Pain under the scapula

Pain under the scapula is a clinical sign of many pathological conditions, among which there may be gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, broncho-pulmonary pathology and others.

The pain symptom can be different in intensity and localization - under the right or left scapula, and sometimes restrict the motor activity of a person. Pain under the shoulder blade is most often associated with skeletal muscle spasms due to stress or with pain reflected from the internal organs located in the scapular region.

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Causes of pain under the shoulder blades

Regio scapularis is the so-called scapular region, which is limited to the lines - in the upper part of the body between the unpaired spinous process of the protruding seventh cervical vertebra and the clavicles, beneath - the medial-vertical line along the lower edge of the scapula, and also the line from the armpits to the edge of the deltoid muscle . Diagnosis of pain under the scapula depends on the nature of the symptom, its location and accompanying clinical signs, since the scapular region itself can only ache with trauma - stroke, bruise.

The causes of pain under the shoulder blades may be as follows:

1. LRS - skopulokostalny, shovel-rib syndrome or muscle syndrome, which lifts the scapula. If the muscle, which is attached to the transverse processes of the upper vertebrae of the neck, is supercooled, traumatized, inflamed or overexerted, it is not able to perform its function normally-to provide a tilt of the neck and raise the shoulder blade. Symptomically, LRS - scapula-rib syndrome manifests itself in the form of aching, sometimes intense pain in the shoulder, at the top of the scapula and under it. Often the pain sensation spreads into the shoulder, the lateral part of the sternum. The most painful point is the point of attachment of the muscle, if you press on it, the pain becomes acute, radiating upward in the neck. In addition, a characteristic feature of the LRS is the sound of crunch when moving with shoulders, hands. Dynamic constant loads, as well as static stress, can create a condition in which the pain under the scapula becomes permanent, exacerbated by exposure to cold, draft. 
2. YABZH - peptic ulcer, as the most common cause, causing irradiating pain under the shoulder blades. The symptom begins with dull, aching pains that build up or weaken after taking medications, vomiting. The pain is directly related to eating, seasonal and most often radiating to the left - from epigastrium to the left scapula, to the chest and back. Pain symptom with peptic ulcer is divided into hunger, late or early pain. In addition, JBW, as a rule, is accompanied by nausea at the peak of the development of pain, vomiting - in 75-80% of cases and heartburn. 
3. Vegetative or as they are often called psychosomatic pains also come in the causes of pain under the scapula. Such feelings are similar to the signs of angina pectoris, cardiac pains, because they cause a feeling of squeezing, burning in the chest, which intensifies and radiates into the arm, under the scapula, under the collarbone, more often to the left, into the heart. The pain symptom can be both intense and aching, indeterminate in nature. The main differential sign of vegetative pain is the lack of effect after taking cardiopreparations - they do not relieve any pain or feeling of pressure. As a rule, with a vegetative-vascular attack help relaxants, sedatives. 
4. An osteochondrosis of the thoracic or cervical spine can cause a one-sided, dull, prolonged, aching pain, which most often begins at the back of the neck and extends downward under the scapula. Pain can occur in the early morning hours, increase with static load (sedentary work), with sudden movements of the body. This condition is accompanied by irradiating pain in the arm, under the scapula, paresthesia of the limb, dizziness, visual disturbances. The symptom is removed by warming up massages, ointments, a warm bath. 
5. Intercostal neuralgia is the most common cause of pain under the shoulder blades. The symptom develops rapidly and is expressed in paroxysmal, one-sided pain, surrounding the intense nature. Painful sensation is spread along the intercostal muscles, gaps and intensifies with deep breathing, coughing, sneezing, with prolonged physical exertion, walking. In the clinical sense, the intercostal syndrome manifests the palpation of the innervating site, which is uncharacteristic for cardiac pathologies, osteochondrosis. Because of the constant muscle tension, pain can spread lower - in the lower back, but more often it is manifested by thrusting sensations, burning under the scapula. 
6. The attack of angina begins with pain in the middle of the chest (retrosternal space), which spread quickly, spread to the left and give under the collar bone, in the back, under the left scapula. Pain is not always stopped by taking nitroglycerin, vasodilating drugs, which can serve as a signal of myocardial infarction. In addition, there is a distinction between the causes of angina pectoris: 
   • Strong, acute pain in the left part of the chest, under the shoulder blade is characteristic for angina of tension, when a person is subjected to physical or psychoemotional stress.
   • Drawing, aching pain can indicate an attack of rest angina, when there is no external, provocative cause for the pain symptom.
7. Causes of pain under the scapula may be associated with a serious, life-threatening condition - perforation of the stomach ulcer, which is accompanied by severe, acute pain, irradiating under the collarbone and under one of the shoulder blades. A characteristic sign of perforation is vomiting, the posture of the patient - pressed hands, knees to the stomach (embryo pose). This symptom requires immediate medical attention, as well as cardialgia.
8. Symptom of Euret or a sign of inflammation in the pericardium, accompanied by the release of exudate. The main manifestations of exudative pericarditis are chest pains, shortness of breath, high fever, fever. The pain is aggravated by the accumulation of effusion and stretching of the pericardium during coughing, the change in the body posture, the sensations can be noisy, but more often they "shoot" into the neck area, under the left scapula. The aggravation of the inflammatory process often causes a clinical picture of the "acute abdomen". 
9. Dissection of the aorta - stratification of the aortic wall (aneurysm). A condition that threatens life, accompanied by intense pain in the back, between the shoulder blades or with a shift to one of them. Most often the pain shifts to the left, gives into the arm and under the left scapula, spreading along the dissecting aorta. The most dangerous consequences of this symptom can be a stroke (if the blood flow of the carotid arteries is disturbed), a heart attack (with violation of the blood flow of the coronary arteries), mesenteric thrombosis, leg paralysis (with violation of iliac artery blood flow), spinal cord injury (with violation of the blood flow of the vertebral arteries). 
10. Herniated disc of thoracic spine. The disease is rarely diagnosed, since the thoracic region is quite stable in this sense. Constant, aching and growing pain in the area of infringement and pathological focus gradually becomes intense, often similar to the symptoms of diseases of the broncho-pulmonary or cardiovascular systems. The main characteristic sign of the hernia can be muscle tension between the shoulder blades and the apparent curvature of the spinal column. The diagnosis is confirmed by X-ray examinations, MRI. 
11. LCB is a cholelithiasis, colic can also manifest as paroxysmal, intolerable pain radiating to the right, under the scapula and above. 
12. The causes of pain under the scapula can be caused by diseases of the respiratory tract - pneumonia or pleurisy. With pneumonia, the pain is localized in accordance with the pathological focus in the tissue, if the process develops in the back, there is pain in the back, between the shoulder blades or under them. Inflammation of the pleura is also accompanied by stabbing pain between the shoulder blades, often under one of them. Pain increases with cough reflex, breathing. 
13. Myositis is an inflammatory process in muscles as a result of hypothermia, acute respiratory viral infection, or overexertion, less often due to bruises. Pain occurs suddenly in acute course, or develops gradually, has a pulling, aching character with chronic inflammation. The pain symptom is associated with movements, physical exertion, change of posture, slopes.

