Pain in the chest at shoulder level can indicate back problems, pain in internal organs, and reflect discomfort in the heart. 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 refer to the details of ways to treat back pain below the shoulder blades.
Thoracic Anatomy
The squamous area belongs to the thoracic spine and is level with the chest. Anatomic study of this area is required to understand which organs may cause direct and indirect disturbance to the patient.
The main anatomical elements include:
- Spine - includes the spinal cord and vertebrae, discs. It is an important part of the entire musculoskeletal system, protecting the spinal cord from damage.
- The right and left shoulder blades belong to the bony structure of the upper clavicle. They look like a triangle and are flat bones. This bony structure has many pits and depressions. These are the attachment sites for ligaments, tendons, and muscles. The blades are highly durable, so they can easily withstand continuous static loads.
- The collarbone is the bone that connects the shoulder blades to the ribcage.
- Heart - responsible for the function of the cardiovascular system, pumping blood through the veins and arteries.
- The lungs are a paired respiratory organ responsible for gas exchange processes.
- Esophagus, stomach - belongs to the digestive organs.
- Ribs - provide the function of protecting the chest. These are flat bones that attach 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 collarbone and collarbone. This is a pair of bones in the shape of a triangle, where the rhombus muscles and a trapezoid part are attached. These muscle groups make the upper shoulder muscles mobile. The shoulder blades are connected by ribs to form a solid body frame. Any discomfort in this area can lead to significant discomfort and limited upper back mobility. For this reason, the pain is unbearable and you should immediately consult a doctor.
The variety of pain sensations is divided into several categories:
- Pain and its characteristics depend on the locality of discomfort - in the middle of the shoulder blades, left or right, whether there is irradiation to the chest or between the ribs, pain is felt higher or lower.
- By the nature of sensations - discomfort, pulling sensations, acute pain, groaning, irradiation, impulses.
- The duration of the pain is intermittent, feels continuous, increases sharply, appears uncomfortable after physical activity.
Usually, traction pain indicates problems with the spine and rarely signals other related problems.
Main reason
Symptoms of subscapular pain occur due to disorders such as the following:
- stomach pain (gastric ulcer, gastritis);
- digestive disorders (heartburn, reflux esophagitis);
- disorders in the work of the cardiovascular system (myocardial infarction, pericarditis);
- lung problems (bronchitis, pneumonia);
- degenerative disorders of the back and spine;
- trauma, inflammation, sprain, myositis;
- Neurological disorders plant.
Statistics show that 90% of shoulder discomfort is caused by back pain. The human spine is responsible for standing upright, so it bears a significant load. Taking care of your own health will help improve your health when physical inactivity and poor posture cause discomfort. The situation worsens with age.
Hurt
If the patient has a bruise or sprain, there may be pain below the shoulder blade with movement or strain. During the acute phase, the pain is constant and felt even at rest. Depending on the location of the injury, the pain occurs on the left or right side of the shoulder blade. The most common types of damage are bone or muscle.
Other types of traumatic injury:
- Wound. It is characterized by superficial pain. Usually, the superficial soft tissues, the upper muscle layer, and the subcutaneous fat layer are bruised. Discomfort occurs under the shoulder blades and below, swelling and local inflammation appear. Usually no specific treatment is needed. This pain should go away on its own within a few weeks.
- Fracture or fissure - pain is acute and non-reflexive and concentrated at the site of injury. Even the slightest movements of the hand cause extremely severe sensations. In this situation, the patient is given complete rest so as not to aggravate the fracture.
- Dislocation, displacement of vertebrae. In this case, the pain will be localized not only in the area of the shoulder blades, but also in the back at the level of the chest area. Usually, the pain occurs due to compression of the nerve endings in the spinal canal, which indicates damaged discs.
Injuries are easy to spot. During movement, you may feel a crackling sound and swelling of the tissue at the site of the bruise.
Bone tumor
The classic presentation of thoracic osteonecrosis is interstitial pain at the costal level. Discomfort arises due to pinched nerve endings. With damage to the thoracic area in the upper part, the patient feels a sharp pain spreading down the arm. The side depends on the extent of the damage to the specific nerve roots. Squeezing the blood vessels increases pressure, headaches, and dizziness.
If the lower part of the thoracic region is affected, then the patient experiences discomfort in the lower back from the shoulder blades. Simultaneously give the left or right hand, depending on the location of the pinched nerve. Over time, the pain becomes more and more intense, the patient begins to feel discomfort not only when exercising but also when resting. Difficult situations - feeling uncomfortable around the clock, even at night. Often, against the background of osteonecrosis, protrusions or hernias occur.
