Pain under left shoulder blade

Basically, pain under the scapula on the left behind from the back is more often characteristic of people of the older age category, but often a similar disease manifests itself at a younger age. Incorrect posture, hereditary factors or sports injuries may be the causes of the condition in question. The main causes of pain under the left shoulder blade from behind from the back should be considered in more detail. After all, this discomfort can be regarded as a good reason to visit a specialist.

Pain under the left shoulder blade, not being the only specific symptom in the clinical sense, is one of the symptoms that can indicate various diseases. Timely and accurate assessment of the nature of pain, its localization helps the doctor choose the right direction for diagnostic examinations and provide assistance, often urgent in cases of cardiac or gastrointestinal pathologies.

Causes of pain under the left shoulder blade

A generalized list of causes of pain under the left shoulder blade is as follows:

• Diseases of the musculoskeletal system:
  • Osteochondrosis of the thoracic or cervical spine.
  • Traumatic injury to the scapula (compression injury to the suprascapular nerve).
  • Intercostal neuralgia.
  • Rib fracture.
  • Sprengel's disease (scapula alata) - pterygoid scapula.
  • myofascial syndrome.
• Diseases of the broncho-pulmonary system:
  • Left sided pneumonia.
  • Pleurisy (dry, left-sided).
  • Tracheobronchitis with autonomic dysfunction.
  • Acute bronchitis.
  • Abscess of the left lung.
• Cardiac diseases:
  • IHD - ischemic heart disease.
  • Myocardial infarction.
  • Pericarditis.
  • Angina pectoris (unstable, stable).
  • Mitral valve prolapse.
  • Rarely - aortic aneurysm.
• Diseases of the gastrointestinal tract:
  • YABZH (Ulcus gastrica) - peptic ulcer of the stomach.
  • Ulcus duodeni - duodenal ulcer.
  • Spasm of the esophagus.
  • GERD is gas esophageal reflux disease.
  • Rarely - exacerbation of pancreatitis.
• A psychogenic factor that provokes VSD is vegetative-vascular dystonia with reflected pain in the left side of the back.

Typical causes of pain under the left shoulder blade in terms of prevalence are as follows:

• Cervical osteochondrosis, which manifests itself most often as one-sided pain at the bottom of the os occipitale - the occipital bone. The pain is aching in nature, intensifies with active movements of the head and constantly radiates under the shoulder blade, into the arm. Also, osteochondrosis of the cervical spine is accompanied by dizziness, numbness, paresthesia in the upper limbs.
• Intercostal neuralgia, which develops as a result of osteochondrosis or for other reasons. Neuralgia is manifested by lumbago, severe girdle pains radiating to the right or left, often under the shoulder blade.

GU (gastric ulcer). The symptom is most often due to seasonality, depends on the nutritional factor and is characterized by paroxysmal, radiating pain, which in clinical practice is classified as follows:

• Hungry pain symptom that develops after a long period after eating (6-8 hours).
• An early pain symptom that develops immediately after eating can be reflected in the back, under the shoulder blade and subsides after the contents of the stomach are evacuated.
• Late pain symptom that occurs 2-3 hours after eating.
• Nocturnal symptom, which is characterized by pain radiating under the shoulder blade.

Pain in YABZH can subside after vomiting or taking medications.

Symptoms of pain under the left shoulder blade

Signs, symptoms of pain in the lower region of the scapula are due to such pathogenetic mechanisms:

1. Girdle pains with localization in one side. This symptom is permanent, less often - paroxysmal, the pain may increase with deep breathing, shortness of breath, coughing, and movement. The symptom is due to the spread of pain impulse along the location of the intercostal muscle spaces, aponeurosis.
2. Burning pains with paresthesias, caused by the transmission of an impulse along the location of the nerve trunk, nerve branches. Pain is reflected in the region of the heart, in the back, in the lower back or under the shoulder blade.
3. Increasing pain radiating under the scapula, into the arm, associated with hypertonicity of the muscles of the shoulder, scapula, back.