Symptoms of pain under the shoulder blades

Symptoms of pain under the shoulder blades are so diverse that in clinical practice there is still no single standard algorithm for differential diagnosis. Each medical specialization has its own patterns for collecting anamnesis, examination, testing, and examinations, but there are often cases when the pain symptom is "masked" and does not indicate a true cause. That is why the patient is required to describe as accurately as possible the nature of the pain, all the circumstances in which it arises. In addition, chronic pain, to which a person "has got used to" often lubricates a diagnostic picture, as a result of which time is lost and the therapeutic effect is much more difficult.

What symptoms of pain under the scapula require immediate medical attention? 

• Drawing, constant pain in the back with irradiation under the scapula, which does not subside within 2-3 days.
• Pain under the shoulder blade with static tension (sedentary work) in people over 50 years old.
• Pain giving under the scapula, growing at night or in a horizontal position.
• Pain with fever.
• Pain accompanied by numbness of arm, shoulder.
• Pain causing pressure, burning, starting from the middle of the chest.
• Pain that is not stopped by cardiac drugs, sedatives.
• Shinging pain, giving under the shoulder blade.
• Acute, severe pain with vomiting.

Symptoms of pain under the shoulder blades are most often described in this way: 

• Sharp pain in the middle of the back, giving under the left scapula. The pain appeared in the morning and intensifies with movements.
• Sharp, severe pain under the shoulder blades.
• Dull pain below the scapula, intensifying with arms raised.
• Drawing, aching pain under the shoulder blade, spreading down to the waist.
• Pain under the left shoulder blade and a feeling of squeezing in the chest.
• Pain under the shoulder blades in the form of a localized area, burning.
• The pain increases when there is a cough.
• Pain under the scapula is replaced by a burning sensation, numbness of the hand.
• Intense pain after vomiting.

Despite the variety of reasons that provoke a pain symptom under the shoulder blades, there are differential signs - danger signals, which allow an experienced physician to exclude relatively benign diseases associated with dorsalgia. Disturbing symptoms that can accompany pain in the area of the shoulder blades are the following symptoms: 

• Hyperthermia - 38-40 degrees.
• Spontaneous pain, increasing and provoking the condition of the "acute abdomen".
• Shortness of breath, cyanosis of the skin.
• Swelling of the hands.
• Pain that does not stop at rest.
• Vomiting.
• Falling blood pressure. Pulse.
• Fainting.

Back pain under the shoulder blades

Back pain in the scapula may be associated with many diseases, but most often it is caused by deformation of the spine, especially if accompanied by a feeling of numbness in the limbs, tingling in the fingers.

In addition, pain in the back under the shoulder blades is provoked by such diseases, conditions: 

• Curvature of the spine - kyphosis.
• Herniated disc in the thoracic region.
• Lateral curvature of the spine - kyphoscoliosis.
• Cardiac ischemia.
• Shoulder-scapular periarthritis.
• Intercostal neuralgia.
• The frontal curvature of the spine is scoliosis.
• Angina pectoris - tension or rest.
• Protrusion (degeneration) of the disk of the thoracic spine without rupture.
• YABZH - peptic ulcer of the stomach.
• Cholecystitis.
• Hepatic colic with concomitant dyskinesia of the gallbladder.
• Dry pleurisy.
• Pneumonia.
• Inflammation of interblade muscles, tendons, supraspinous ligaments.

Pain under the scapula on the left

The pain symptom under the left scapula can be associated with such diseases: 

1. Periodic pain under the left scapula can signal a developing stomach ulcer. The pain grows rapidly, accompanied by nausea, and then vomiting, a symptom associated with food intake or lack of it - hungry pain. The pain begins in the epigastrium and extends sideways - to the right or to the left, most often irradiating under the left breast, and under the left scapula.
2. Vegetative crises are also characteristic of left-sided pains, massaged under cardiopathy. The pain under the scapula on the left, the pulling, aching character, often causing a feeling of fear, not being controlled by nitroglycerin and other cardiac drugs is a typical sign of psychogenic conditions. 
3. Myocardial infarction most often has symptoms clearly expressed in the clinical sense - burning in the middle of the chest, pain giving to the left side of the jaw, to the hand, under the left shoulder blade, numbness of the limb, nausea. 
4. Angina pectoris - attacks of pain can develop with stress, stress (angina of tension) or as an exacerbation of chronic form (rest angina). 
5. Intercostal neuralgia is accompanied by acute pain, often surrounding the character, giving it to the right or to the left under the shoulder blade. Symptom can be strengthened by changing body posture, physical activity. The pain is removed by heating, relaxation of muscles. 
6. Osteochondrosis of the cervical and thoracic parts is also one of the reasons that provokes pain under the left scapula. The pain symptom is accompanied by dizziness, nausea, numbness of the hands or one arm. 
7. The perforation of the ulcer is an acute condition, which is expressed in very severe pain, radiating to the clavicle area, under the scapula. In addition to intense pain, the patient is characterized by a pose with knees pressed to the stomach, cold sweat, cyanosis, drop in blood pressure, pulse.

