Painful sensation 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 do not count physical activity or stand in a draft.
Self -administration of painkillers when subscapularis pain occurs is totally unacceptable: such a sensation of pain can be a sign of a life -threatening condition.
At the same time, attention and, often emergency medical treatment, requires not only acute pain, but also a dull ache under the left shoulder blade.
The nature of the pain and the accompanying symptoms help suggest a specific disease. However, only a qualified physician, based on a patient’s complaint, will be able to understand which organ damage is causing the pain, prescribe the necessary diagnostic examinations and, if necessary, provide emergency assistance.
Causes pain under the left shoulder blade in the back from the back
The proximity of the lungs, heart and spine, as well as the extensive network of nerve fibers, expands the list of possible causes of subscapularis pain. In this case, each disease is characterized by other specific symptoms, and the nature and duration of the pain sensation also changes.
Pathology of the musculoskeletal and nervous systems
Diseases of the spine and skeletal muscles of the back are common causes of left subscapularis pain. Pain in such diseases is often biased.
- Osteochondrosis - the formation of osteophytes in the thoracic or cervical spine causes excruciating pain on the left or right, starting from the neck and upper back, and ending with irradiation to the arms. The pain does not go away at rest, is often prolonged but bearable.
- Intercostal neuralgia - accompanied by severe pain spreading throughout the intercostal space and exacerbated by shortness of breath, dizziness, sneezing / coughing. Often, with neuralgia, the sensitivity of the skin to the source of the pain also changes. Neuralgia gives rise to paresthesia in the form of goose bumps, while numbness 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 prolonged stay in one position (office worker). People complain of dull pain that is not intense located between the neck and shoulders, radiating under the scapula.
Important! The causes of pain under the left shoulder blade from behind from behind, which radiate to the arm and are depressing in nature - osteochondrosis and angina pectoris - have their own characteristics. With angina pectoris, the pain lasts up to 30 minutes, with osteochondrosis - several days. In addition, angina pectoris attacks are stopped by Nitroglycerin or other heart medications.
Sometimes subscapularis pain is provoked by myositis (at the same time stiffness of movement and tension of certain muscle groups is observed), scapular injury (acute pain, always preceded by falls, blows, etc. ) or oncology (pain can occur. Periodically, notintense). Bone tuberculosis, that is, the defeat of the scapula, cannot be ruled out.
Heart and blood vessel disease
Cardiac pathology is one of the most dangerous, which can be diagnosed when a patient complains of subscapularis pain. In this case, the pain in heart disease does not always begin on the front surface of the chest (behind or on its left side). Causes of pain below the left shoulder blade, in the heart area can be:
- Angina pectoris - a pressing pain in the back of the sternum extending below the left scapula and collarbone, to the jaw and arms. The intensity of pain decreases during rest, but changes in body position do not bring relief. With scapular-costal (vertebrogenic) syndrome, the situation with increased pain is radically opposite. Angina pectoris attacks are equated with the intake of Nitroglycerin, with vertebral pain, manual therapy is excellent.
- Myocardial infarction is an acute growing pain in the heart with characteristic irradiation to the left (including under the scapula) not stopped by cardiac glycosides. The patient experienced severe fear, which did not occur with damage to the spine and nerve fibers. Immediate hospitalization required!
- Hypertensive crisis - is often accompanied by a depressive heartache radiating to the left shoulder blade. The cause of pain is easily determined by measuring a/d.
- Pericarditis - with this disease, the pain decreases at rest and when the trunk is tilted forward. Pain arises in the anterior heart area, radiating below the scapula, but not as strongly as 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 immediate call from the medical team.
Important! Both for ischemic heart disease (angina pectoris, heart attack), and for cervical osteochondrosis, numbness of the tongue on the left side 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 pretending (psychogenic factors), the patient is often nervous, trembling, has a fever and a feeling of lumps in the throat.
Respiratory tract diseases
Pain under the scapula on the left can cause the following lung diseases:
- Pneumonia - gives pain only when the focus of inflammation is located near the pleural membrane. Painful sensations with weak intensity arise periodically, have point localization, and intensify with respiration.
