The shoulder blade is a three-dimensional triangular bone that connects the collarbone and collarbone. It possesses the external name similar to a famous tool - a garden shovel. The scapula and head of the scapula make up the shoulder joint, which is the most flexible joint in the human skeleton.
Pain below the right collarbone from the back from the back in most cases indicates pathology of the articular elements of the shoulder, spinal or disc (paravertebral) structures. Other possible causes are damage to internal organs - the bronchi, lungs, kidneys, and gallbladder. Persistent squamous pain syndrome almost always indicates a serious problem requiring medical and sometimes surgical treatment.
Muscle tension and inflammation
A large number of muscles are attached to the scapula: biceps, sternocleidomastoid, small and large rhombus, deltoid. Usually, it is painful below the right shoulder blade due to a stretch or an inflammatory process develops.
Stretching can put a lot of strain on your back, when lifting and carrying weights, sudden movements and prolonged uncomfortable body positions. However, as practice shows, in more than half of the cases, the cause is due to the patient overexertion and improper exercise.
Symptoms of stretch marks are as follows:
- sharp pain of varying intensity;
- pain increases when turning and leaning;
- relief at rest;
- swelling and bruising (with severe damage).
The basic principle of sprain treatment is complete rest and removal of any tension. Immediately after the injury, you should apply ice or cold compress to the painful area, if necessary, you can take more numbing pills.
With concerns about myositis - myositis - pain increases with pressure and movement. Sometimes there is mild swelling and redness. Often the general condition gets worse: body temperature rises, headache, and small painful pressures are felt in the muscles.
The causes of myositis are varied, but most often it develops against the background of an acute respiratory viral infection, influenza or tonsillitis. It should be noted that in the thoracic region, inflamed muscles are relatively rare, since myositis is localized mainly in the upper or lower back.
One of the diseases is myositis or fibromyalgia - an extremely rare form of the disease. Congenital disorders of bone formation (bone formation) develop rapidly and manifest in childhood.
Fibrodysplasia is the formation of liquefaction points in the muscle structure that gradually enlarge and damage the surrounding tissues. Ossification can be localized almost anywhere - near the spine, on the extremities or in the pelvic region.
Authority to solve:Myositis cannot be cured and cannot even be treated with surgery on its own. After removing the ossificates, they are formed again.
myofascial syndrome
Muscle pain in the back is most common after a headache. More than 40% of people have chronic pain syndrome, of which the majority are women.
Myofascial syndrome is a progressive condition characterized by the formation of trigger points (pain) in the muscles. The diameter of each spot varies from 1 to 3 mm, the accumulation of spots can create a pain area of 1 cm2. These spots are formed under the influence of trauma and muscle strain.
Several factors can trigger this process:
- skeletal deformities - scoliosis (curvature of the spine to the left or right), pelvic asymmetry, short one of the limbs, flat feet;
- back injury;
- diseases of the spine - osteonecrosis, spondylolisthesis, as well as hernia and protrusion;
- long-term use of drugs - β-blockers, cardiac glycosides, calcium antagonists, antiarrhythmics, anesthetics;
- connective tissue damage in autoimmune diseases - rheumatism, lupus erythematosus.
Gallstones
With gallbladder disease, pain often radiates down the right shoulder blade. This is due to the contraction of smooth muscles when the walls of the bladder are irritated by the stones that form. A biliary colic occurs, as a rule, suddenly, and is concentrated on the right side below the ribs.
The pain syndrome has an acute, exacerbating nature and in most cases occurs after consumption of fatty, fried, spicy foods, and alcoholic beverages. The cause of the attack can be heavy exertion, nervous tension or prolonged lying on the side.
If there is a blockage in the bile duct, the pain is dull and persistent. A concomitant symptom was heaviness in the right abdomen, as well as nausea, which turned to vomiting. May increase body temperature, sometimes up to high values. With common bile duct obstruction and sphincter of Oddi obstruction, jaundice develops and stools become discolored.
Treatment of gallstone disease can be conservative and surgical. In the absence of complications, specific therapy is not performed. Single stones can be removed by shock wave lithotripsy.
Subrenal abscess
Back pain in the shoulder blade area can be explained by the formation of a subrenal abscess - an abscess localized under the dome of the diaphragm. Usually, it appears after abdominal surgery, when peritonitis develops. The causative agent can be staphylococcus, streptococcus or E. coli.
Infection enters the body after partial or complete resection of the stomach, removal of the pancreas, suturing of a perforated ulcer, or removal of the spleen. The cause can be an inflammatory pathology of internal organs, open or closed abdominal trauma, as well as severe lung damage, osteomyelitis of the vertebrae and ribs.
General symptoms appear first - weakness, sweating and fever. The raised body temperature can be kept constant or increased cyclically. Then it begins to hurt in the upper third of the abdomen and lower chest from the affected side. Pain syndrome of varying intensity usually radiates below the collarbone, shoulder or collarbone.