See also: Pain under the left scapula

Pain under the scapula on the right

The pain symptom manifested under the right scapula is associated with such diseases: 

• Biliary colic with spasm of the bladder, ducts due to obstruction by calculi. The pain is sharp, cutting, localized under the right rib and giving back under the shoulder blade. 
• The pain under the scapula on the right can be provoked by a diaphragmatic abscess. The symptom is very acute, it intensifies with inhalation, not even deep, irradiating more often to the right. 
• Pyelonephritis in acute form begins with pain in the lumbar region, which subsequently spreads higher and is given under the right scapula. Purulent process in the right kidney is accompanied by painful urination, increased body temperature. 
• Myofascial syndrome is also the cause that causes pain under the scapula on the right. These are chronic muscle pains associated with irritation of certain trigger points. 
• Among the factors that provoke a pain symptom under the right scapula, sometimes there is also herpes - shingles. It is a viral disease not considered life threatening, however it causes very strong, painful pains, burning sensation of numbness. Herpes is typically a rash, itching, muscle pain, giving off under the shoulder blade. 
• Osteochondrosis is one of the reasons that often provokes irradiating pains under the scapula, including the right one. 
• Right-sided pneumonia. Pain in pneumonia is most often manifested in the acute stage, may be fever, fever.

See also: Pain under the right scapula

If the pain passes under the shoulder blade

Any pain symptom that "gives away" is called irradiation. The impulse of visceral pain can be so intense that the irritation of the primary nervous branch is rapidly transmitted along the chain into the terminal branch, that is, far from the original source. Pain gives under the scapula most often from an organ that is affected by inflammation and can be provoked by such causes: 

• Increased pressure in the intestines during inflammation, ulcerative process. The postbulbar department of the duodenum under the ulcer radiates to the right under the scapula.
• Biliary colic (gallbladder, liver).
• Sharp pain gives under the left scapula and with an attack of angina, when there are sensations of pressure, compression.
• Pericarditis can also manifest as reflected pain under the shoulder blades.
• Stratification of the walls of the aorta (aneurysm) is manifested by severe retrosternal pain with irradiation into the neck, to the left side, the shoulder, under the scapula.
• Pneumothorax (spontaneous) - acute pain in the chest with a reflection under the scapula, in the area of the scapula.
• Exacerbation of pancreatitis.
• Renal colic.
• Acute musculoskeletal dorsalgia.
• Myocardial infarction.
• Osteochondrosis of the cervical spine.

Reflected pain can be transient, but it can also signal that an acute condition develops that requires immediate medical attention. If the pain is given under the scapula and is not stopped by spasmolytics, heart medications, you should consult a doctor who will conduct the examination, differential diagnosis and prescribe adequate treatment.

Pain under the shoulder blades for inspiration

The pain symptom under the scapula, which increases with inspiration, is a signal that is characteristic of the following pathologies:

• Dry pleurisy - an inflammatory process in the pleura, the shell of the lungs. Pain can increase with tilts, movements, abate horizontally or on the side. The accumulating fluid in the cavity of the pleura provokes swelling and pain under the scapula when inhaled. 
• Pericarditis is an inflammatory process in the pericardial pericardial bag, the disease manifests itself as weakness, chest pain, which becomes more intense with inspiration. 
• Pain under the shoulder blades with deep breath can testify to intercostal neuralgia, which manifests itself in the form of girdling pains, which seem to tighten the chest. 
• Diseases of the gallbladder, spasm, colic, can also be accompanied by a pain symptom associated with inhalation. 
• Renal colic (pyelonephritis, kidney abscess) can also be accompanied by pain in the hypochondrium, so intense that it spreads throughout the epigastric region, renders under the scapula and intensifies with inspiration.

Aching under the scapula

The aching pain under the scapula is evidence of a chronic process in both muscle tissue, in the spine, and in the internal organs, which can signal their pathologies with reflected pain.

Spade-rib syndrome - LRS is the most common cause of aching pain. This syndrome is characterized by vegetative pains - aches, aching sensations, dull pains, which are often associated with weather conditions. In the clinical sense, aching pain under the scapula is not a specific sign of a particular disease, therefore, pain differentiation should be carried out by the method of exclusion of threatening conditions. Often, the aching nature of pain in the region of the scapula can serve as the first signal of an attack of angina of rest, also myocardial infarction, which does not always have a clearly expressed clinical picture, can be such a symptom. However, the main factors that provoke aching pain are osteochondrosis, scoliosis, kyphosis and other degenerative, dystrophic pathologies of the spine.

In addition, aching pain under the scapula can be caused by psychogenic factors, vegetative crises, fibromyalgia. The most alarming symptom is accompanied by nausea and vomiting, as this may be the onset of an exacerbation of a stomach or duodenal ulcer.