Scoliosis
Violation of posture is the most common disease of the spine that occurs at a young age. The first problems were observed from the very first grades of school - children did not control their posture properly and did not understand why adults asked them to sit evenly. Over time, abnormal movement habits develop. A person sits in a position that is comfortable for him, but this position causes a static overload of the muscles and the development of imbalances. If the spine stays in a mismatched position for a long time, then curvature will occur, with many consequences.
In adulthood, many people develop hypodynamia - a state of low physical activity, when a person leads a sedentary lifestyle. The result is persistent back pain due to muscle weakness. If there is curvature in the chest area, the pain is localized in the shoulder blade area. Sometimes there is a diffuse discomfort in the cervical region. A characteristic difference of scoliosis is that one shoulder is higher than the other in a relaxed, standing position.
During the initial examination, the treating person can see the disease. It is necessary to treat the disease for a long time and with the help of an integrated approach. To relieve pain, you need to establish a lifestyle, stop stressing, and start moving. When stressed, muscle tone can increase, causing health to decline. Massage helps a lot, it is also useful to do exercise therapy for the back.
Hernias and the protrusion
A herniated disc is a serious condition characterized by protrusion of the spinal canal through the fibrous ring of the disc. The previous state of the hernia was protrusion. With disc protrusion, the disc is partially damaged, and the fibrous capsule is stretched. Hernias occurs with exertion, due to heavy lifting. Genetic factors play an important role in their appearance. If a family member has a hernia or protrusion, the probability is high that it will occur according to age in children.
If the hernia or condyle is across the thoracic region, pain occurs in the shoulder blade. There is also pain in the arm or shoulder during irradiation. Lateral depends on specific pinched nerve roots. The painful shots are explained by the destruction of the nerve endings, which are pinched by the excessive compression of the back.
When the lower back is affected, the legs will have back pain, when the ankle herniation, the pain spreads to the head. In all situations, hernia requires complex treatment aimed at relaxing the back, relieving acute pain and eliminating muscle tension. With hernia and protrusion, it is useful to perform exercise therapy, participate in physiotherapeutic procedures. In some rare and advanced cases, surgery is required.
kyphosis
This is a form of curvature similar to scoliosis, but in the opposite direction. If with scoliosis the spine is curved to the right or to the left, then with scoliosis there is a pronounced stooping of the upper shoulder blades. One of the characteristic signs of the disease is the sensation of pain in the interstitium before any outward signs of disease. Pain below the left or right shoulder blade, depending on the nature of the curvature. Usually the pain occurs on both sides and spreads to the arms and neck. There are two main mechanisms for pathogenesis:
- Neurogenesis. In the process of curvature, the spine undergoes a degenerative process that compresses the nerve roots of the spinal cord. Pain occurs in the right and left collarbone areas, usually in the neck, collarbone or arms, less often in the shoulder joint.
- Muscle. Constantly being in a concave state causes muscle imbalance and overactivity. In the upper back, the muscles are clamped, causing them to increase in tone and cause severe pain. The rest of the back muscles also suffer. Low blood pressure can occur in the lumbar region.
As a result, the vertebral artery is compressed, which causes a constant violation of cerebral circulation. Gradually, health deteriorated, the work of internal organs malfunctioned. With such a patient, it is necessary to perform complex work, including the services of a rehabilitation person, exercise therapy.
Spondylolisthesis disease
Sometimes the development of spondylolisthesis presents with pain on the right or left side in the shoulder blade area. The disease is characterized by damage to the facet joints and discs. As the disease progresses, the patient loses mobility, has a feeling of stiffness, which is most evident in the morning.
The disease manifests itself in several stages:
- Deformity and destruction of cartilage. If blood circulation is impaired in this area, the integrity of the connective tissue is destroyed, and the articular disc becomes thinner. The healing process in bone and connective tissue deteriorates significantly. Increased physical activity in this area results in minor injuries.
- Further deformation changes occur. The disc nucleus appears in the disc, the mobility is poor, leading to increased destruction of cartilage tissue. The person may feel constant pain, even when in a calm state.
- The final stage is the process of ossification, the formation of osteoclasts. These tumors damage nearby joints, tendons, muscles, and ligaments. In this case, an operation will be required.
The characteristic manifestation of spondyloarthritis in the early stages is pain only with exertion. Discomfort at rest will lessen, as there is no traumatic factor.
Intercostal neuralgia
This condition refers to disorders of the vagus nerve. When suffering from the disease, there will be sharp, shooting pain in the shoulder blades, ribs and ribcage. This type of pain is often confused with a heart attack. A characteristic difference is the lack of obvious localization in the region of the heart. Feelings of discomfort increase with inspiration. The pain is accompanied by a feeling of spasm. If the patient thinks he has angina, after taking nitroglycerin, there is still no relief.
