Pain under the right shoulder blade

The pain under the right shoulder blade is one of the varieties of radiating pains, which tend to be located away from the true source of pathology.

A person can feel such reflected pain in any area of the body where nerve roots are located, which are connected with the main inflamed area.

Pain sensations are transmitted through vegetative nerve fibers from the source of the disease to the spinal cord and are reflected in certain innervation locations. Repercussion syndrome develops (a reflection in Latin is a repercussio), which can sometimes cause difficulties in the diagnostic sense, although at present almost all irradiation pains are well studied and an experienced doctor can understand the real cause of the pain symptom. Under the right scapula, there is no internal organ that can hurt, inflame, so the causes of painful manifestations may be as follows:

Causes of pain under the right shoulder blade.

1. Osteochondrosis of the cervical or thoracic spine. In the chronic course of the disease, degenerative changes in the vertebral processes can provoke the infringement of nerve endings, manifested by pain under the right scapula.
2. Injuries or damage to the trapezius muscles in the area of the right shoulder. The pain under the right scapula is manifested in statics (sitting, standing), less often when walking.
3. Subphrenic abscess (purulent inflammation under the dome of the diaphragm, purulent peritonitis). Diaphragmatic-hepatic peritonitis is characterized by chronic pain, extending to the right, including under the scapula.
4. Compression injury of the right suprascapular nerve. This damage is characterized by intermittent pains under the scapula and diffuse, diffuse pains throughout the humeral fold.
5. Pyelonephritis, renal colic. The pain is acute and quickly spreads from the lower back up towards the right hypochondrium and under the right scapula.
6. Hepatic (biliary) colic, cholecystitis. The pain is provoked by a strong spasm in the ducts or the gallbladder due to blockage of the bile duct calculus. Pain is acute, paroxysmal, localization of pain is quite clear - under the right edge with a reflection in the area of the scapula, collarbone or shoulder.
7. Adhesions after suffering right-sided pleurisy. The pain under the right shoulder blade is a residual phenomenon that occurs during the resorption process of adhesions.
8. Acute pancreatitis with a lesion of the pancreatic head. With this localization of the inflammatory process, pain most often radiates to the right and is reflected in the right hypochondrium and under the scapula.
9. Right myofascial syndrome. Chronic muscle pain that can move and radiate to the area under the right shoulder blade.

The causes of pain under the right shoulder blade can be varied, so the nature of the pain is important: the pain can be strong, sharp, pulling, transient, or chronic.

How to recognize pain right scapula?

Severe pain under the right scapula may indicate such diseases:

• Acute vertebral radiculopathy or infringement of the nerve roots with right-sided displacement of intervertebral discs (intercostal neuralgia). This disease is secondary, developing on the background of chronic compression of nerve endings in the zone of their exit - in the "tunnel". The so-called "tunnel" is formed from various structures - osteophytes, hernia, articular tissue. The longer the pathological process of intervertebral disc degeneration lasts, the smaller the lumen in the tunnel becomes, the blood supply to the nerve endings is disturbed, puffiness and pain symptoms appear, including the reflected severe pain under the right scapula.
• Pancreatitis in the acute stage is accompanied by characteristic surrounding pains, as a rule, they radiate evenly under both shoulder blades. However, with inflammation of the pancreatic head, the pain spreads mainly to the right and feels like a backache in the region of the right scapula. The common pain symptom is permanent and does not subside when the position of the body changes, it does not increase with tension, inspiration or cough.
• Cholecystitis in the acute stage is the main cause of pain reflected in the right shoulder blade. The symptom is so characteristic that many patients with a chronic disease already know that the inflammation has begun. In addition to the pains that extend up to the right, acute cholecystitis is accompanied by fever, nausea, vomiting and often yellowing of the skin.
• Hepatic colic is very similar to an attack of cholecystitis, it is also accompanied by severe pain under the right shoulder blade, but there is no nausea, no vomiting, or hyperthermia.
• Spontaneous pneumothorax (traumatic perforation of the pleura) is characterized by a sudden, pronounced pain in the middle of the chest radiating to the area of the scapula.

[1], [2]

Dull pain under right scapula

• Nephritis or chronic pyelonephritis in stage II of the process, when changes in the renal tissue are sclerotic. The pain is felt periodically, as pulling, dull, extending to the lower back or upper body. In the right-sided process, the pain symptom radiates to the right shoulder blade. In addition to clinical implicit pain, the disease is accompanied by painful urination, subfebrile body temperature, and rarely nausea.
• Chronic cholecystitis is also manifested by dull pain that may occur paroxysmally, but does not cause obvious discomfort to the patient. The pain gives in the epigastrium (under the spoon) and at the same time "stretches" under the scapula.
• The causes of dull pain in the area of the right scapula are various malignant processes localized in the internal organs on the right. Tumors of the liver, pancreas, right kidney, or right lung may manifest as periodically dull pain under the right scapula.
• Cirrhosis of the liver in the initial stage, which in addition to the characteristic clinical picture, manifests itself in the form of blunt right-sided pain sensations, reflected under the scapula.