Severe pain under the scapula

Intense severe pain under the scapula - left or right - is an occasion to seek medical help, often such a pain symptom can not be stopped independently, and it can also indicate life-threatening conditions. Severe pain under the scapula can be provoked by such diseases: 

• Dagger, sharp, shooting pain, which is amplified during inspiration, reflected in the shoulder, may be a sign of spontaneous pneumothorax. Additional clinical symptoms of pneumothorax are rapidly developing shortness of breath, tachycardia, a drop in arterial pressure, a slowing of the pulse, an increase in (compensatory) veins on the neck. 
• Severe pain, which irradiates under the scapula and is accompanied by hypertension, indicates an exacerbation of the osteochondrosis of the thoracic spine. Simultaneous back pain under the scapula, headache and a jump in blood pressure are a clear symptom of infringement of nerve endings in the cervical or thoracic region. The pain can be strengthened by turning the body, shoot at inclines or movements and is not stopped by cardiac drugs, sedatives. 
• Severe pain under the scapula can be associated with perforation of the ulcer of the upper stomach. If the perforation progresses quickly, the pain intensifies with every minute, the overall clinical picture of the ulcer is typical - acute pain with irradiation, possible vomiting, cold sweat, cyanosis of the face, characteristic postures - podzhatye knees to the chest. 
• Hepatic (bilious) colic also manifests itself with severe pain, giving upwards to the right, under the scapula, in the neck and even in the region of the right eye. Painful symptom is associated with blockage of the bile duct after taking fried, fatty foods. 
• Purulent process in the area between the diaphragm and the organs located below, subdiaphragmatic abscess is an acute condition requiring immediate medical attention. Developing bacterial infection in this form can trigger general intoxication, sepsis. In fact, it is a purulent peritonitis, limited by a diaphragm, manifested by severe pain in the hypochondrium, with irradiation to the right - the shoulder, under the shoulder blade. Also, typical hyperthermia is up to 40 degrees, febrile state, nausea.

A strong irradiating pain symptom is not recommended to be tolerated for more than an hour, if by available means it can not be stopped, it is necessary to call emergency help.

Dull pain under the scapula

The nature of pain under the shoulder blades can vary from aching, blunt to very intense, acute. Dull pain under the scapula indicates that the cause is most likely associated with the muscular system, tendons and ligaments.

In clinical practice there are data confirmed by long-term observations: 

• 85-90% of all pain symptoms in the back and shoulder area are due to inflammation, stretch, muscle damage and tendon-ligament apparatus. As a rule, these pains are dull, aching.
• 5-7% pain symptoms in the back, under the shoulder blades, in the scapula area are associated with neurological pathologies (radicular syndrome). This intense, acute pain.
• 3-4% due to other causes - diseases of the respiratory system, heart, gastric tract, biliary pathology. The pain is usually intense, acute and requires immediate medical attention.

Dull pain under the scapula is most often a reflex, vertebrogenic syndrome, for which characters are such signs: 

• The pain has a clear localization - under the right or left scapula, in the middle of the back between the shoulder blades.
• The pain does not radiate in the limbs, other parts of the body.
• The pain is dull, aching.
• The pain symptom is amplified by physical stress on the damaged muscles, ligaments.
• The pain site is painful when palpated.
• Absence of symptoms of abaissement of the disc and compression (radicular syndrome).
• Absence of vegetative-vascular disorders.

Typical causes that provoke whining, dull pain under the shoulder blades are the degenerative process in the intervertebral discs (osteochondrosis) of the cervical region in the C5-C7 zone. In addition, dull pain can be a consequence of the inflammatory process in the intervertebral joints, a signal of the developing severe pathology - Bechterew's disease (ankylosing spondylitis). Often the stupid nature of pain is a sign of arthrosis, a hidden trauma of the intervertebral joints, spondylosis, scoliosis.

Among the reasons that provoke a painful symptom under the scapula of a dull, dull character, there are diseases of the internal organs: 

• Pleurisy.
• Bronchitis in chronic form.
• Pneumonia in chronic form.
• Atony of the gallbladder is dyskinesia of the hypotonic type.
• Chronic pyelonephritis (sclerotic process of kidney tissue).
• The oncological process in the liver, pancreas in the initial stage.
• Also, dull pain under the scapula on the left often signals a developing cardiovascular pathology - pericarditis, myocarditis.
• The pain symptom grows gradually, increases in stressful situations, with concomitant infectious and viral diseases. Also often manifested and hidden bronchitis in the atypical form, pneumonia, when the pain increases only with a cough or, if it goes to sleep on the "unhealthy" side.

Sharp pain under the scapula

The sharp nature of the pain in the area of scapula, underneath them indicates a serious, sometimes life-threatening condition.

The reasons for causing severe pain under the shoulder blade may be as follows: 

• The dissecting wall of the thoracic aorta (aneurysm). The pain is sharp, intense, radiating over the spine, most often to the left, to the shoulder, under the scapula.
• The initial stage of pleurisy. Pain sharp, acute, intermittent, often localized under the right or left scapula in the zone of fluid accumulation in the pleura. If pleurisy is accompanied by intercostal neuralgia, the pain acquires a shingling character.
• Spontaneous pneumothorax, which manifests as a sharp pain under the scapula (reflected from the chest). The condition is characterized by severe shortness of breath, acrocyanosis.
• Attack of acute pancreatitis. The disease is accompanied by a sudden sharp pain in the epigastrium with a reflection to the left in the chest, in the shoulders, in the heart area, under the scapula.
• Myocardial infarction is most often characterized by increasing pain, but it can manifest a sharp, intense, rapidly spreading chest pain, radiating to the left in the shoulder, jaw, under the scapula, in the back.

Pain behind the shoulder blades

The pain behind the shoulder blades, between them, as a rule, is not intense, so the person does not pay attention to the symptom, considering it temporary, transitory. The untimely determination of the cause, the factor provoking such pain, can lead to the development of chronic, difficult to treat diseases.

Persistent, persistent pain between the shoulder blades, under them is most often caused by muscle tension, which in turn is explained by professional specifics - sedentary work in the office, behind the sewing machine, at the wheel of the car and so on. Usually, the pain behind the shoulder blades is not associated with life-threatening pathologies and even with dystrophic changes in the spinal column, since the thoracic region does not have mobility, it is stable enough, stable. More often disturbances, changes, less often - inflammations, concern the muscular system of the interblade area, ligaments and tendons can also be stretched.

Pain of this type, associated with the muscles, is characterized by a sense of gravity, tension, which quickly pass with active movements (exercises) massage or warming up.