The pain symptom under the left shoulder blade can feel like it can vary from aching, tolerable to sharp, burning, cutting. There are certain typical complaints of pain under the left shoulder blade from patients:

• Acute pain in the left back under the scapula, the pain sensation intensifies when turning, moving and subsides at rest.
• Cutting sensation on the left, passing into the area between the shoulder blades.
• Dull, aching pain below the shoulder blade on the left, felt when the arm(s) is lifted up. Pain is associated with a certain position of the body.
• Pulling sensation of pain, the symptom extends below the left shoulder blade to the lower back. The pain is permanent, not relieved by cardiological drugs.

Symptoms, manifestations of pain under the scapula on the left can be combined according to etiological signs as follows:

Cardiac diseases: IHD, myocardial infarction, angina pectoris	The pain begins in the retrosternal region (less often in the middle of the back) and is reflected to the left side - arm, jaw, under the shoulder blade, back. The pain is spreading in nature, causes a feeling of squeezing, burning
Aneurysma dissecans - aortic aneurysm	The pain symptom is characterized as constant, growing, accompanied by sharp, shooting sensations to the left in the back, under the shoulder blade. Pain develops very quickly and is a life-threatening symptom
Pericarditis - pericarditis	Reflected to the left side of the pain subsides at rest, in a sitting position, when bending forward
Pleuritis - pleurisy	A sharp, stabbing pain symptom, the intensity of which depends on the depth of breathing. The pain can be felt as a tingling under the shoulder blade, with a deep breath - as a cutting, strong, penetrating
Left sided pneumonia	The pain is not intense, aching, transient, may increase with movement, deep breathing, the pain is reflected under the scapula as a localized "point"
Cervical osteochondrosis	Aching, pulling pain, which increases in static or after physical exertion, the pain symptom may be reflected to the left, including under the shoulder blade. Pain, unlike cardialgia, is not stopped by cardiac drugs.
Ulcerative processes in the gastrointestinal tract	The pain is intense, often intolerable. With perforation in the cardiac zone of the stomach, the pain is reflected to the left in the upper back. The pain symptom at the initial stage of the process subsides after vomiting

Pain on the left under the shoulder blade

Pain on the left in the lower region of the scapula may be associated with such diseases:

• Ulcerative process in the gastrointestinal tract. As a rule, the pain symptom increases - with a chronic disease gradually, with an exacerbation or perforation - rapidly. The pain girdle, shooting, reflected can subside after the food is evacuated into the intestines or with the help of vomiting.
• Neurogenic pain, VVD (vegetative-vascular dystonia). The pain symptom is felt as squeezing, pressing, spreading to the left, often under the shoulder blade. VVD is also characterized by impaired respiratory functions, increased sweating, hand tremors, a feeling of spasm, a coma in the throat, a feeling of fear, panic.
• Pain on the left under the scapula may be associated with developing myocardial infarction, which is often felt as another attack of coronary artery disease, angina pectoris. A pain symptom, as a rule, begins to develop in the retrosternal zone, less often from the back, radiates to the left side, "spills" and causes a burning sensation.
• Cervical osteochondrosis, less often osteochondrosis of the thoracic region. This disease is accompanied by a characteristic aching, but tolerable pain symptom, which can intensify with increasing load, including static.

It should be noted that for an accurate clinical picture, it is very important to describe the sensations, the nature of the pain symptoms, which can be as follows:

Pain radiates under the left shoulder blade

The description of such a symptom is a typical characteristic of radiating pain, the pathological source of which can be located quite far from the place of pain. Pain gives under the left shoulder blade most often with diseases of the stomach and heart. The cardial zone of the stomach, undergoing an inflammatory or erosive process, often manifests itself as pain reflected to the left. For an experienced doctor, it is not difficult to accurately determine the primary source of pain according to the diagnostic scheme of Zakharyin-Gedd or Gaava-Luvsan. These methods are designed to differentiate the clinical signs of referred pain according to the specific transmission of impulses along the autonomic pathway of the nervous system to symptomatic areas.

