Pain in the chest region at shoulder level may indicate back problems, pain in the internal organs, and a reflection of cardiac distress. To find out the cause, you need to clearly explain the complaints to the doctor and undergo an examination. Depending on the diagnosis, therapy is prescribed. You should also consider in detail the ways to treat back pain under the shoulder blades.
Anatomy of the chest
The scapular area belongs to the thoracic spine and is located at chest level. It is necessary to study the anatomy of this area to understand which organs may concern the patient directly and indirectly.
Key anatomical elements include:
- 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 scapula belong to the bony structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bone structure has many pits and depressions. These are the places where ligaments, tendons and muscles connect. The blades have high strength, so they can easily withstand constant static loads.
- The clavicle is the bone that connects the shoulder blade to the chest.
- Heart - responsible for the functioning 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 - offer a protective function of the chest. These 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 clavicle. It 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 tied together with the ribs to form a strong torso frame. Any discomfort in this area can lead to considerable discomfort and limited movement of the upper back. For this reason the pain can not be tolerated and you should immediately consult a doctor.
The variety of pain sensations is divided into several classifications:
- Pain and its character according to the localization of unpleasant sensations - between the shoulders, left or right, if there is radiation in the chest or between the ribs, the pain is felt higher or lower.
- By the nature of sensations - unpleasant, attractive sensations, acute pain, groans, radiation, pulse.
- The duration of pain is episodic attacks, it is felt constantly, increases significantly, unpleasant sensations occur after physical activity.
Most often, traction pains indicate spinal problems and rarely signal other related problems.
The main reasons
Symptoms of pain below the shoulder blades occur due to such disorders:
- stomach pain (gastric ulcer, gastritis);
- digestive disorders (heartburn, esophageal reflux);
- disorders of the cardiovascular system (myocardial infarction, pericarditis);
- lung problems (bronchitis, pneumonia);
- degenerative disorders of the crest, spine;
- trauma, inflammation, spasm, myositis;
- neurological disorders.
In 90% of cases, as statistics show, the discomfort in the shoulder blades is caused by back pain. The human spine is responsible for walking straight, so it carries a considerable load. Taking care of one's health helps to improve well-being when physical inactivity and poor posture cause discomfort. The situation worsens with age.
INJURY
If the patient has a bruise or sprain, pain below 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, pain appears on the left or right side of the shoulder blade. The most common types of injury are bone or muscle corsets.
Other types of traumatic injuries:
- Injury. Characterized by superficial pain. Most often, superficial soft tissues, upper muscle layer and subcutaneous fat suffer from bruising. Unpleasant sensations occur under the shoulder blades and below, swelling and a localized local inflammatory process appear. No specific treatment is usually required. This pain goes away on its own within a few weeks.
- Fracture or crack - the pain is acute and has no reflection and is concentrated at the site of injury. Even the slightest movement of the hand causes torturous sensations. In such a situation, the patient is shown complete rest, so as not to aggravate the situation with a fracture.
- Displacement, displacement of beads. In this case, the pain will be localized not only in the shoulder blade area, but also in the back at the level of 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 crack is felt, swelling of the tissue is noticed at the site of bruising.
Osteochondrosis
The classic manifestation of osteochondrosis of the chest region is intercapular pain at the level of the ridge. Unpleasant sensations arise due to tight nerve endings. With a lesion of the chest region in the upper part of the patient, he feels a sharp scapular pain radiating to the arm. The side depends on the damage to the specific nerve roots. During the squeezing of blood vessels, there is increased pressure, headache and dizziness.
If the lower part of the chest region is affected, then the patient has discomfort in the lower back from the scapula. Also gives in the left or right hand, depending on the location of the crushed nerve. Over time, the pain becomes more intense, the patient begins to feel discomfort not only during motor activity, but also during the rest period. Difficult situation - discomfort is felt around the clock, even at night. Often, on the background of osteochondrosis, extensions or hernias appear.
