The main causes of pain under the left shoulder blade
There are many causes of pain, but they can all be divided into 2 groups:
- Pain associated with pathologies of the musculoskeletal system. Pain under the left shoulder blade can be caused by osteochondrosis of the cervical or thoracic region, intercostal neuralgia, osteomyelitis, bone tuberculosis, scapula injuries, rib fracture or crack, myofascial or scapulocostal syndrome, glenohumeral periarthritis.
- Pain that occurs due to diseases of the internal organs. Pain under the left shoulder blade can be a symptom of heart disease, bronchopulmonary system, gallbladder, stomach ulcers, esophageal spasm, exacerbation of pancreatitis.
Rare pathologies that cause pain radiating to the shoulder blade include splenic rupture. This pathology requires immediate surgical treatment, since massive abdominal bleeding occurs with a risk of death.
No less dangerous for the body is pain in the back on the left under the shoulder blade, which develops against the background of cardiac diseases:
- dissection of an aneurysm of the ascending aorta;
- cardiac ischemia;
- angina pectoris;
- pericarditis, myocarditis, pericarditis;
- myocardial infarction.
Pain in the left shoulder blade from the back, which radiates to the arm and chest area, may indicate heart disease. Numbness of the limb often occurs. Depending on the disease, accompanying symptoms appear: lack of air, compression of the throat, squeezing of the chest, a feeling of cardiac arrest.
Pain under the left shoulder blade may appear during pregnancy due to increased stress on the back
Let's take a closer look at the main causes of pain under the shoulder blade from the back on the left.
Gallbladder diseases
With cholecystitis and cholelithiasis, heaviness appears in the right side, pain radiating under the shoulder blade on the left. An acute attack of inflammation of the gallbladder causes severe pain, nausea, vomiting, and increased body temperature. If it is provoked by obstruction of the bile ducts by a stone, the pain syndrome occurs as biliary colic.
With chronic inflammation, the nature of the pain is aching. Unpleasant sensations appear after eating fatty foods, with long breaks between meals.
Relapses of attacks can occur after physical or nervous strain, against a background of stress.
Subphrenic abscess
It is an accumulation of pus under the diaphragm. Most often, an abscess forms on the right side, but left-sided localization is also possible. The pathology is manifested by the following symptoms:
- pain in the left side, radiating under the scapula to the sternum;
- acute pain in the chest, which intensifies when inhaling;
- high body temperature;
- hiccups;
- increased sweating;
- nonproductive cough;
- dyspnea.
Without treatment, the disease can cause empyema, pneumonia, and lung abscess.
Bronchopulmonary diseases
Diseases of the lower respiratory tract (bronchi, lungs and pleura) cause both chest and scapular pain, which are always complemented by a specific bronchopulmonary clinical picture:
- increased body temperature;
- weakness, lethargy;
- labored breathing;
- chest pain (usually from the affected lung) of moderate intensity, which intensifies when coughing or inhaling;
- cough;
- wheezing.
Pain syndrome in the back of the back in the area of the left shoulder blade most often occurs with pneumonia, dry pleurisy, pneumothorax, acute bronchitis or abscess of the left lung.
With tumors, back pain in the area of the left shoulder blade is not accompanied by fever and high temperature, but there is a cough and breathing problems
Kidney diseases
Scapular pain may occur due to problems with the right kidney, since it is located close to the scapula. With its inflammation, the formation of purulent infiltrates or stones, the pain is often localized on the right, but can also radiate to the left. The pain is often dull or aching, but can also be sharp. It is paroxysmal, ascending, that is, it rises from the lower back, accompanied by nausea, vomiting, and elevated body temperature.
Diseases of the musculoskeletal system
Problems with the spine and neurological disorders associated with them are the main cause of back pain in the area of the left shoulder blade. Pain can occur with any movement, turning the body, sneezing, breathing, or taking a deep breath. They can radiate into the arm, combined with a crunching sound and limited mobility.
Often pain in the scapula area occurs due to the following diseases:
- cervical and thoracic osteochondrosis;
- herniated intervertebral discs;
- protrusion;
- scoliosis;
- radiculitis.
Against the background of degenerative processes in the spine, not only blood vessels and nerve endings are pinched, but also muscles spasm. Muscle spasm provokes the occurrence of scapular-costal syndrome.