Acute pain under the right shoulder blade.

This is usually an attack of liver colic, acute cholecystitis or a symptom of gallstone disease. Also, acute pain under the right scapula may indicate a hypertensive form of gallbladder dyskinesia. Hyperkinetic dysfunction of the bile ducts can be triggered by both food and neurological, psychoemotional factors. Stress, emotional overload, eating disorders (overeating, spicy, fried or fatty) meals are the main causes of GWD, which is accompanied by periodic paroxysmal epigastric pain with irradiation left or right, often in the upper right part of the body. Pain sensation spreads in the back, under the right shoulder. Acute pain under the right scapula may increase with inhalation, bending. As soon as the provoking factor is removed, the pains go away. In addition to the painful symptom of the patient, there are characteristic neurological signs - irritability, fatigue, poor sleep, sweating.

Sharp pain under the right shoulder blade

This symptom is a typical symptom of the final stage of subphrenic abscess, when the sensation increases sharply with a strong breath and is reflected in the shoulder and right scapula.

Also, a sharp pain in the lower lobe of the scapula may be one of the signs of renal colic or purulent infiltration in the right kidney for pyelonephritis. The painful symptom extends to the iliac region, in the hypochondrium, often under the scapula. In addition to pain, purulent pyelonephritis is accompanied by fever, frequent and painful urination.

Hepatic colic is a sharp, sharp pain that occurs most often at night. Painful sensations are acute and extend to the right shoulder, often given through the scapula to the neck. If the colic lasts more than 4-5 hours, the pain spreads throughout the abdominal area, accompanied by nausea and vomiting, which indicates an acute clinical picture requiring hospitalization.

Stabbing pain under the right shoulder blade

These are usually transient sensations that are not associated with serious pathological disorders in the internal organs. Most often, stabbing pain is a symptom of neurological disorders in osteochondrosis of the cervical or thoracic spine. Unlike pains of a similar nature on the left side, which may indicate a life-threatening cardiovascular disease, right-sided transient pains are provoked by an uncomfortable posture, sharp turn or physical overstrain. However, stabbing pains can also be a sign of spasm of the walls of the bile ducts and the beginning of an attack of biliary colic or exacerbation of cholecystitis. Therefore, if the pain recurs, increases or "spreads", the nature of it changes within 1-2 hours, you should consult a doctor, or call emergency care.

Pulling pain under the right shoulder blade

These pains are most likely associated with changes in the structure of the spine or with spasms of the muscular system of the shoulder girdle. Osteochondrosis of the cervical vertebral column is characterized by aching, pulling sensations, which can be slightly enhanced when the body position changes or with a static, constant load (the same posture). The pain can appear in the morning after sleep and disappears during the day after moderate distributed movements. Also, the pain symptom is relieved by heat or rubbing, which indicates a spastic cause of pain. For all other diseases, pulling pain under the right shoulder blade is not typical. An exception may be malignant tumor processes of internal organs - the liver, right kidney, pancreatic head or right lung. Since oncological diseases develop latently and manifest in the initial stages as insignificant, in the clinical sense, implicit symptoms. Also reflected upward pulling pains may be accompanied by pyelonephritis, but, as a rule, this is atypical and rare.

Constant pain under the right shoulder blade

This is a clear symptom of JVP hypotonic type. Dyskinesia of the bile ducts in this form in clinical practice is much more common than the hyperkinetic form, especially in women and children. The pain develops gradually in the area of the right hypochondrium and can be reflected upwards into the right shoulder and under the scapula. A painful symptom does not cause severe discomfort, as many patients note - it is tolerable. This persistent nature of pain is “habitual” for those suffering from gallbladder disease. In comparison with the exacerbation of the process or an attack of cholecystitis, the constant pain under the right scapula is transferred by patients much easier and does not require urgent treatment. However, the wave-like course of the underlying disease can increase and move from the remission stage to the acute phase, therefore, anyone who feels chronic radiating right-sided pain should undergo a comprehensive examination and start treatment as soon as possible. The main danger of undiagnosed pulling pains in the right upper part of the body can be gastroduodenitis, acute cholecystitis, cholelithiasis

Burning pain under the right shoulder blade

May indicate both the infringement of the nerve roots in osteochondrosis, and serious pathologies requiring urgent treatment. These include right-sided pneumonia, which often develops asymptomatically in the initial stage and may manifest as intermittent burning pain under the right scapula. Also, such pain may indicate atypically developing angina, it is characterized by left-sided reflected pain, but in some cases there is also an irradiation under the right scapula. The nature of the pain, which in clinical practice is called causalgia (from causis - burns and algos - hurts), speaks of inflammation and or damage to the peripheral nerve processes. Thus, burning pain under the right scapula may occur either during the infringement of the nerve roots, or with atrophy of the surrounding tissues, which is characteristic of pneumonia or angina pectoris - angina pectoris.

