What does shoulder pain mean?

12 June 2021

Back pain in the shoulder is a characteristic symptom not only of diseases of the spine but also of internal organs. Why is it important to consult a doctor and make an appointment with a specialist? Effective methods to get rid of discomfort.

If you are worried about back pain in the shoulder blades, such symptoms could be a sign of diseases of the spine or shoulders, neuropathy, sciatica. Careful collection of the patient's pathologies and complaints allows you to determine the cause of the problem and decide on further treatment.

Often, back pain in the shoulder blades is the first signal of pathological changes in the body. And the definition of a trigger allows you to prevent the exacerbation of the disease at an early stage. Symptoms can occur on one side of the body or spread down the arm, appearing on inhalation - all of which are important in the diagnosis.

The cause of pain and its localization

As a rule, discomfort in the shoulder area occurs when moving. For example, a static stretch of the body, an awkward turn. In this case, pain below the shoulder blade signals damage.

Important!Localized unilateral pain (left below the collarbone or right side) is rare. It is due to the symmetrical arrangement of the nerve roots of the spinal cord.

Injury

Pain may signal muscle or bone damage. In this case, the symptoms were diffuse and of varying intensity. The pain is strong and persistent.
Injuries that can cause pain in the shoulder blades:

Broken, cracked. A serious injury in which the pain is focused directly on the shoulder blades. Symptoms are aggravated with minimal movement, so the patient is unable to move.
Bruises. The discomfort is superficial, it occurs due to damage to the musculature and is localized to the lower part of the shoulder blades. On examination, signs of inflammation and swelling of tissues can be detected. Symptoms persist for 14-21 days.
Degeneration or displacement of the vertebrae. Joint pain occurs below the shoulder blades or at their level. The discomfort may be aggravated by compression of the nerve roots.

With wounds in the affected area, the soft tissue is edematous, pain appears suddenly. There is often a crackling sound when moving.

Protrusion and herniation of the spine

With this pathology, the spinal cord and nerve roots are compressed, accompanied by decreased sensitivity and sharp pain below the right and left collarbone.

Possible location discomfort:

Lower back pain left or right fibula. Indicates a lesion of 6-12 discs that may involve the lumbar spine in the pathological process. Since the latter is subject to increased stress, there is a high risk of spinal herniation.
Above the shoulder. Localized protrusion in the cervical spine or segments 1-3. The discomfort becomes more pronounced with head movement.
Between the shoulder blades. Pain is observed when 3-6 segments of the spine are affected. It becomes more pronounced with a deep breath, turning the body, catching the upper limbs to the sides.

Note!With ptosis, the pain persists even at rest. The cause is nerve root compression and muscle spasticity.

Bone tumor

If the back is painful in the shoulder blade area, symptoms may indicate degenerative bone disease of the thoracic spine. This symptom occurs due to entrainment of the spinal cord or nerve roots and deformity of the disc. The disease progresses gradually, causing increasingly vivid symptoms.

The area of discomfort is determined by the location of the lesion:

2-6 segments. Discomfort localized at shoulder blade level, possibly irradiated to arm and neck. May increase intracranial pressure, dizziness due to compression of blood vessels.
6-12 segments. Pain below the collarbone in the left or right back and extending down the lower back.

Note!With osteonecrosis, the pain is one-sided.

Osteoarthritis of the vertebrae

This pathology is also characterized by unilateral positional pain syndrome. With degenerative spondylosis, there is a violation of mobility, a feeling of stiffness due to damage to the discs and facet joints.

Symptoms depend on ignoring pathological changes:

Destruction of cartilage tissue. It develops against the background of a decrease in blood circulation and a violation of the integrity of the connective tissue. The cartilage element becomes fragile - quickly damaged and slowly renewed. The situation is aggravated with microtraumas due to overexertion. In this case, the pain radiates down the shoulder blades and lower back.
Disc deformity. Tissue thickening is accompanied by reduced mobility, as well as pain in the shoulder blades and back. Against this backdrop, destructive processes are intensifying.
Formation of bone growth. Present in the form of advanced spondylolisthesis. They lead to damage to blood vessels, muscle tissue, nerves, and joints.

With spondylolisthesis, the pain occurs after exertion and may be localized to the shoulder blades or between them. At rest, symptoms disappear.

Scoliosis

Accompanied by the phenomenon of the spine is curved in the horizontal direction due to the tension of the muscles that support the posture. In this case, the spinal cord and nerves are compressed, unpleasant sensations are observed under the shoulder blades.