One of the most common causes of pain in the scapula is cervical osteochondrosis. At first, the pain syndrome is mild, but as degenerative changes occur, it becomes acute and shooting. The pain is accompanied by dizziness, tinnitus, blurred vision, and increased blood pressure.
With cervical osteochondrosis, pain radiates to the arm
More rare diseases of the musculoskeletal system that can provoke scapular pain include osteomyelitis, bone tuberculosis, and malignant neoplasms.
Muscle strain and inflammation
The back muscles that surround the shoulder blade support the spine in an anatomically correct position and protect the internal organs that are located nearby. Their inflammation or injury is not only accompanied by pain, but also provokes a decrease in muscle tone and the occurrence of instability in the shoulder.
Intercostal neuralgia
The disease is accompanied by inflammation of the intercostal nerves and appears against the background of the following provoking factors:
- injuries to the ribs or spine;
- hypothermia;
- excessive physical activity;
- osteochondrosis.
The intensity of the pain syndrome depends on the severity of the pathology and the timeliness of treatment. The pain can be aching, but sometimes it hurts so much that you can’t stand it.
It is important to contact a neurologist in time, who will provide qualified and, most importantly, timely assistance, otherwise intercostal neuralgia will cause a person severe discomfort:
- the pain becomes shooting, cutting in nature;
- pain increases when moving your hand, coughing or inhaling;
- numbness occurs in the affected area of the body;
- heart rhythm is disturbed.
A neurologist with more than 10 years of experience sees patients in a medical clinic. Only he can correctly determine what causes the sudden pain under the left shoulder blade - neuralgia or cardiac pathology. It is impossible to make a correct diagnosis on your own.
Diseases or injuries of the scapula
Cracks and fractures of the scapula, glenohumeral arthritis are accompanied by pain, limitation of movement, damage to blood vessels and pinched nerve endings.
Injuries to the scapula are more common among athletes, patients with osteoporosis, and cancer of bone tissue.
When urgent help is needed for pain under the ribs
In the following situations, urgent help is needed if you feel sharp pain under your right rib.
Serious injury
A fall or a strong blow can cause damage or even rupture of abdominal organs and pain in the right side. The most dangerous are rupture of the liver and kidney, which can provoke severe bleeding, which can lead not only to pain but also to death. Symptoms of bleeding are:
- strong heartbeat;
- “cold” sweat, chills;
- pale skin;
- dizziness, fainting.
Acute appendicitis
This is an acute inflammation of the appendix, an extension of the intestine, which is felt as pain in the right side under the ribs. If it occurs, you cannot do without surgical intervention, otherwise peritonitis may develop - when all the organs of the abdominal cavity are involved in the inflammatory process. Therefore, it is extremely important to consult a doctor immediately if you have the following symptoms:
- severe aching or stabbing pain on the right side of the abdomen, especially typical when it starts in the center under the sternum and is practically not relieved by painkillers;
- symptoms of intoxication: fever, chills, nausea, vomiting;
- muscle tension, pain in the peritoneum in the right side, which indicates that the process is beginning to spread.
A consultation with a surgeon will help determine the symptoms of appendicitis.
Acute cholecystitis
The second most common disease that causes inflammation of the gallbladder, leading to pain. This happens, for example, if there are stones in it, which will cause acute pain in the right side under the ribs. In the case of acute cholecystitis (diagnosed by a surgeon or therapist), urgent surgical intervention is necessary in order to have time to remove the bubble before other organs are involved in the process. Symptoms of the disease are similar to appendicitis:
- pain in the right side of the abdomen: constant, often severe, slightly relieved by antispasmodics;
- yellowing of the skin;
- nausea and vomiting that does not bring relief;
- an increase in temperature is not always possible;
- chills, weakness.
Acute intestinal obstruction
This is a dangerous condition that, without proper help, can lead not only to pain, but also to death. It is dangerous because when the contents of the intestine linger in it for a long time, it begins to be absorbed into the blood and poison the entire body. In some cases, a rupture of the wall and intestine occurs, and the contents leak into the abdominal cavity - this is called “fecal peritonitis.” This condition often ends in death. Find out about the causes and quick methods to eliminate constipation here. Intestinal obstruction occurs for the following reasons:
- disruption of normal intestinal function: normally, the intestinal walls “push” the contents through the intestines, but with poor nutrition and various diseases, the process is disrupted;
- “overlapping” of the intestinal lumen with a tumor or foreign object;
- torsion, compression of the intestine;
- a section of the intestine gets into the hernia and becomes pinched in it.