Scoliosis
Posture disorder is the most common spinal disease that appears at a young age. The first problems are noticed in the first grades of school - children do not control the proper posture and do not understand why adults want them to sit evenly. Over time, abnormal movement habits develop. A person sits in a comfortable position for him, but this position causes static muscle overload and the development of imbalance. If the spine stays in an analgesic position for a long time, then a curvature occurs, which is fraught with consequences.
In adulthood, many people experience hypodynamics - 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, then the pain is localized in the shoulder blade region. Sometimes there is radiation discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in a standing and relaxed state.
At 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 alleviate the painful condition, you need to establish a lifestyle, stop being nervous and start moving. Under stress, muscle tone can increase, which will cause a deterioration in well-being. Massage helps a lot, it is also useful to perform exercise therapy for the back.
Hernias and extensions
The appearance of an intervertebral hernia is a severe condition characterized by an elongation of the spinal canal through the fibrous ring of the disc. The previous condition of the hernia is elongation. With extension, the disc is partially damaged and the fibrous ring stretches. Hernias appear during strenuous physical exercise, due to heavy lifting. An hereditary factor plays an important role in their appearance. If the family has close relatives with hernias or extensions, then they are more likely to appear as children get older.
If a hernia or extension is located at the level of the chest region, then the pain appears in the region of the shoulder blades. There is also radiation of pain in the arm or shoulder. The side depends on the specific nerve roots tight. Painful shooting is explained by damage to the nerve endings, which get stuck due to excessive compression in the spine.
When the lower back is affected, the back pain is given to the leg and when a cervical hernia appears, 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 tightness. With hernias and extensions, it is beneficial to perform exercise therapy, to follow physiotherapy procedures. In rare and advanced cases, surgery is required.
kyphosis
This is a curvature similar to scoliosis, but in the opposite direction. If with scoliosis the spine is curved to the right or 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 intercapsular area in the presence of external signs of pathology. It hurts under the blade of the left or right shoulder, depending on the nature of the curvature. Usually the pain appears on both sides and gives in the arms, neck. There are two main mechanisms for the formation of pathology:
- Neurogenic. During the onset of curvature, degenerative processes occur in the spine, which causes the nerve roots of the spinal cord to constrict. There is excruciating pain in the region of the right and left shoulder, which is given in the neck, clavicle or arm, less commonly in the shoulder joint.
- Muscular. Constant standing in a concave position provokes muscle imbalance and overload. In the upper back, the muscles are tight, which provokes their hypertension and severe pain. The rest of the back muscles also suffer. Hypotension may appear in the lumbar region.
As a result, the vertebral artery is congested, which causes a persistent violation of cerebral circulation. Gradually, there is a deterioration of well-being, there are dysfunctions 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.
Spondyloarthritis
Sometimes the development of spondyloarthritis shows pain in the right or left shoulder region. The disease is characterized by damage to the site joints and intervertebral discs. With the development of the disease, there is loss of mobility, there is a feeling of stiffness, which is more pronounced in the morning.
The pathology is manifested in several stages:
- Deformation and destruction of cartilage. If blood circulation is impaired in this area, then the integrity of the connective tissue is destroyed, due to which the articular disc becomes thinner. Restorative processes in bone and connective tissue deteriorate significantly. Increased physical activity in this area leads to microtrauma.
- Further deforming changes occur. Seals appear on the disc, mobility deteriorates, which leads to increased destruction of cartilage tissue. The patient may feel constant pain, even in a relaxed state.
- The terminal stage is ossification, the formation of osteophytes. These growths damage adjacent joints, tendons, muscles and ligaments. In this case, an operation will be required.
A characteristic manifestation of spondylarthrosis in the initial stage is the appearance of pain only during physical exercise. Rest discomfort is reduced, as there is no traumatic factor.