Burning under the shoulder blade

This is a signal of developed intercostal neuralgia, a protracted deforming process in the spine. However, the sensation of burning pain is most characteristic for an attack of angina pectoris and a more serious, life-threatening condition - myocardial infarction.

Constant pain under the left shoulder blade

Constant pain under the left shoulder blade, caused by pneumonia, may subside in a horizontal position, when the body is turned to the healthy side.

Pain under the left shoulder blade and cough indicate a possible left-sided inflammation of the lung, which is also manifested by the following symptoms:

• Dry, rarely wet cough. The most specific symptom, in addition to pain under the left shoulder blade, is the presence of pus or blood in the sputum. Even a single discharge of this kind should be the reason for an immediate examination and start of treatment.
• Subfebrile body temperature, which rarely rises. Hyperthermia is characteristic of the stage of exacerbation of pneumonia.
• Pain radiating to the affected lung. The pain symptom intensifies with a deep breath, frequent breathing, exertion, coughing. The lung tissue is not equipped with pain receptors, they are only in the pleura, so any painful pulmonary symptom can be considered a sign of pleurisy. It is necessary to differentiate such symptoms with a possible deforming process in the cervical spine.
• Feeling short of breath, shortness of breath, shallow, rapid breathing.

Stitching pain under left shoulder blade

Pain under the left shoulder blade from behind is a pain symptom localized in the back. In clinical practice, such manifestations are called scapular-costal thoracalgia, or vertebrogenic pain. It is possible to differentiate pain under the left shoulder blade from behind from cardiac conditions in this way:

Symptom	Ischemic heart disease (cardialgia)	Vertebrogenic pain
Description of pain	Pressing, compressing, most often in the retrosternal zone, with reflection to the left. Accompanied by fear	Stitching, pressing, burning without anxiety, tachycardia
Frequency of pain	Short-term, paroxysmal (several minutes, rarely up to half an hour)	Rarely - short-term, more often one that lasts several hours, possibly days
Change in body position	Does not affect the nature of the pain	Influences, may increase or minimize the pain symptom
Influence of physical activity	Affects, at rest the pain can subside	Pain can persist at rest, and subside after physical exertion, as there is a change in static muscle tension.
The influence of drugs	Pain is relieved with cardiac drugs	Pain is relieved by antispasmodics and analgesics. Nitrates (cardiac drugs) do not affect the nature of the pain
Impact of manual therapy	Virtually no effect	Significant relief due to the release of compressed nerve roots

Pressing pain under left shoulder blade

This is a sign of developing osteochondrosis, a possible onset of an attack of coronary artery disease, as well as evidence of an exacerbation of vegetative-vascular dystonia. Pressing pain under the left shoulder blade, which is felt as bursting, burning, requires immediate medical attention and relief of the attack, as it is most likely associated with angina pectoris or a pre-infarction condition. Pressing pain under the left shoulder blade may also indicate a vegetative-vascular crisis, which is very similar in symptoms to cardiac pain, but is not stopped by heart drugs, but is amenable to sedatives or tranquilizers. Also, VSD is characterized by the absence of a causal relationship between pain and physical activity, load, while coronary artery disease can be aggravated by overstrain, intensive work.

Throbbing pain under left shoulder blade

This is most likely a manifestation of left-sided protrusion of the intervertebral disc of the cervical or sternal spine. In addition to the fact that a herniated disc manifests itself as a throbbing pain under the left shoulder blade, it is accompanied by headache, unstable blood pressure, dizziness, paresthesia of the left hand. It can also hurt the left shoulder, the entire left half of the back to the lower back. Protrusions are detected using MRI, radiography. Pulsation below the scapula may be a symptom of an incipient aortic dissection. Aortic aneurysm is a life-threatening condition, its rupture requires almost instant medical care, which is not always possible, so any reflected, throbbing pain in the back, in the area of the shoulder blades should be the reason for a comprehensive examination and neutralization of the root cause of the symptom.