Other symptoms of scoliosis:

Deformity of the thorax. There is displacement of the ribs and vertebrae, resulting in damage to the spinal cord and its branches. Therefore, back pain is observed on the left side below the shoulder blade or on the right side.
Breathing disturbances. Due to the deformation of the thorax, lung dysfunctions are observed - one of them is compressed, the second is an attempt to compensate for the lack of gas exchange.
Violation of heart activity. Due to the deviation of the spine, it is difficult to breathe, the skin is pale, and the heart rate changes.

Note!Scoliosis is characterized by compression of the spinal cord, so that discomfort is localized between the shoulder blades or below them. The pathological focus is well-defined and can spread to adjacent areas only with spasticity.

kyphosis

Kyphosis is a backward curvature of the spine in which the shoulder blades are pulled forward, resulting in a stooped posture. In this case, the pain was localized on the shoulder blades, bilateral in nature, spreading down to the neck and arms.

Mechanism of pain formation in kyphosis:

Muscle. The curvature of the spine leads to overwork of the muscles in the collar area and they spasm, accompanied by pain in the shoulder blades.
Neurogenesis. In the context of a curved spine, the distance between the vertebrae gradually decreases. This leads to invasion of the branches of the spinal cord and the appearance of pain in the shoulder blades, which can radiate down the neck, collarbone, and shoulders.

With kyphosis, the vertebral artery is compressed, leading to impaired cerebral circulation, dysfunction of internal organs.

Tooth decay

The pathology is characterized by compression of the lumbar roots that form the sciatic nerve. With the defeat of the upper part, the pain is localized below the shoulder blades and below. Discomfort is bilateral, it becomes more obvious with sudden movements.

If left untreated, sciatica can be accompanied by other symptoms:

burning pain in the back (below the shoulder blades and in the lower back) - indicates compression of the spinal roots;
low back pain with irradiation in the legs;
convulsions;
violation of sensitivity in the buttocks, lower back;
numbness along the nerve (can be seen in the legs, thighs, feet).

Nerve pain

Inflammation of the nerve fibers in this anatomical region can cause pain below the shoulder blade. A common cause of pathology is hypothermia.

Inflammation can affect structures such as:

Intercostal nerve. 1-4 pairs are located along the lower edge of the affected rib. The pain is localized below the shoulder blades and below, in the lateral parts of the chest, rarely extending to its anterior parts.
Epidermal and supraclavicular nerves. Characterized by the appearance of pain in the shoulder blades from the back into the clavicle region. Sometimes symptoms extend to the shoulder.
Subchondral nerves and subchondral nerves. Feeling discomfort under the left or right shoulder blade. As the inflammation spreads to the muscles, the pain increases when you move your hand.

Note!With neuralgia, the pain is usually unilateral - the symptoms are localized to the part that has undergone hypothermia.

Periarthritis of shoulder-fish scale

It is characterized by inflammation of the shoulder joint and surrounding tissues. It is accompanied by impaired mobility, which can only be resolved after warming up the muscles.

With periarthritis of the jaw joint, discomfort is observed at the level of the shoulder blades and below. In the early stages, it occurs after intense physical activity, as the disease progresses - at rest. Other symptoms of the disease:

numbness of the upper extremities;
headache;
reduced mobility of the spine.

Heart disease

Pain below the shoulder blades can be a sign of heart disease. This is due to the fact that the branches of the parasympathetic trunk connect with the spinal cord, and the nerve roots go to this organ. If there is pain below the left collarbone from behind from behind, symptoms may indicate a mild form of myocardial infarction. It can persist for several days, increasing with exercise and decreasing with rest.

Other signs of illness:

burning pain, pressing behind the sternum;
heart rhythm disturbances;
heart palpitations;
shortness of breath;
dizziness;
nausea vomiting;
hypertension.

Digestive system disease

The mechanism of onset of pain is similar to that of the previous one - spreading along nerve fibers. The localization of the symptom depends on the organ affected, rarely the discomfort is bilateral.

Diseases of the digestive system - the cause of pain under the shoulder blades

If the back is painful on the left side below the shoulder blades, it is possible to develop:

inflammation of the stomach lining;
pancreatitis (inflammation of the pancreas);
stomach ulcers.

In addition, with such pathologies, there is nausea, vomiting, heartburn, belching, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, pale skin, low blood pressure, weakness, dark stools.

Discomfort under the right shoulder blade can be a sign of diseases such as the following:

duodenal ulcer;
Hepatitis;
cirrhosis;
biliary stone.