Pain below the right or left shoulder blade indicates pain in specific areas. Numbness and spasms are not typical for this pathological process. Given the specific nature of the symptoms of the disease, the specialist will make a diagnosis without any problems. Treatment is with injectable B vitamins and muscle relaxants (muscle relaxants). Treatment of intercostal neuralgia should be handled by a neurologist.
Causes of pain under the left shoulder blade from behind from behind - heart disorders
Usually, back pain indicates that you have a heart disorder. Why back pain is a glans pain indicates coronary artery disease, myocardial infarction or pericarditis. If the pain is sudden, increases with exertion but is not accompanied by symptoms of spinal diseases, you need to urgently consult a cardiologist for advice. Self-treatment or delay can bring the situation to a critical state.
The most common causes of cardiac discomfort, causing pain below the left shoulder blade from behind from behind:
- Heart attack. In addition to irradiation, the patient feels pain in the heart muscle. The cause of the pathology is associated with the blockage of large arteries and veins by a thrombus. If the clot breaks off and blocks the flow of blood vessels around the heart, a heart attack occurs. In this state, one must act quickly, otherwise the patient will die. The etiology of the pathology that has arisen is atherosclerosis, agglutination of red blood cells, increased platelets in coagulation.
- Ischemic heart disease or angina attack. According to information from a medical journal, an attack of coronary heart disease develops suddenly. Dull, paroxysmal pain. The attack can be easily stopped by taking nitroglycerin. This disease requires further medical monitoring, as it can occur at the most unexpected time. If the attack lasts more than a few hours and the medicine does not help, you need to call an ambulance. In addition to heart discomfort, the patient has shortness of breath, shortness of breath occurs, aggravated with exertion.
- Pain below the left shoulder blade from the back from the back may indicate the development of an attack of pericarditis. Pathology is characterized by fluid accumulation with an inflammatory lesion of the serous membrane of the heart. Diagnosis includes testing for markers of inflammation, including testing for rheumatism. Pericarditis is often a complication of a pre-existing infectious disease, including upper and lower respiratory tract diseases. Long-term, complex therapy is performed.
Diseases of the respiratory system
When suffering from long-term respiratory diseases, the patient may eventually experience radiating pain in the shoulder blades. Most often, complications caused by such diseases:
- Chronic or acute bronchitis. In the early stages, the disease presents as a dry cough. Gradually, irritation of the larynx increases and a dry cough appears. If the disease has developed against the background of SARS, then the body temperature will increase. The disease does not require specific treatment, just observing bed rest, drinking warm water is enough. Rarely, antipyretics and antibiotics may be needed.
- Pneumonia. If the patient complains of severe chest pain accompanied by irradiation, cough, dyspnea, and fever, the specialist must rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural sheets, followed by the accumulation of loose sputum in the pleural space. Unpleasant illness. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is required.
- Pneumonia. Usually develops as a complication of SARS. Pneumonia is characterized by a severe course, which is accompanied by cough, shortness of breath, chest pain on inspiration and strong fever. The disease is confirmed by chest X-ray and can be treated with antibiotics.
Digestive tract diseases
All disorders of the gastrointestinal tract causing discomfort in the shoulder blade region are reflected in pain. What problems can arise:
- Gastritis or stomach ulcer. If there is a pain syndrome, the patient feels discomfort under the chest (bottom of the shoulder blades on both sides). It sounds like muscle pain. With stomach upset, a burning sensation in the solar plexus can be felt in parallel. The disease is treated in a complex way, drugs are used to reduce acidity, wound healing agents (proton pump inhibitors). If pathogenic bacteria are found, antibiotics will be prescribed.
- Esophageal reflux, heartburn. The discomfort occurs in the chest area, often radiating to the scaly area. The cause of the disease is because the contents of the stomach back up into the esophagus. The discomfort is related to the irritating effect of hydrochloric acid on the esophagus. There is a sour taste, the feeling of having a lump in the throat. In rare cases, vomiting occurs. To prevent pain, you need to limit eating fried, spicy and greasy foods. In symptomatic treatment, acid-reducing antacids based on magnesium and aluminum hydroxide are used.
Editorial comments
Discomfort in the squamous area is often associated with exacerbations of musculoskeletal disorders. Less often, heart disorders, neurological problems, and diseases of the stomach and respiratory system lead to discomfort. To learn more about the causes of back pain, you should study the corresponding article on our website.