Painful sensations under the scapula - this symptom can be encountered by adults suffering from diseases of the musculoskeletal system or pathology of internal organs, and children who simply did not calculate the physical activity or stood in a draft.
Self-administration of painkillers when subscapularis pain occurs is absolutely unacceptable: such painful sensations can be a sign of life-threatening conditions.
At the same time, attention and, often emergency medical care, deserves not only acute soreness, but also a dull pain under the left shoulder blade.
The nature of the pain and the accompanying symptoms help to suggest a particular disease. However, only a qualified doctor, based on the patient's complaints, will be able to understand the damage to which particular organ caused the pain, prescribe the necessary diagnostic examination and, if necessary, provide emergency assistance.
Causes of pain under the left shoulder blade in the back from the back
The proximity of the lungs, heart and spine, as well as an extensive network of nerve fibers, expands the list of possible causes of subscapularis pain. In this case, each disease is characterized by other specific signs, and the nature and duration of pain sensations also change.
Pathology of the musculoskeletal system and nerves
Diseases of the spine and the muscular frame of the back are a common cause of subscapularis pain on the left. Pain in such diseases is often one-sided.
- Osteochondrosis - the formation of osteophytes in the thoracic or cervical spine provoke pulling pain on the left or right, starting from the neck and upper back, and ending with irradiation into the arm. The pain does not go away at rest, often prolonged but bearable.
- Intercostal neuralgia - accompanied by intense pain spreading throughout the intercostal space and aggravated by breathing, turning, sneezing / coughing. Often, with neuralgia, the sensitivity of the skin over the source of pain also changes. Neuralgia provokes paresthesia in the form of goose bumps, while numb pain under the left shoulder blade often occurs with myocardial infarction, angina pectoris.
- Scapular-rib syndrome - is a "reward" for hard physical work or activities associated with a long stay in one position (office workers). People complain of non-intense dull pain localized between the neck and shoulder, radiating under the scapula.
Important! The causes of pain under the left shoulder blade from the back from the back, which radiates into the arm and is of a pressing nature - osteochondrosis and angina pectoris - have a distinctive feature. With angina pectoris, pain lasts up to 30 minutes, with osteochondrosis - several days. In addition, an attack of angina pectoris is stopped by Nitroglycerin or other cardiac drugs.
Sometimes subscapularis pains are provoked by myositis (at the same time stiffness of movements and tension of certain muscle groups are observed), injuries of the scapula (acute pain, always preceded by a fall, blow, etc. ) or oncology (pain can occur periodically, not intense). Tuberculosis of the bones, namely, the defeat of the scapula, cannot be ruled out.
Diseases of the heart and blood vessels
Cardiac pathology is one of the most dangerous that can be diagnosed when a patient complains of subscapularis pain. At the same time, pain in heart disease does not always begin on the front surface of the chest (behind or to the left of it). The cause of pain under the left shoulder blade, in the area of the heart can be:
- Angina pectoris - pressing soreness behind the sternum extends under the left scapula and collarbone, into the jaw and arm. The intensity of the pain decreases at rest, but the change in body position does not bring relief. With scapular-costal (vertebrogenic) syndrome, the situation with increased pain is fundamentally the opposite. The attack of angina pectoris is leveled by taking Nitroglycerin, with vertebral pain, manual therapy is excellent.
- Myocardial infarction is an acute, growing pain in the heart with a characteristic irradiation to the left (including under the scapula) is not stopped by cardiac glycosides. The patient experiences severe fear, which is not the case with damage to the spine and nerve fibers. Immediate hospitalization required!
- Hypertensive crisis - often accompanied by pressing heart pain radiating to the left shoulder blade. The cause of pain is easily determined by measuring a / d.
- Pericarditis - with this disease, the pain subsides at rest and when the trunk is tilted forward. Soreness arises in the area of the heart in front, radiates under the scapula, but not as intense as in acute myocardial ischemia (angina pectoris, heart attack).
- Detachment, aortic aneurysm is a dangerous condition characterized by throbbing pain under the scapula. The rapid increase in pain requires an urgent call of the medical team.
Important! Both for ischemic heart disease (angina pectoris, heart attack), and for cervical osteochondrosis, numbness of the tongue on the left is characteristic.
Important! Often, a symptomatic picture similar to cardiac pathology is given by vegetative-vascular dystonia. At the same time, the demonstration of his serious condition is clearly feigned (psychogenic factor), the patient is often nervous, trembles, experiences a fever and a feeling of a lump in his throat.