Pain, which is caused by damage, stretching of the tendons, is felt differently, it causes a feeling of ache under the shoulder blades, often a pain symptom is reflected in the heart area. Also, a person complains of numbness of hands, a sensation of tingling, "crawling crawling." Neutralize this pain with cardiac drugs is not possible, but you can get rid of it and it's quite simple: 

• Periodically change body posture, preferably every half hour. If the work is sedentary, you need to stand up, walk around, do circular movements with your hands, shoulders, bring together and dilate the shoulder blades. 
• It is advisable to give 20-30 minutes daily for stretching exercises of the muscles of the interlopar zone, and for the general muscle tone of the body. Regular exercises will help prevent muscle spasms and pain behind the shoulder blades.
• It is necessary to periodically massage the shoulder-lobe zone, the collar zone.
• Periodically you can perform the following exercise: put a small (tennis) ball on the floor, lie on top of his back and "ride" on the ball, passing it vertically and between the shoulder blades.

If the pain symptom on the side of the back under the shoulder blades is accompanied by a cough, subfebrile temperature, the pain increases with breathing, a cough reflex, the doctor should be consulted, examined to exclude the diseases of the broncho-pulmonary system.

Drawing pain under the shoulder blades

The pulling character of the pain is most often due to the increased muscle tone due to the infringement of the nerve roots. The cause, by which the pulling pain develops under the shoulder blades, may be myofascial syndrome, as well as osteochondrosis of the cervical spine, less often the intervertebral hernia with protrusion.

Degenerative changes that reduce the height of the intervertebral openings, provoking the displacement of the vertebrae to the right or left, are accompanied by the inevitable infringement of nerve endings. In contrast to intercostal neuralgia, characteristic acute symptoms, shingles, dystrophic pathologies of the spine develop more slowly and are accompanied by aching, pulling, constant pain.

In addition, the pulling pain under the shoulder blades can be provoked by the scapulostenal, scapula-rib syndrome - LRS. In addition to painful sensations, a person clearly hears a specific sound - a crunch. Also for LRS are typical reflected pain that spreads to the shoulder, neck, often to the nape. The course of the disease is long, it recurs, but the prognosis is quite favorable.

Pain under the scapula when moving

Strong, intense pain, which increases with movement or breathing, indicates the compression of the nerve roots. Compression is caused by muscle spasms, hernia, protrusion and provokes pain under the scapula when moving.

The causes of such pains are most often associated with diseases, conditions: 

• Neuropathy of the thoracic and suprathiopathic nerve as a result of overexertion (sport), trauma, viral disease.
• Intercostal neuralgia, typical signs of which are sharp, girdling pain, aggravated by movement, interfering with breathing, inclinations. Pain is paroxysmal one-sided, during the peak of pain a person "freezes", it is difficult for him to inhale. Intercostal neuralgia is the result of neglected, timely, chest osteochondrosis. The thoracic zone of the spine is stable, the deformation of the discs develops for a long time and is accompanied by unexpressed periodic blunt pains, which can also increase with movement. Due to the nonspecific symptoms, not expressed pain, osteochondrosis of the sternum is often "masked" for the symptomatology of other diseases - cardiac, broncho-pulmonary. The acute stage of the disease is a compression of the intercostal nerves, in which the intensity of pain depends on the position of the body, motor activity. 

Any reflected pain increases in motion. Irradiating pain is associated with diseases of the lungs, heart, gastrointestinal tract, gallbladder. Similar symptoms require differential diagnosis.

Constant pains under the scapula

If the pain is permanent, it is a direct evidence of the developing inflammatory process, either in musculoskeletal tissue or in internal organs.

Causes that cause constant pain under the scapula: 

• Osteochondrosis of the cervical spine, which is accompanied by a constant, dull, one-sided pain. Sensation of aching pain begins with the lower part of the occiput, pours down into the middle of the back and shifts towards the deformed vertebrae, reflected under the shoulder blade, less often in the arm. The pain can periodically abate when warming up, massage.
• The beginning of intercostal neuralgia may not be typical, and not accompanied by acute symptoms. Constant pain sensation, burning under the scapula may indicate the osteochondrosis of the thoracic region, which in the stage of exacerbation passes into the intercostal neuralgia, that is, in the compressive compression of the nerve roots. 
• Muscular hypertonia due to chronic static stress is also expressed as permanent back pain, under the shoulder blades. This symptom is typical for many professions associated with monotonous movements or poses - drivers, office workers, students. 
• Constant pains under the scapula may indicate inflammation of the hollow organ located in the zone of the scapula. Such pains are often the first signal about the stomach ulcer, perigastritis. 
• Constant intense, shrouding pain, reflected under the scapula is also characteristic for herpes zoster - herpes zoster, herpes. Pain begins with the chest and lasts until the underlying cause is neutralized.

Pain when coughing under the shoulder blade

• Pain when coughing under the scapula, in the back is a typical sign of bronchopulmonary diseases. 
• Pleuropneumonia is a complex pathology, accompanied by intense or aching pain, depending on the stage of development. Pain increases with a cough reflex.
• Tracheitis (inflammatory process in the mucosa of the trachea). The pain begins with the upper, middle part of the chest, can be irradiated in the back, under the scapulae when coughing. The nature of the pain symptom is sharp, stitching, if the cough subsides, the symptom also becomes less intense.
• Tuberculosis is the infectious pathology of the broncho-pulmonary system, in which the symptoms can develop both long-term and fast. The main visible sign of tuberculosis is persistent cough within 1-1.5 months with sputum, hyperthermia, chest pain. If the disease is unilateral, the pain is worse when coughing and is reflected in the back, under the shoulder blade.
• Oncological process in the lung, malignant tumor. Pain is evidence of a late stage of the process, often terminal. Reflection of pain can be in the shoulder girdle, in the neck, in the back and under the scapula. Painful sensations increase with coughing, deep breathing.
• Pain when coughing under the scapula can accompany and croupous pneumonia - acute, life-threatening condition, in which there is a very high body temperature, stitching pain, coughing up, lack of air.