Sudden pain under left shoulder blade

May be related to compression, . suprascapular nerve injury. Such an injury is manifested by a sharp sudden pain at the bottom of the scapula, the pain symptom can spread along the shoulder and reduce the motor functions of the arm. Also, sudden pain under the left shoulder blade indicates radiculopathy, in which the nerve roots are infringed upon left-sided displacement of the intervertebral discs of the cervical, less often the thoracic spine. This is a secondary sign, which is a consequence of chronic pressure on the nerve endings by osteophytes, herniated articular tissue. A long degenerative process, as a rule, is accompanied by aching constant pain, however, a sudden exacerbation can be caused by protrusion of an intervertebral hernia or severe swelling in the displacement zone. Very rarely, sudden pain in the left shoulder blade may be a symptom of a collapsed left lung (pneumothorax). Such cases in clinical practice are not common, however, sudden, sharp pain with shortness of breath and dizziness is a reason to call emergency care.

Sharp pain under left shoulder blade

It can signal an attack of angina pectoris, which "starts" from the retrosternal zone and manifests itself in spilling pains reflected to the left side. Pain in angina pectoris is characterized as sharp, squeezing, squeezing, the symptom may subside at rest and after taking certain drugs - validol, nitroglycerin, and other drugs that activate the coronary blood supply. In addition, acute pain under the left shoulder blade can be caused by left-sided protrusion of the intervertebral disc, the symptom is aggravated by movement, changing body position, that is, by changing the position of the spine or ribs.

Aching pain under left shoulder blade

The aching nature of pain indicates a chronic, protracted process that provokes a symptom. Most often, aching pains are associated with osteochondrosis of the cervical spine, as well as with chronic heart diseases - myocarditis, pericarditis. Aching pain under the left shoulder blade with inflammation of the heart muscle (myocarditis) is unstable, it can be triggered by overstrain, fatigue, stress and is accompanied by shortness of breath, pallor of the skin, general poor condition, nausea.

Dull pain under left shoulder blade

Most often associated with developing cervical or thoracic osteochondrosis. The onset of the disease is characterized by implicit, weak pains radiating towards the infringement of the roots. Pulling, periodically subsiding sensations in the initial period do not really disturb a person, since they are quite tolerable, moreover, pains can disappear after warming up, massage, bathing in a warm bath.

Severe pain under left shoulder blade

This is a reason to immediately consult a doctor, since an intense pain signal is not typical for the scapular zone, therefore, it is associated with a serious, possibly threatening condition. At best, severe pain under the left shoulder blade can signal intercostal neuralgia, but a more alarming cause may be a stomach ulcer or a pre-infarction condition, a heart attack. In a situation where the symptom is associated with PUD (gastric ulcer), a person experiences such severe pain that he cannot move, pressing his arms or legs to the diseased area.

Sharp pain under left shoulder blade

It may be a sign of intercostal neuralgia, in which case the neuropathy is aggravated by palpation of the pain zone, with a deep breath, when there is a feeling that the breath is "catching". Irritation of nerve endings, roots can be permanent, but most often episodic sharp pains are typical for neuralgia, the intensity of which subsides at rest or after warming up, relaxing the pain zone. Also, a sharp pain under the left shoulder blade is characteristic of left-sided pneumonia in the acute period, when the patient feels stabbing, cutting symptoms in all the left half of the chest, reflected under the shoulder blade. Pneumonia in the acute stage is accompanied by a cough, which exacerbates pain, and pus or blood may also be released in the sputum. Much less often in the left side of the back, in the region of the scapula, pain is reflected during exacerbation of pancreatitis, which is characterized by encircling, cramping pains.

Drawing pain under left shoulder blade

Most often associated with the conduction of pain impulses along the intercostal nerves and is caused by cervical osteochondrosis in the initial stage of development. Constant compression of the nerve roots provokes tolerable, aching, pulling pain below the occipital bone, which can be reflected in the left or right zone of the back, arms.

