Painful sensations under the scapula - this symptom can be found by adults suffering from diseases of the musculoskeletal system or pathology of internal organs, and children who simply did not calculate physical activity or stood in a draft.
Self-administration of analgesics when subscapular pain occurs is absolutely unacceptable - such pain sensations can be a sign of life-threatening conditions.
At the same time, care, and often emergency medical care, deserve not only a sharp pain, but also a dull ache under the left shoulder blade.
The nature of the pain and the accompanying symptoms help suggest a particular disease. However, only a qualified doctor, based on the patient's complaints, will be able to understand the damage to which 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, broadens the list of possible causes of subscapular 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 structure of the back are a common cause of left-sided subscapular pain. The pain in such diseases is often one-sided.
- Osteochondrosis: Osteophyte formation in the thoracic or cervical spine causes pulling pain to the left or right, beginning in the neck and upper back and ending with irradiation to the arm. The pain does not go away at rest, often prolonged but bearable.
- Intercostal neuralgia: accompanied by severe pain that spreads throughout the intercostal space and is 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: It is a "reward" for hard physical work or activities associated with a long stay in one position (office workers). People complain of a non-intense dull pain located between the neck and shoulder, radiating below the scapula.
Important! The causes of pain under the left shoulder blade from the back from the back, radiating to the arm and pressing in nature (osteochondrosis and angina pectoris) have a distinctive feature. With angina, the pain lasts up to 30 minutes, with osteochondrosis - several days. Also, an angina attack is stopped with nitroglycerin or other heart medications.
Sometimes subscapular pain is caused by myositis (at the same time there is stiffness of movements and tension of certain muscle groups), scapula injuries (acute pain, always preceded by a fall, blow, etc. ) or oncology (can pain occur). periodically, not intense). Tuberculosis of the bones, that is, the defeat of the scapula, cannot be ruled out.
Diseases of the heart and blood vessels.
Cardiac pathology is one of the most dangerous, which can be diagnosed when a patient complains of subscapular pain. In this case, the pain in heart disease does not always begin on the front surface of the chest (behind or to the left). The cause of pain under the left shoulder blade, in the heart area, can be:
- Angina pectoris: oppressive pain behind the breastbone that extends below the left scapula and clavicle, up to the jaw and arm. The intensity of the pain is reduced at rest, but changing the position of the body does not relieve. With scapular-costal syndrome (verterogenic), the situation with increased pain is radically opposite. The angina attack is leveled with the intake of nitroglycerin, with spinal pain, manual therapy is excellent.
- Myocardial infarction is a sharp, increasing pain in the heart with characteristic radiation to the left (even below the scapula) that 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 crushing 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 disappears at rest and when the trunk leans forward. The pain arises in the area of the heart in front, radiates below the scapula, but is not as intense as in acute myocardial ischemia (angina pectoris, heart attack).
- Aortic aneurysm detachment is a dangerous condition characterized by throbbing pain under the scapula. The rapid increase in pain requires an urgent call from the medical team.
Important! For both ischemic heart disease (angina pectoris, myocardial infarction) and cervical osteochondrosis, numbness of the left tongue is characteristic.
Important! Vegetative-vascular dystonia often gives a symptomatic picture similar to heart disease. At the same time, the demonstration of his serious state is clearly feigned (psychogenic factor), the patient is usually nervous, trembles, experiences fever and sensation of a lump in the throat.
Respiratory tract diseases
Pain under the scapula on the left can cause the following lung diseases:
- Pneumonia: produces pain only when the inflammatory focus is close to the pleural membrane. Painful sensations of weak intensity appear periodically, have a specific location and are intensified by breathing.
- Pleurisy: Unlike pneumonia, the pain is sharp and stabbing. Its intensity depends on the depth of the breath.
Concomitant pulmonary symptoms accompanying pain when inhaling under the left shoulder blade are rapid shallow 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 cough (in the initial stage of pneumonia and with dry pleurisy).
Gastrointestinal tract pathology.
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 a nonspecific location of the ulcerative process (the back wall of the stomach or its heart part). The pain disappears after vomiting, taking acid-reducing medications. Perforation of the ulcer is accompanied by increased pain (such as cutting with a knife), the patient presses the legs against the stomach and covers them with his hands.
- Pancreatitis: accompanied by severe waist-type pain (even below the left shoulder blade). An attack is always associated with errors in nutrition (fatty, salty, fried foods, alcohol, starvation). Vomiting does not relieve.
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 subscapular pain
When collecting the 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 specific symptoms of diseases of different organs allows you to narrow the range of causes to a specific system of the body: the heart, lungs, the musculoskeletal system, the gastrointestinal tract. The preliminary diagnosis is 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 regions, computed tomography or magnetic resonance imaging.
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 the painful sensations under the scapula, the accompanying symptoms, you should consult a doctor:
- urgent call for emergency care: acute pain with increasing intensity and a rapid deterioration of the general condition;
- traumatologist - suffering an injury that caused the pain syndrome;
- cardiologist - with concomitant chest pain (constant or periodic), shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the left shoulder blade, aggravated when raising the arm, there is a clear connection between the appearance 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 a trivial VSD and finds confirmation of an acute surgical pathology or an oncological process. In the future, the doctor appoints a consultation with a narrow-profile specialist.
Preliminary treatment regimens
Depending on the diagnosis, the treating physician 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;
- The pathology of the spine and muscles requires a course of non-steroidal anti-inflammatory drugs;
- Heart disease - pain syndrome requires taking nitroglycerin (it 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-reducing 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 the 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 does the outcome of the disease depend on this, but the chances of a full recovery are also increased.
In severe cases, timely medical care saves the life of the patient.