Stitching pains under the scapula

The feeling of stitching pain in the back, under the shoulder blade is most often due to the inflammatory process in the pleura, especially if the inter pleural ligament is shorter than normal. Cough in the syndrome is frequent, light, but permanent. Cough, as well as stitching pain under the scapula in this condition, increases during a conversation, a deep breath or exhalation, as well as with loads, sometimes minor. Pain tingling symptom can increase with prolonged walking, while running.

More often than not, the character of the sensations is not considered a sign of serious pathologies, often such pains pass without treatment, independently. However, a systematic tingling under the scapula, which does not disappear within 2-3 weeks, is the reason for going to the doctor.

As a rule, stabbing pains are not caused by diseases of the bone or muscle system, are not associated with the spine. The most common cause of such signs are broncho-pulmonary, cardiac and neurological diseases. In addition, the factors that cause tingling in the scapula area can be the following pathologies: 

• Beginning perforation of the stomach ulcer.
• Vegeto-vascular syndrome.
• Osteochondrosis of the cervical spine with infringement of nerve roots without protrusion, hernia.
• Intercostal neuralgia in the initial stage.
• Atypical development of myocardial infarction.
• Spasmodic bile ducts.
• Atypical course of pyelonephritis.

Stitching pains under the scapula require careful differential diagnosis, so the pain, accompanied by nausea, hyperthermia, irregular blood pressure, should not be ignored. It is necessary to undergo complex diagnostics and find out the cause of pain.

Pain and burning under the shoulder blade

Burning is a characteristic sign of a deformed spine, because most often (80-90%) pains in the back are associated with the musculoskeletal system.

• One of the most common causes that provoke pain and burning under the shoulder blade is osteochondrosis of the cervical, less often of the thoracic spine. The pain begins with the neck and spreads in the form of a burning, aching sensation down, often under the scapula area. This is due to the compression of the nerve roots by the offset processes of the vertebrae. The pain is usually not intense, constant and varies depending on the position of the body, movements. 
• In addition, burning under the scapula can be caused by an attack of biliary (hepatic) colic, blockage of the bile ducts. 
• Renal colic, exacerbation of pyelonephritis quite often irradiate under the scapula and are accompanied by acute, burning pain. Such symptoms are very intense, especially with a drop in blood pressure, and therefore require emergency care. 
• Pain and burning under the scapula - this is one of the signs of reflux esophagitis in the stage of exacerbation. 
• Intercostal neuralgia is often accompanied by a feeling of tingling, burning in the zone of infringement, girdling with pain, giving in the heart, in the back.

Pain with a sigh under the scapula

The pain symptom, which increases with inhalation and localized under the scapula, can be caused by such diseases: 

• Stretching of muscles, ligaments of the interblade area, pain of overexertion.
• Renal colic, which is often manifested as an upward bulging pain, which increases with deep breathing. Most often such a symptom develops in the right hypochondrium zone, spreads up, then gives back, back.
• Pain when inhaled under the scapula is a typical sign of intercostal neuralgia, when the character of the pain is so strong that the person literally freezes. Each breath brings an intolerable, sharp pain.
• Pain that occurs with deep breathing, often inhaling, radiating in the back, in the area of the scapula, may indicate an exacerbation of cholecystitis, biliary colic.
• Often a factor causing such a pain can be trauma, both visible and hidden. Fracture of the ribs is not always accompanied by strong pain, often a bruise is accompanied by a fracture, but a person suffers discomfort. The only sign of latent damage to the rib that gives under the shoulder blade can be pain when inhaling and coughing.

Tinea pain under the shoulder blades

Paroxysmal, shingles under the shoulder blades is a typical symptom of intercostal neuralgia. Compression infringement of nerve endings with deformed vertebrae (discs) provokes severe pain, which can begin on one side of the body and move as if along a circle along the intercostal spaces. The symptom is reflected in the lower back, in the back, accompanied by difficulty breathing and intensified with an awkward turn, slope, physical activity. Also, pain can build up under stress.

The shroud, irradiating in the back, scapula pain, can serve as a signal of exacerbation of pancreatitis. This condition is characterized by severe pain, fever, cold sweat, cyanosis of the skin.

Perforation (perforation) of the stomach ulcer (cardial wall part), as a rule, irradiates the pain in the subclavian area, but can often manifest itself as shingles.

It should be noted that for spinal pain there are no precise diagnostic criteria, therefore any pain, especially acute, which lasts for several hours, requires urgent medical care.

Burning pain under the scapula

Burning pain under the scapula is a sign of osteochondrosis, infringement, compression of the nerve roots. Often, such pain disguises as cardialgia, especially it resembles restless stenocardia or clinical manifestations of myocardial infarction.

How to distinguish what the burning pain means under the shoulder blade?

Attack of angina pectoris: 

• The pain is pressing, compressive, spastic.
• The pain symptom is localized most often in the chest area, on the left, it can spread higher, reflected under the scapula, in the arm, in the jaw, in the neck.
• An objective external cause provoking pain is stress, emotional tension, physical stress.
• Pain rarely lasts more than 15 minutes.
• The pain symptom is stopped by the intake of nitroglycerin, other cardiac drugs (after 5-10 minutes).
• The pain can calm down at rest.
• The pain does not depend on the movement.

Burning pain under the scapula when infringed is directly related to movement, activity, posture, and does not subside after the application of cardiac drugs. It is stopped by non-steroidal anti-inflammatory drugs, straightening of the spine, in other ways.

Pain in the spine under the shoulder blades

Most often, the pain in the spine under the shoulder blades is not really related to diseases of the bone system, that is, the vertebral column. The most common causes of such pain are caused by neuralgia, myalgia. A number of compression-ischemic conditions, diseases of the peripheral nervous system, intercostal neuralgia and other factors are the root cause of painful sensations under the shoulder blades in the spine.

