performed:

1. X-ray or CT scan - using these methods you can detect osteonecrosis, curvature of the spine and the consequences of trauma.
2. MRI >- The spine, shoulder joints or internal organs are examined, depending on the suspected pathology.
3. Electrocardiogram - helps to identify heart diseases.
4. Blood and urine tests provide information for a number of somatic, inflammatory, and joint diseases.
5. Ultrasound - is prescribed for somatic diseases, if it is not possible to undergo MRI.

Usually, the pain below the shoulder blade is nerve-related. Therefore, CT and MRI are considered the "gold standard" in the diagnostic protocol.

General principles of treatment

The main task is to eliminate the symptoms and provoking factors. First, the patient's health is stabilized, then the underlying pathology is treated.

The treatment program includes:

1. Medications - Pain relievers are often prescribed to reduce pain and inflammation. Then the fund is prescribed depending on the pre-existing pathology - antibiotics, gastroprotectors, diuretics.
2. Physiotherapy - strengthens the spine, treats somatic diseases. Drug electrophoresis used in shoulder blade area, warming procedure, SWT.
3. Massage - warm-up is carried out accompanied by damage to the spine. From such procedures, the muscles above and below the shoulder blades are relaxed, posture is improved. In this case, you need the professional help of a chiropractor or osteopathic physician.
4. Gymnastics - performed after pain is eliminated, a program is compiled, depending on the disease that a physiotherapist, a rehabilitation specialist performs.

Prevent

After successful treatment, the patient should follow a preventive program that will prevent the recurrence of the pathology:

• watch your posture;
• choose a mattress of moderate firmness and an orthopedic pillow;
• twice a week massage the shoulder blades and below;
• follow a low-calorie diet for obesity;
• give up bad habits;
• carry out the prophylaxis of somatic pathology (if it is present in the history of pathology);
• see a doctor every six months.

Pain in the shoulder blades and below may be of a neurological or neurological nature. When nerves are damaged, symptoms are acute and sudden, appearing spontaneously.

Visceral and joint diseases are characterized by gradual and prolonged pain, which 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.