Symptoms of intestinal obstruction:
- sharp, spastic attacks;
- nausea, vomiting without relief;
- lack of stool;
- pallor, poor health.
Acute myocardial infarction
The cause of acute myocardial infarction is a thrombus in a vessel
What is myocardial infarction and what does it look like:
One of the infrequent forms of manifestation of cardiac infarction is pain in the abdomen and under the ribs in front. The following symptoms can distinguish it from other diseases:
- the pain syndrome is severe and cannot be relieved by medications;
- feeling of strong heartbeat;
- if you have a tonometer, you can measure your blood pressure - it will be either sharply increased or very low;
- feeling unwell, dizziness, nausea, loss of consciousness.
If you suspect a myocardial infarction, you urgently need to call 03.
Types of pain under the shoulder blade on the left
Before proceeding with diagnosis and treatment, it is important to understand the nature, localization, intensity of pain, their connection with movement, breathing, and eating. If it hurts below the left shoulder blade after eating, then heart pathologies and diseases of the musculoskeletal system can be ruled out. The cause of pain is diseases of the gallbladder, pancreas, and stomach.
The nature of the pain syndrome can be girdling, acute, burning, increasing, aching, dull, sharp.
Aching pain in the left shoulder blade
It can be constant or periodic, indicating both pathologies of internal organs and diseases of the spine. Without treatment, it can turn into a stabbing, burning sensation. Attacks more often occur when raising an arm, physical activity, or staying in one position for a long time.
Appears with scoliosis, chronic cholecystitis, scapular-costal syndrome, intervertebral disc herniation, initial stages of cervical osteochondrosis, bruises and other mild injuries, intercostal neuralgia.
Acute pain under the left shoulder blade
This is a severe pain syndrome in the back below the shoulder blade, which limits movement and makes breathing difficult. Characteristic for myocardial infarction, bursitis of the shoulder joint, exacerbation of osteochondrosis, spondylosis, hernia, subphrenic abscess, pleurisy, acute cholecystitis, intercostal neuralgia.
In case of myocardial infarction, pain under the scapula from behind is not relieved by analgesics, it decreases after taking nitroglycerin
Sharp pain in the area of the left shoulder blade
It may occur suddenly or be the result of prolonged aching pain. Shooting, sharp pain is a sign of osteochondrosis, hernia, trauma, intercostal neuralgia, tuberculosis of the scapula, aortic aneurysm, perforated gastric ulcer, radiculitis.
Stitching pain behind the left shoulder blade
It manifests itself as lumbago, which is typical for pinched nerve endings in diseases of the musculoskeletal system. If it is accompanied by compression of the chest and lack of air, then myocardial infarction or lung abscess cannot be ruled out.
With a perforated stomach ulcer, pain occurs, as if stabbed with a knife.
Nagging pain in the left side of the back under the shoulder blade
Inherent in most pathologies of the musculoskeletal system, as well as bronchopulmonary diseases.
Constant pain on the left side under the shoulder blade
Such pain does not leave the patient even in a lying position. It interferes with sleeping, breathing, and walking. More often, pain intensifies with physical activity, coughing, and sneezing.
Constant nagging or aching pain occurs with injuries to the spine or scapula, scapular-costal syndrome, bronchopulmonary diseases, pyelonephritis, and oncology. Girdle pain with disorders of the digestive system is characteristic of patients with acute pancreatitis.
Burning pain on the left side of the shoulder blade
It is simply unbearable and occurs with intercostal neuralgia, myocardial infarction, angina pectoris, muscle strain.
Important! If a burning sensation that spreads to the sternum is accompanied by shortness of breath, you should immediately call an ambulance. This is a sign of a heart attack.
Chronic and systemic diseases with pain in the right hypochondrium
Chronic cholecystitis
Chronic cholecystitis refers to long-term, sluggish inflammation of the gallbladder wall, leading to pain in the right side. As a rule, it is caused by stones located in it. Sometimes the stones “irritate” the wall of the bladder, causing dull aching pain under the ribs. In addition, stones can break down and pass through the bile ducts, causing more severe sensations and even colic. To identify chronic cholecystitis, it is necessary to do an ultrasound of the gallbladder. If these diseases are suspected, the diagnosis is prescribed by a general practitioner.