The list of possible factors associated with the stretching of the tendons, muscles, inflammation of the nerves: 

• Plexitis is a neuropathy of the brachial nerve. This inflammatory process in the nerve plexus, which calls for the destruction of the muscle tissue of the interblade area, reduces the sensitivity of the skin on the surface of the shoulder, the median nerve. Clinically, the nerve of the brachial plexus manifests itself in the paresis, peripheral partial paralysis of the hand due to atrophy of the inner humerus, deltoid and biceps, the arm can hang like a whip, the pain is spontaneous, piercing, giving under the shoulder blade.
• Intercostal neuralgia, which is typical of a sharp girdle of pain, which is most often one-sided, spreading around the chest. Pain in the spine under the shoulder blades is often the peak of the disease, it is so intense that it is difficult for the patient to breathe in.
• Compression of the dorsalis scapulae - the dorsal nerve of the scapula, which innervates the rhomboid muscles, the muscle that controls the movement of the shoulders, the shoulder blades.

Check, determine what caused the pain in the spine under the shoulder blades yourself is quite difficult, but the primary differentiation can be done. A typical sign of neurologic diseases of the interlopar area is a painful sensation in the "pose of Napoleon" - the crossing of arms in front, on the chest. If the pain is accompanied by an increase in temperature, a drop in blood pressure, tachycardia, a general severe condition, do not self-diagnose and treat, you should immediately call a doctor.

Pain in the muscles under the scapula

In order to determine what causes the pain in the muscles under the scapula. It is necessary to accurately describe the nature of pain, all accompanying symptoms. As a rule, muscular pains in the upper back are distinguished by depth, pulling, aching character, any shooting pain is a sign of infringement of nerve roots, and not inflammation of muscle tissue. The muscular symptom can arise spontaneously, without visible explanatory reasons, but more often it develops against the background of fatigue, after physical exertion or static tension of the body. The reason, which can be a factor provoking pain in the muscles under the shoulder blade: 

• Overexertion of muscles of interblade area. This is a typical professional syndrome associated with performing a monotonous work or a static body posture. Drivers, office workers, students, all those who during the day are forced to sit in the same position, perform repetitive actions with one hand (painters, builders), sooner or later face muscle pain in the back and between the shoulder blades. Also, a similar sign may appear in pregnant women, whose spine is subjected to increased stress due to changes in posture (increases abdomen), weight gain.

Myositis is an inflammatory disease accompanied by pain in the muscles. The cause of myositis can be such factors: 

• Drafts, severe hypothermia of the back, neck.
• Chronic tension of muscles of a professional nature.
• Injury of back, including concealed (bruised).
• Acute respiratory infections (ARI, ARI).
• Overexertion due to increased training (sports), illiterate distributed load, improperly performed preliminary warm-up.

Myositis is one of the most harmless causes of pain in the scapula, pain symptom with massage, hot rubbing, taking anti-inflammatory drugs. Myositis is more dangerous, accompanied by a purulent process in the muscles, this is associated with an acute infection that can provoke an abscess, an abscess in a certain area of the back. This condition is characterized by an increase in body temperature, intense pain, redness, swelling in the place of accumulation of pus. Purulent myositis is treated with both conservative methods and with small surgical intervention.

Pulsating pain under the scapula

Ripple in the back, under the shoulder blades, can be associated with causes that do not threaten life, but it can also be a sign of a developing serious illness. Periodic pulsating pain under the scapula is most often due to bulging out of the disc, its loss from the contours of the contour of the vertebral body, the developing compression of the nerve endings. It should be noted that the protrusion is the initial stage of the intervertebral hernia, when the fibrous ring remains intact, does not collapse, but the process of its destruction has already begun. The protrusion of the disc, which can be stopped and prevented from developing, is manifested by periodic shooting pains or pulsations in that part of the back where the displacement occurs. The protrusion of the vertebrae of the thoracic spine, PMD (protrusion of intervertebral discs) may eventually transform into an intervertebral hernia, which in turn manifests itself with intense pain and heavier symptoms. The etiology of protrusions is associated with degenerative processes in the spine with osteochondrosis, and the factors that contribute to the development of deformation are known to many of us: 

• A sedentary lifestyle, physical inactivity, static tension of the body.
• Professional risks - sport, specialization features.
• Age over 50 years.
• Irrational nutrition (excess salts).
• Excess body weight.
• Harmful harmful habits - alcohol abuse, smoking.
• PMD - protrusion of the intervertebral discs of the thoracic region is manifested by pulling pains in the initial stage, with the development of the disease, the pain becomes intense, radiating to the area of the scapula, causing a sensation of pulsation.

Pulsating pain under the scapula is the beginning of irradiating pain, when the transmission of a nerve impulse occurs pointwise, gradually. Painful sensations are tolerable, but require differential diagnosis, since pulsation can be associated with atypical development of pathological processes in the internal organs - lungs, heart, stomach, gallbladder.

Pain under the scapula after vaccination

Prophylactic vaccinations are one of the most innocuous causes that provoke pain in the back, in the area of the shoulder blades.

Pain under the scapula after vaccination is usually associated with vaccination against diphtheria. Often the site of the injection swells, the skin is hyperemic, the area under the shoulder blade hurts. However, this condition does not last more than 2-3 days, usually on the second day all discomfort phenomena subsided.

Pain under the scapula after inoculation is due to the body's response to the introduced strains, viruses, bacteria, which are used to "teach" the immune system to resistance to harmful microorganisms. The vaccines introduced consist of weakened agents, so you should not be afraid of complications. Local reaction in the form of pain under the scapula - this is absolutely normal phenomenon, which indicates that the process of "dating" took place. Do not grind, wet the area in the scapula, lubricate it with anesthetics or apply warming procedures. As a rule, before vaccination the doctor conducts explanatory work and informs the person in detail about possible unpleasant complications and actions in such cases.