Intercostal neuralgia
This condition refers to disorders of the vagus nerve. When a pathology appears, a sharp pain appears, shooting at the shoulder blade, ribs and chest. This type of pain is often confused with a heart attack. A characteristic difference is the lack of a clear localization in the heart region. Unpleasant feelings intensify with inspiration. The pain is accompanied by a feeling of tightness. If the patient thinks he has angina pectoris, then after taking nitroglycerin, there is no relief.
Pain under the right or left shoulder indicates innervation in specific areas. Numbness and spasms are not typical of this pathological process. Given the specifics 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). The therapy of intercostal neuralgia should be treated by a neurologist.
Causes of pain under the left shoulder blade from the back to the back - cardiac disorders
Often, back pain indicates a heart disorder. Why back pain is a referred pain phenomenon that indicates coronary artery disease, myocardial infarction or pericarditis. If there is a stabbing pain of a sudden nature, which increases with physical exertion, but there are no symptoms of spinal diseases, you should urgently visit a cardiologist for a consultation. Self-medication or procrastination can bring the situation to a critical state.
The most common causes of heart distress, causing pain under the left shoulder blade from the back to the back:
- Myocardial infarction. In addition to radiation, the patient feels excruciating pain in the region of the heart muscle. Causes of pathology are associated with blockage of arteries and large veins by a thrombus. If the thrombotic plate detaches and blocks the vascular flow around the heart, a heart attack will occur. In this condition, action must be taken quickly, otherwise the patient will die. The main cause of the pathology that has arisen is atherosclerosis, agglutination of erythrocytes, platelets with increased clotting.
- Ischemic heart disease or angina pectoris. According to information from a medical article, an attack of coronary artery disease develops suddenly. There is a dull pain, which is paroxysmal in nature. The attack is easily stopped by taking nitroglycerin. The disease requires further medical supervision because it can occur at the most unexpected moment. If the attack lasts more than a few hours and the medication does not help, you should call an ambulance. In addition to the disturbance in the heart, the patient's breathing is realized, shortness of breath appears, which is aggravated by physical exertion.
- Pain under the left shoulder blade from the back to the back may indicate the development of a pericarditis attack. 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 tests. Pericarditis is often a complication of a previous infectious disease, including upper and lower respiratory tract respiratory diseases. Long-term, complex therapy is performed.
Diseases of the respiratory system
In the presence of prolonged respiratory diseases, the patient may eventually experience radiating pain in the shoulder area. 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, laryngeal irritation increases and a wet cough appears. If the disease has developed against the background of SARS, then there is an increase in body temperature. The disease does not require specific therapy, it is enough to observe bed rest, drink more warm juice. Antipyretics and antibiotics may rarely be needed.
- Pleuritius. If the patient complained of severe chest pain with possible radiation, cough, shortness of breath and fever, then the specialist should rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural sheets, followed by accumulation of liquid saliva in the pleural cavity. The disease is difficult to bear. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is required.
- Pneumonia. It often develops as a complication of SARS. Pneumonia is characterized by a severe course, accompanied by cough, shortness of breath, chest pain during inspiration, and strong fever. The disease is confirmed by a chest radiograph and can be treated with antibiotics.
Diseases of the gastrointestinal tract
All disorders of the gastrointestinal tract that cause discomfort in the shoulder area have a reflected pain character. What problems may arise:
- Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, then the patient feels uncomfortable discomfort in the lower chest region (the end of the shoulders on both sides). It may seem like muscle aches. With an attack of stomach pain, 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, curing agents (proton pump inhibitors). If a bacterial pathogen is detected, antibiotics are prescribed.
- Esophageal reflux, heartburn. Discomfort appears in the chest area, often radiating to the scapular area. The cause of the pathology is the return of stomach contents to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour eruption, a sensation of a lump in the throat. In rare cases, vomiting occurs. To prevent an attack, you should limit your consumption of fried, spicy and fatty foods. In symptomatic treatment, acid-reducing antacids based on magnesium and aluminum hydroxide are used.
Editorial thought
Unpleasant sensations in the scapular area are most often associated with a worsening of diseases of the musculoskeletal system. Rarely, 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 that you study the relevant article on our website.