Other causes of symptoms

The following factors can also cause pain in the shoulder blade area:

Inconvenient sleeping place. In particular, the mattress is flat and sleeping on the left side can cause pain for the opposite person, because the spine is curved and the roots are compressed.
Vascular dystonia. Accompanied by a drop in blood pressure, shortness of breath, decreased cardiac activity and sometimes back pain in the shoulder area.
Polio. An infectious disease in which pain in the shoulder blade has a neurological cause.
Pneumonia. With pleurisy, the symptom occurs due to the friction of its plates against each other. The peak of pain occurs when taking a deep breath.
Kidney disease. Characterized by pain, sharp pain under the right shoulder blade. In addition, there is a change in the color of urine, the amount of urine.
Poisoned. Unpleasant sensations occur when an excess of toxins or decay products accumulate in the body as a result of a cold or severe poisoning. It is accompanied by chills, muscle aches, fever.
Subrenal abscess. Pain below the shoulder blades is observed on inhalation, arising from the accumulation of pus in the upper abdominal cavity.
Psychosis. Sometimes psychosis is accompanied by unpleasant sensations in the back, but the mechanism of its development has not been studied.

Types of pain

The nature of pain in the shoulder blade area can vary. Depending on this criterion, it is possible to assume a possible disease and determine the cause of the discomfort:

Shoots, strokes, occur when turning or moving. Typical for pinched nerves. This feature makes it possible to distinguish it from pain in gallstone disease - with this diagnosis, the discomfort is constant and independent of movement.
Pain like cutting, boredom with varying intensity. May manifest neuralgia, arthritis.
Tingling, pain, or burning. Such pain in the area of the shoulder blades indicates diseases of the internal organs. Symptoms develop due to compression of the nerve roots, which may become more pronounced with movement.
Sharp pain at the level of the shoulder blade down. Typical for spinal hernia. Often accompanied by numbness of hands or feet, low back pain.

Which doctor should I see?

If pain is felt in the shoulder area, you should make an appointment with a neurologist. Your doctor will conduct an examination, establish a diagnosis, and determine a treatment strategy. In case of detection of pathology of internal organs, he will refer to a stenologist - a gastroenterologist, cardiologist, orthopedist (depending on the diagnosis).

Survey

To determine the cause of pain in the shoulder blade area, the patient is assigned the following diagnostic procedures:

Clinical study of blood, urine. They show inflammatory changes, which help diagnose somatic diseases.
Check X-ray, CT. They allow you to detect curvature of the spine, injuries and their consequences, osteonecrosis.
Supersonic. It is used to determine the pathology of internal organs.
ECG. Information in case of suspected heart disease.
Magnetic resonance imaging. Reflects the condition of the spine, shoulders, and internal organs. The area of investigation is determined by the physician depending on the proposed diagnosis.

Note!Pain below the shoulder blade is often a sign of neurological abnormalities. Therefore, CT and MRI are the "gold standard" in determining the cause of a symptom.

Treatment Features

The goal of treatment is not only to eliminate the pain, but also to remove the factor that led to its occurrence. When seeking medical help, pain syndrome is relieved in parallel, while treating the underlying cause is indicated to eliminate the underlying disease.
A treatment program may include the following:

Medical treatment. To relieve pain, drugs from a number of analgesic and anti-inflammatory drugs are used. Depending on the cause of the symptoms, antibacterial agents, diuretics, gastroprotectors, etc. can be used.
Physical therapy. Helps speed up recovery from somatic pathologies, to strengthen the spine. To eliminate pain in the shoulder blade area, electrophoresis, UHT and heating procedures are used.
Massage. Helps to eliminate muscle spasms, improve posture, reduce pain sensations. It is prescribed for problems with the spine. Sometimes the intervention of a chiropractor or chiropractor is required.
Exercise. Shown during recovery. A set of exercises is selected for each patient, depending on the established diagnosis.

How to prevent shoulder discomfort?

Each patient who has undergone a subsequent course of treatment is advised to follow some precautions. They are necessary to prevent recurrence of the disease.
It is important to follow the following rules:

create favorable conditions for sleep - choose orthopedic pillows and mattresses of moderate firmness to support the physiological position of the spine;
watch your posture;
adhere to the principles of proper nutrition;
try to prevent exacerbations of chronic pathologies;
giving up addictions (smoking, drinking);
See your doctor regularly for preventive checkups.

Shoulder pain can be due to neurological and neurological causes. In the second case, the symptoms are strong and pronounced. With somatic origin, pain increases gradually and persists for a long time, independent of body movement.
Pain relievers may be used to relieve an unpleasant symptom. However, in order to completely eliminate the sensation of pain, it is important to undergo a full course of treatment aimed at eliminating the underlying pathology. Only a doctor can develop the correct course of treatment after a complete examination.