In the case of calculous (stone) cholecystitis, jaundice often occurs, giving a yellowish-green color to the skin.
Hepatitis
These are diseases affecting liver tissue. They can be caused by chronic intoxications, for example, alcohol and viruses that parasitize the liver. Viruses include hepatitis viruses A, B, C, E, D. Of these, viruses of types B and C linger in liver cells for a long time, causing periodic exacerbations, pain in the right side, accompanied by discomfort in the peritoneum and jaundice. If hepatitis is suspected, the hepatologist will prescribe blood tests to evaluate the condition of the liver or find the virus.
Kidney diseases
The kidneys are located closer to the back, so that with kidney disease, patients are more often bothered by colic in the lower back and pain in the right side. If the kidney “suffers”, complaints arise of right-sided pain in the back and abdomen. They can be pulling, “dull”, sometimes intense, “stabbing” - renal colic. The most common cause of kidney damage is an ascending infection from the bladder that penetrates the renal pelvis (pyelonephritis). Read more about kidney diseases here. In addition, glomerulonephritis (inflammation of the kidney tissue itself) and hydronephrosis (fluid retention inside the kidney) occur. Any of these pathologies require diagnosis and treatment, since the kidneys are the main “tool” for removing toxic substances such as urea from the body. Diagnostics includes ultrasound of the kidneys, blood tests, urine tests - prescribed by a urologist
Inflammation of the ovaries
In women, pain in the abdomen and front right side is often caused by ovarian diseases. This may be inflammation, cysts, tumors of the appendages. Even the maturation of the egg (ovulation), which occurs once a month, can cause discomfort. The ovaries are located in the pelvic cavity, so spasms are localized in the lower part, but there are exceptions. If you have similar symptoms, see a gynecologist.
How to relieve pain under the left shoulder blade
Pain sensations below the shoulder blade on the left, especially if they are quite intense, interfere with movement and breathing freely, require qualified help, since they pose a threat to human health and life. You cannot ignore them and self-medicate. Taking analgesics, antispasmodics and other painkillers can relieve pain, but will not eliminate the cause, which must be discovered by a doctor.
Important! Emergency care will be required in case of severe pain with increasing intensity and rapid deterioration in well-being.
Which doctor should I consult for pain on the left under the scapula?
At the first painful sensation in the area of the shoulder blade, you should consult a specialist and undergo diagnostics. Since the nature of back pain is often neurological, you should make an appointment with a neurologist.
The doctor will conduct a visual examination, study the patient’s complaints, draw up a clinical picture: the nature and conditions of the pain syndrome (in a lying position, during movement), its intensity, accompanying symptoms.
With glenohumeral arthritis, pain worsens at night, when lying down
To understand exactly why your back hurts, your doctor will prescribe an additional examination:
- laboratory - clinical analysis of blood and urine, which will show the inflammatory process;
- instrumental, necessarily including MRI, since this diagnostic method provides the most accurate information about the condition of the spine, muscle tissue, nerve endings and blood vessels.
You can undergo magnetic resonance imaging using the new 2021 Siemens Symphony 1.5 Tesla device at the SmartMed clinic. Immediately after the examination, the doctor will interpret the results obtained, make a final diagnosis and prescribe effective treatment.
If instrumental diagnostics reveals a pathology that is not within the competence of a neurologist, the doctor will refer the patient to a therapist, pulmonologist, cardiologist, gastroenterologist, traumatologist or other specialists.
My right side hurts - what else could it be?
If you have pain on the right side in the area under the rib on the side, there may also be non-standard reasons. The list of diseases is described below:
Cholangitis
Bile ducts arise from the liver and gallbladder. If they are damaged, severe attacks of pain in the hypochondrium may occur. The ducts are often damaged by debris from gallstones coming from the gallbladder. The attack can be easily relieved with antispasmodics and may be accompanied by chills - these are their distinctive signs. Confirm the diagnosis using ultrasound.
Tumors
Tumors can grow from any tissue, including liver, kidney, and intestinal tissue. They may not manifest themselves for a long time, but one of the symptoms is spasms and pain. Therefore, it is important for long-term, persistent spasms to consult an oncologist and be examined.
Doctor's advice
Pain in the right hypochondrium does not always occur due to pathology of the internal organs. Often the source of sensation is in the back - the muscles or spine. Sudden overstrain of a muscle during work or exercise leads to micro-tears and stretching, which results in pain. Any degenerative processes in the spine (osteochondrosis, as the most common) can cause pain. A characteristic symptom in both cases will be increased pain when moving, inhaling, coughing, decreasing or stopping at rest.