Pain under the scapula during pregnancy

The period of pregnancy is often accompanied by atypical sensations for the expectant mother. These conditions are caused by hormonal changes, as well as an increase in the uterus and a shift in the surrounding organs. Also, the cause that can cause pain under the scapula during pregnancy is often excessive load on the spine. If before the conception a woman had an anamnesis of osteochondrosis, the pregnancy will only aggravate the deformation of the discs and provoke periodic pain in the back, under the shoulder blades.

In addition, the factors that provoke pain in the scapular region can be: 

• Intercostal neuralgia, worsening on the background of catarrhal diseases, stress, physical activity.
• Hidden pneumonia or pleurisy.
• Stretching of the ligamentous apparatus, which is associated with increased production of a specific hormone - relaxin.
• The shift of the center of gravity forward (the stomach increased), the tension of the muscular system.
• Rarely - exacerbation of pyelonephritis.

It should be noted that the transient pulling pain under the scapula during pregnancy is often not a threatening symptom, because every woman before registration takes a comprehensive examination and then is subject to constant follow-up. Pre-traced ultrasound, x-ray or fluorography, blood tests, urine and so on, enable the gynecologist to anticipate possible complications and take action in advance. As a rule, implicit, pulling back pains under the scapula pass after the 20th week of pregnancy, in other cases, a woman should consult a doctor and go through additional diagnostics to avoid unnecessary anxiety.

Sharp pain under the scapula

Acute pain symptoms develop suddenly and differ in intensity, increase in pain. Acute pain under the scapula can be associated with such diseases: 

• Biliary colic, an attack of acute cholecystitis. The pain "starts" in the right side under the ribs, wears an acute girdle and is reflected in the right shoulder, under the scapula, neck, often in the lower back. Symptom is caused by a narrowing of the bile ducts, their obstruction by an advancing stone. The cause of this condition can be both the reception of fatty, fried foods, and infection, nervous or physical overwork.
• Acute pain under the scapula can become a signal penetrating ulcer of the stomach ("covered" perforation) with spikes that spread into the pancreas. The disease is accompanied by a constant pain, periodically increasing acute pain, often girdling, reflected in the upward under the scapula or down into the lower back.
• Intercostal neuralgia, which is characterized by acute pain, girdling, and shooting. Pain is aggravated by movement, slopes, and physical exertion.

Diagnosis of pain under the scapula

Diagnosis of pain under the scapula is a complex and complex task, since this symptom is not specific and may indicate a number of similar clinical manifestations of diseases.

The main steps, which involves differential diagnosis of pain under the scapula: 

• Anamnesis.
• Determination of the nature of pain from the patient's words and objectively.
• Measurement of blood pressure, pulse.
• Palpation of the back, interscapular area.
• Conducting orthopedic tests.
• Detection of concomitant symptoms.
• Exclusion of acute conditions, life-threatening diseases.
• Exception or confirmation of psychogenic etiology of pain.
• Referral to a specialist for additional examinations - x-ray of the chest, spine, CT, MRI, ultrasound of the heart, cardiogram, bronchoscopy, FGD, blood, urine and so on, depending on the specific disease.

It should be remembered that the diagnosis of pain under the scapula is the prerogative of the doctor, not a single reference book, the source can not help a person accurately determine the source of the pain symptom, establish his specific cause in absentia.

Treatment of pain under the scapula

The task, which solves the treatment of pain under the shoulder blade, is not limited to the relief of pain symptoms. Of course, acute pain requires anesthesia, cupping, as well as life-threatening conditions - perforation of the ulcer, myocardial infarction, spontaneous pneumothorax and others.

But the main goal in therapy is the elimination of the underlying cause, therefore, the treatment of pain under the shoulder blade directly depends on the results of diagnosis, the patient's condition, his age, and accompanying pathologies.

This is due to the lack of specific recommendations under this article about the treatment of pain under the shoulder blades, the amount of self-help that could be used at home is very limited.

If the pain in the area of the scapula is associated with myalgia, muscle overstrain, it can be removed at home using a reasonable load, performing a set of exercises, warming up, warming up the muscles.

All other conditions caused by diseases of the internal organs require the presence of a physician who will choose the method and method of treating pain under the scapula and the underlying disease. Therapy can be both conservative and operative, for example, in case of perforation of the ulcer or blockage of the bile ducts. In addition, various procedures can be prescribed, such as reflexology, massage, warming, possibly stretching the spine.

It is necessary to pay attention to the alarming, menacing symptoms that signal the urgent conditions, they include: 

• Angina pectoris.
• Gastrointestinal erosive processes.
• Broncho-pulmonary diseases.
• Myocardial infarction.
• All cardiopathology.
• Pyelonephritis, renal colic.
• Spontaneous pain under the scapula, acute nature.
• Pain behind the breastbone, giving in the back, in the area of the scapula, not stopping with the intake of cardiac drugs.
• Pain provoking loss of consciousness.
• All syndromes accompanied by high fever, vomiting, irregular blood pressure, dyspnea, slowing of the pulse or its acceleration.

The treatment of pain under the scapula can be quite successful with timely diagnosis and compliance with all medical prescriptions.

Prevention of pain under the scapula

It is impossible to provide concrete recommendations that would concern preventive measures against pain under the shoulder blades, since such pain symptoms can be associated with multiple diseases. Accordingly, the prevention of pain under the scapula is all possible measures that prevent the underlying disease, which is diagnosed by a doctor.

In fact, the task of preventive actions is to prevent relapses of pain, reduce the risk of exacerbation of the revealed pathology.

In addition, if the symptom is associated with a neurological factor, muscle spasms, prevention of pain under the scapula are simple rules: 

• Control of static tension, performing a variety of exercises that help relieve muscle tension.
• Regular exercise, maintaining a muscular corset in a tone.
• Avoidance of hypothermia, drafts.
• Visiting of sessions of massage, physiotherapeutic procedures.

Pain caused by osteochondrosis is also prevented by a reasonable motor load, by performing a complex of exercise therapy, by taking certain drugs that restore the structure of bone, cartilaginous tissue.