Respiratory tract diseases
Soreness under the scapula on the left can cause the following lung diseases:
- Pneumonia - gives pain only when the inflammatory focus is located near the pleural membrane. Painful sensations of weak intensity arise periodically, have a point localization, and intensify with breathing.
- Pleurisy - unlike pneumonia, the pain is sharp, stabbing. Its intensity depends on the depth of breathing.
Concomitant pulmonary symptoms accompanying pain when inhaling under the left shoulder blade are shallow, rapid breathing, shortness of breath, fever. Hyperthermia can also occur with pericarditis. It is extremely rare for a slight increase in temperature to occur with severe neuralgia, myositis.
Important! Unlike heart disease, with pathology of the respiratory tract, pain is accompanied by night sweats and coughs (in the initial stage of pneumonia and with pleurisy - dry).
Pathology of the gastrointestinal tract
Pain under the scapula often accompanies gastrointestinal diseases. In this case, the symptomatic picture is as follows:
- Peptic ulcer - severe cutting pain is always associated with food intake (occurs before or immediately after eating), radiates to the scapula with nonspecific localization of the ulcerative process (the back wall of the stomach or its cardiac part). The pain subsides after vomiting, taking acid-lowering drugs. The perforation of the ulcer is accompanied by increased pain (like cutting with a knife), the patient presses his legs to his stomach and covers them with his hands.
- Pancreatitis - accompanied by severe pain of a girdle nature (including under the left shoulder blade). An attack is always associated with errors in nutrition (fatty, salty, fried foods, alcohol, starvation). Vomiting does not bring relief.
Important! The pathology of the gastrointestinal tract, which caused pain under the scapula on the left side, is accompanied by other characteristic symptoms - bloating, indigestion, vomiting, belching.
Diagnosis of subscapularis pain
When collecting anamnesis, the doctor pays attention to the relationship of pain with physical activity, food intake, stress, and also specifies concomitant chronic and recent diseases.
Assessment of the nature of pain, the presence of certain symptoms specific to diseases of different organs allows you to narrow the range of causes to a specific system of the body - the heart, lungs, musculoskeletal system, gastrointestinal tract. The preliminary diagnosis is confirmed by the following studies:
- heart - measurement of a / d, ECG, echocardiography and Doppler scanning;
- lungs - chest x-ray;
- spine - X-ray of the cervical and thoracic regions, CT or MRI.
In the future, a more detailed examination of the damaged organ may be required. Only then is the treatment of the identified disease prescribed.
When and which doctor should I contact?
Depending on the degree of intensity and nature of painful sensations under the scapula, accompanying symptoms, you should consult a doctor:
- urgent call for emergency care - sharply arisen pain with increasing intensity and a rapid deterioration in general condition;
- traumatologist - getting an injury that provoked pain syndrome;
- cardiologist - with concomitant chest pain (constant or periodic), shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the left shoulder blade, aggravated by raising the arm, there is a clear connection between the occurrence of pain and physical activity, previously diagnosed degenerative pathology of the spine;
- gastroenterologist - there is a connection between pain and food intake, there are other signs of gastrointestinal disease (nausea, vomiting, etc. );
- pulmonologist - pain under the scapula is accompanied by cough, shortness of breath;
- therapist - pain occurs without a clear cause, permanent or temporary.
It is the therapist who often diagnoses both a trivial VSD and finds confirmation of an acute surgical pathology or oncological process. In the future, the doctor appoints a consultation with a narrow-profile specialist.
Preliminary treatment regimens
Depending on the diagnosis, the attending doctor selects an effective treatment for the causative disease. An important point in complex therapy is the elimination of pain syndrome:
- For neurological pain, strong pain relievers are most often used;
- Pathology of the spine and muscles requires a course of non-steroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires taking Nitroglycerin (does not help with a heart attack), Validol has only a reflex effect and does not in any way improve the condition of the heart muscle in ischemic disease;
- If you suspect a gastrointestinal disease, it is advisable to take antispasmodics, acid-lowering drugs (with an ulcer).
Only by eliminating the causative disease, the patient gets rid of the pain under the scapula. In acute conditions, urgent hospitalization and intensive treatment are sometimes required.
The radicality of treatment depends on the nature of the disease and the duration of its course, therefore, a doctor should be consulted at the first painful symptoms. Not only the outcome of the disease depends on this, and the chances of a full recovery increase.
In severe cases, timely medical care saves the patient's life.