Victoria Druzhikina Neurologist, Therapist
Liver echinococcosis
This is an “exotic” disease that is more common in the southern regions. At the same time, a parasite lives in the liver tissue - echinococcus, which gradually destroys the liver. The course of the disease resembles hepatitis; it is difficult to make a correct diagnosis in advance.
Pleurisy
The lungs are covered on the outside with a membrane called the pleura, in which fluid accumulates during various infections. The lower edge of the lung is at the level of the lower ribs, so inflammation of the pleura in this place can cause spasm and pain in the right side. Read more about pleurisy here.
If you have pain in the right hypochondrium, you should not use a heating pad. Heat can increase inflammation, leading to worsening of the condition.
Treatment of pain on the left side of the shoulder blade
All therapeutic measures are aimed at eliminating the root cause and relieving pain. The doctor selects medications based on why the pain in the shoulder blade area occurs.
If the cause is a disease of the musculoskeletal system or its complications, then drug therapy looks like this:
- anti-inflammatory non-steroidal drugs;
- muscle relaxants;
- analgesics;
- local anesthetic agents.
Drug therapy must be supplemented with physiotherapeutic treatment, massage, and therapeutic exercises. A neurologist from the SmartMed clinic draws up a comprehensive therapy program, taking into account the individual characteristics of the patient.
If conservative therapy does not provide the desired therapeutic effect, the patient is indicated for surgery
Treatment
First of all, you should understand that the doctor will prescribe treatment and therapy for you individually, having found out the cause of the pain. Here we will give examples of the main therapy used in medical practice. If there is no indication for surgical intervention, then first of all, therapy is aimed at relieving spasms and the inflammatory process, and then depending on the cause of the disease.
Drugs used in therapy:
- Antispasmodics: “No-shpa”, “Baralgin” (in injections), “Spazgan” (tablets).
- Anti-inflammatory drugs: Nimesulide, Aspirin, Ibuprofen.
- Broad-spectrum antibiotics: Levofloxacin, Amoxicillin.
- Hepatoprotectors: “Essentiale”, “Karsil”.
- Medicine to improve the flow of bile: Allohol.
- Heart medications: Nitroglycerin, beta-blockers (bisoprolol, metoprolol)
Effective medications for pain relief
You can use antispasmodics to relieve and relieve pain, but you should understand that in case of acute pain you need to wait for an ambulance and find out the cause. Ketorol and Baralgin are considered effective means of relieving pain and spasms , especially for back pain. For stomach pain, " No-shpu" is given as an injection . You can take “No-shpu” and “Spazmalgon” in .
Let me explain about pain therapy for pain in the right hypochondrium. If the cause is a stomach disease, then No-shpa or Spazmalgon is used, i.e. drugs with an antispasmodic effect. Why them and not analgesics? The stomach begins to worry when there is a defect in the mucous membrane, i.e. in the presence of an ulcer or gastritis. And any analgesic or non-steroidal anti-inflammatory drug (analgin, meloxicam, xefocam, etc.) has an extremely negative effect even on the intact gastric mucosa, not to mention the inflamed one. Therefore, taking even one such tablet for an ulcer can aggravate the situation and provoke gastric bleeding - a life-threatening condition. Therefore, if acute surgical pathology (appendicitis, for example) is excluded, but you do not know whether the pain comes from the stomach or not, then it is safer to take an antispasmodic drug than any other.
Victoria Druzhikina
Neurologist, Therapist
To determine how serious your situation is, use an online consultation with a doctor on our website in a paid or free mode.
The doctor will make a preliminary diagnosis and give recommendations for first aid and advise on further actions. Under no circumstances should you self-medicate or get carried away with painkillers, as they do not eliminate the true cause of spasm and pain.
Be healthy!
Useful articles on the topic: What can you take for stomach pain: a review of medications. What can pain under the left rib in front indicate?
This article has been verified by a current qualified physician, Victoria Druzhikina, and can be considered a reliable source of information for site users.
Bibliography
1. https://vmede.org/sait/?page=7&id=Xirurgiya_gosp_sind_abdulaev_2013&menu=Xirurgiya_gosp_sind_abdulaev_2013
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