Diagnosis of pain under the left shoulder blade

Differentiation of symptoms in left-sided thoracalgia is extremely difficult, since pain is not specific and can be a sign of many diseases and conditions, including those requiring emergency medical care. Diagnosis of pain under the left shoulder blade requires complex measures, multiple examinations, but its main task is to exclude threatening conditions, such as gastric ulcer (gastric ulcer), angina attack, pre-infarction condition and heart attack, rupture of a dissected aorta. To accurately determine the cause of the symptom, the diagnosis of pain under the left shoulder blade should include the following actions:

• Interrogation and collection of anamnesis, including hereditary and professional. The patient finds out how the pain symptom is associated with food intake, with physical, static, emotional stress, where the pain radiates, how it is felt.
• Direct visual inspection, listening and palpation. Also mandatory is the measurement of pulse, blood pressure, possibly body temperature.
• X-ray examinations are prescribed, often in several projections, to clarify the nature of possible pathologies of the spinal column or the broncho-pulmonary system.
• An electrocardiogram is mandatory, which shows the parameters of the heart.
• Perhaps the appointment of CT, MRI. Computed tomography is a method that helps to specify the disease, which is not determined by X-ray.
• If you suspect gastritis, gastroesophageal reflux, GU, it is possible to prescribe fibrogastroduodenoscopy - FEGDS.
• CBC - complete blood count and urinalysis, possibly a biochemical analysis of blood serum, are standard diagnostic methods for almost any disease.

Treatment of pain under the left shoulder blade

Therapeutic appointments for left-sided thoracalgia, pain at the bottom of the scapula directly depend on the results of the diagnosis. The primary treatment of pain under the left shoulder blade can only be associated with the relief of an acute life-threatening condition. If a person suffers from chronic coronary artery disease, then taking heart medications will help relieve the first painful sensations. If the pain does not subside within 5-10 minutes, an ambulance should be called. Acute pain caused by stomach ulcers, osteochondrosis or hernia (protrusion) is best relieved with the help of a doctor, and not on your own, so the treatment of left-sided pain is the implementation of medical recommendations, and not the advice of relatives, neighbors or acquaintances. Self-medication often leads to sad consequences, especially when it comes to heart pathologies.

Most often, a pain sign in the back, shoulder blades is a reflective, projection pain, the source of which is in another zone. Therefore, after the removal of acute pain, all diagnostic measures should be carried out in full. Thus, the treatment of pain at the bottom of the left shoulder blade is the treatment of the underlying disease, which provokes a pain symptom. Therapeutic appointments for pain in the back, in the area of the shoulder blades can be done by such doctors:

• Traumatologist.
• Vertebrologist.
• Neurologist.
• Gastroenterologist.
• Cardiologist.
• Therapist.
• Psychotherapist, psychiatrist.

Treatment of pain in the region of the left or right shoulder blade should begin with a visit to the local doctor, where an initial examination will be performed and the direction of further actions will be chosen. Further, all stages of treatment will be appointed by a narrow specialist after receiving the results of a comprehensive examination.

How to prevent pain under the left shoulder blade?

In order to prevent a pain symptom, it is necessary to find out its root cause, then the prevention of pain under the left shoulder blade will be really effective.

If a person suffers from angina pectoris, coronary artery disease, or has already suffered a myocardial infarction, the best prevention of pain under the left shoulder blade is the constant use of cardiological drugs, gentle physical activity, diet and psycho-emotional balance.

If the pain is caused by a deforming, progressive process in the spine, then pain prevention should consist of a long period during which special therapeutic exercises are performed, non-steroidal anti-inflammatory drugs are taken.

Pain at the bottom of the shoulder blade, provoked by gastrointestinal diseases, is prevented with a sparing diet and taking antacids, prescribed drugs. In addition, YABZH is very dependent on the psycho-emotional state, so a positive attitude, mastery of relaxation techniques, anti-stress techniques will help to prevent pain under the left shoulder blade.

Preventive measures in the prevention of pain symptoms and the development of the disease, in principle, are, first of all, regular dispensary examinations. Even if there are no disturbing signs, pains, it is worth consulting a doctor, undergoing a preventive examination to make sure that neither pains nor diseases threaten you in the near future.