- Pleurisy - unlike pneumonia, the pain is sharp, stabbing. Its intensity depends on the depth of breathing.
The corresponding pulmonary symptoms that accompany pain when inhaling under the left shoulder blade are shallow, rapid breathing, shortness of breath, fever. Hyperthermia can also occur with pericarditis. Very rarely a slight increase in temperature with severe neuralgia, myositis.
Important! Unlike heart disease, with pathology of the respiratory tract, the pain is accompanied by night sweats and coughing (in the early stages of pneumonia and with pleurisy - dryness).
Pathology of the gastrointestinal tract
Pain under the scapula often accompanies gastrointestinal disease. In this case, the picture of symptoms is as follows:
- Peptic ulcer - severe cutting pain is often associated with food intake (occurs before or immediately after a meal), radiating to the scapula with nonspecific localization of the ulcerative process (the back wall of the stomach or part of the heart). Pain decreases after vomiting, taking acid -lowering drugs. Penetration of the ulcer is accompanied by an increase in pain (such as cutting with a knife), the patient presses his foot to his abdomen and covers it with his hands.
- Pancreatitis - accompanied by severe pain of a pelvic nature (including under the left shoulder blade). Attacks are often associated with errors in nutrition (fatty, salty, fried foods, alcohol, starvation). Vomiting does not bring relief.
Important! Pathology of the gastrointestinal tract, which causes pain under the scapula on the left, is accompanied by other characteristic symptoms - bloating, indigestion, vomiting, belching.
Diagnosis of subscapularis pain
When collecting anamnesis, physicians pay attention to the relationship of pain with physical activity, food intake, stress, and also determine the corresponding chronic and recent illness.
Assessment of the nature of pain, the presence of specific symptoms specific to diseases of different organs allows you to narrow the range of causes to specific systems of the body - heart, lungs, musculoskeletal system, gastrointestinal tract. The initial diagnosis was confirmed by the following studies:
- heart - a / d measurement, ECG, echocardiography and Doppler scan;
- lungs-chest x-ray;
- spine - X -ray of the cervical and thoracic area, CT or MRI.
In the future, more detailed examination of the damaged organ may be required. Only after that treatment of the identified disease is prescribed.
When and which doctor should I call?
Depending on the degree of intensity and nature of the painful sensation under the scapula, the accompanying symptoms, you should see a doctor:
- urgent call for emergency care - pain that arises suddenly with increasing intensity and rapid deterioration in general condition;
- traumatologist - gets an injury that gives rise to pain syndrome;
- cardiologist - with simultaneous chest pain (persistent or periodic), shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the left shoulder blade, exacerbated by raising the arm, there is a clear link between the occurrence of pain and physical activity, previously diagnosed degenerative pathology of the spine;
- gastroenterologist - there is a link between pain and food intake, there are other signs of gastrointestinal diseases (nausea, vomiting, etc. );
- pulmonologist - pain under the scapula accompanied by cough, shortness of breath;
- therapist - pain occurs for no apparent reason, permanent or temporary.
It is the therapist who often diagnoses both trivial VSD and finds confirmation of acute surgical pathology or oncological process. In the future, doctors appoint consultations with narrow -profile specialists.
Early treatment regimen
Depending on the diagnosis, the attending physician selects an effective treatment for the underlying disease. An important point in complex therapy is the elimination of pain syndromes:
- For nerve pain, strong painkillers are most often used;
- Spinal and muscular pathology requires a course of nonsteroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires the intake of Nitroglycerin (does not help with heart attacks), Validol has only a reflex effect and does not in any way improve the condition of the heart muscle in ischemic diseases;
- If you suspect gastrointestinal disease, it is advisable to take antispasmodics, acid -lowering drugs (with ulcers).
Only by eliminating the causative disease, the patient eliminates the pain under the scapula. In acute conditions, immediate hospitalization and intensive care are sometimes required.
The radicality of treatment depends on the nature of the disease and the duration of its course, therefore, the doctor should be consulted at the first painful symptoms. Not only does the outcome of the disease depend on this, and the chances of full recovery increase.
In severe cases, timely medical treatment saves the patient’s life.