Osteochondrosis and pain under the right scapula

Osteochondrosis. The pain under the right shoulder blade can be one of the symptoms of the cervical deforming process or osteochondrosis of the thoracic spine. This is typical for everyone who is involved in sedentary office work, and this feature is especially typical for schoolchildren or students. With such a static posture, constant compression of the nerve endings occurs, resulting in chronic pain, which is reflected in the direction of the shift of the intervertebral discs. The pain can be aching, pulling, give to the neck or shoulder, as well as under the right shoulder blade. Symptom increases with awkward turns, movements, often in the morning after sleep. Often, osteochondrosis and pain under the right scapula are accompanied by numbness of the fingers of the hand, a headache. Also one of the reasons for this pain may be S-shaped scoliosis of the thoracic spine.

[3], [4]

Pain in the right shoulder blade

The pain gives in the right scapula - this is evidence of such diseases:

Cholelithiasis	Acute, paroxysmal pain, with nausea, vomiting, fever, feverish state, icteric color of the skin
Spontaneous traumatic pneumothorax	Sharp, sharp pain in the chest, radiating to the area of the scapula (under the scapula)
Cholecystitis in the acute stage	Pain in the right hypochondrium, common in the epigastric region. The pain radiates to the area between the shoulder blades, under the right shoulder blade, to the right shoulder, to the chest. The pain lasts from several hours to several days.
Renal colic, pyelonephritis	Paroxysmal pain, sharp, cutting nature, radiating to the lower back. With the development of the syndrome, pain radiates upward, if the right kidney is inflamed, there are purulent infiltrates, the pain gives up under the right scapula.
Pancreatitis in the acute stage, inflammation of the pancreatic head	The pain occurs suddenly and is permanent. The symptom spreads through the epigastric region and radiates to the region of the sternum, often beneath the right scapula and shoulder.

If the pain gives in the right shoulder blade and its intensity increases, you should call emergency medical care, especially for conditions involving hyperthermia in the range of 38-40 degrees.

Aching pain under the right shoulder blade

The aching pain in the area of the right shoulder, in the scapula and under it, may indicate a chronic process that develops in organs distant from the scapula. Irradiating (reflected) pains that do not have an intense character are a typical sign of a lurking inflammatory process in the liver, kidneys, gallbladder, or pancreas. Often, the aching pain under the right scapula does not stimulate people to see a doctor, while patients try to use various home-based treatments and only aggravate the pathological process. Diagnosis of aching reflected pain is often difficult, as the clinical picture is not manifested, and the main pain symptom is removed by “popular” methods - rubbing, warming, massage. Oncological diseases that can develop over the years and manifest periodic aching, radiating pain symptoms are also dangerous. Identified in the early stages, many oncoprocesses can be stopped, an acute pain symptom is, unfortunately, a sign of the terminal stage. The aching pain under the right shoulder blade may be a signal of such diseases: 

• Chronic cholecystitis.
• Chronic pyelonephritis.
• Gallstone disease in the initial stage.
• Liver diseases, including cirrhosis or hepatitis.
• Chronic pancreatitis.
• Osteochondrosis.
• Chronical bronchitis.
• Hidden pneumonia or pleurisy.
• Tumor processes.

Treatment of pain under the right shoulder blade

Treatment of pain under the right scapula is impossible without examination and identification of the root cause. Such painful sensations are reflected, which means that the real source of the disease is at a distance from the shoulder blades, especially since there are no internal organs in this zone that could provoke pain. In order to cure a painful symptom, whatever its nature - acute pains or nagging pains, dull, you need to consult such doctors: 

• Neuropathologist.
• Vertebrolog.
• Traumatologist.
• Cardiologist.
• Gastroenterologist.

The first step, of course, can be a visit to the local doctor who will conduct the initial examination, collect anamnestic information and decide which narrow specialist to refer the patient to. There will also be an x-ray, general blood and urine tests, possibly an initial analgesic therapy that relieves a painful symptom. When symptoms of acute nature, when the pain is accompanied by fever, vomiting, fever, you should call the doctor at home or an ambulance.