Characteristic signs of an abscess are difficulty breathing, dry cough, hiccups, and pain that increases with movement, deep breathing, coughing, and sneezing. The patient breathes frequently and shallowly, trying to stay in a semi-sitting position.
Treatment of subrenal abscess consists of surgically opening and draining the abscess, followed by antibacterial, antitoxic, anti-inflammatory, and restorative therapy.
Authority to solve:If the operation is not carried out in time, the abscess will invade the abdominal cavity and pleural cavity, which is almost guaranteed to cause death.
Pleurisy
Pain near the collarbone can cause diseases of the bronchi - lungs - pneumonia or bronchitis, which complications into pleurisy. In this case, it can hurt both below and above the shoulder blade. However, the main source of pain is the chest and upper abdomen.
Pleurisy is always a complication of another disease, including malignancy. It can be caused by bacterial, viral or fungal infections, trauma, and chest surgery.
In some cases, pleurisy develops against the background of autoimmune diseases - scleroderma, rheumatoid arthritis, lupus erythematosus, vasculitis, as well as pulmonary thromboembolism, myocardial infarction, pancreatitis.
In 25% of patients with pleurisy, a malignant tumor is diagnosed - mesothelioma or metastases from other organs (mammary glands, ovaries). Metastatic pleurisy usually has mild symptoms and usually presents only with pain behind the sternum.
When large amounts of secretions accumulate, a puncture is required to drain or drain. Depending on why pleurisy has developed, specific treatment is prescribed. It may include antibiotics, steroids, and anti-inflammatory drugs. The form of tuberculosis is treated with special drugs.
Urinary stone disease
Stone formation in the urinary system most often occurs in middle-aged people - between the ages of 25 and 50. The disease progresses in different ways: in some, symptoms are limited to a single episode of discomfort, while others complain of frequent exacerbations. In some cases, urolithiasis has a prolonged chronic course.
The main symptom is renal colic when the ureter is blocked. The localization of the pain syndrome depends on the location of the stone, and the intensity depends on its size. Pain in the right collarbone occurs when the right kidney is affected. If the stone is lower then lower back or abdomen pain.
Typical symptoms of urolithiasis are frequent nausea and burning sensation when urinating, fever, and nausea.
Treatment methods can be conservative and surgical. Usually, an operation is required, the signs to perform it are:
- large rocks;
- the development of kidney failure;
- localization of plaques in the kidneys, renal pelvis or ureters;
- purulent pyelonephritis.
Surgery can be open or laparoscopic. Shock wave lithotripsy is the most gentle method to reduce the rate of postoperative complications.
During operation, the rock is crushed by a reflector that emits electro-hydraulic waves. After crushing, the stone and sand particles are excreted in the urine. Sometimes their movement along the ureter causes renal colic, which is easily stopped with medication.
Authority to solve:Any operation is not a guarantee of no recurrence. Therefore, complex therapy is necessarily carried out, which can last for several years.
Intercostal neuralgia
Intercostal neuralgia (thoracic pain) is characterized by severe symptoms and is often presented by acute, penetrating pain in the ribs, both anteriorly and posteriorly. It may appear intermittently or intermittently. The syndrome is painful, burning or dull, but always uncomfortable.
The characteristic sign of sciatica is pain that worsens when inhaling, changing body position, or sneezing. Usually, during pain, the muscles twitch, sweating increases, the skin turns red or, conversely, pale. Numbness occurs at the site of damage to the nerve endings.
The immediate cause of the pathology is compression of the nerve roots, which is facilitated by various factors and pathologies:
- bone necrosis;
- spondylitis;
- ankylosing spondylitis;
- primary and metastatic tumors;
- disruption of the stomach (gastritis);
- age-related changes in blood vessels;
- metabolic disease;
- chest trauma;
- flu, SARS;
- cool down and manuscript;
- prolonged or severe nervous tension;
- high physical activity;
- unsuccessful rotation, in a prolonged static position.
Authority to solve:Intercostal neuralgia is characterized by pain lasting from a few seconds to three minutes. During this time, the patient tries not to breathe or move, so as not to increase the pain.
The mainstay of treatment is pain relief, for which non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed. For severe pain, blockade therapy with anesthetics and steroids is performed. To increase the threshold of CNS excitability, sedatives are used.
Specific therapy depends on the source of the nerve pain and may include antivirals, antihistamines, and muscle relaxants.
Neoplasms
Bone tumors in the shoulder blades are rare and can be both benign and malignant. The former include osteosarcoma and choroidal tumor, the latter - chondrosarcoma and Ewing's sarcoma. Osteosarcoma is characterized by slow growth and favorable course. It mainly affects children and young adults aged 5 to 20 years.
Osteomas can grow asymptomatically and manifest only when surrounding structures - nerve roots and blood vessels - are compressed. Treatment is only surgery, there is practically no recurrence.
Chondroma is a benign tumor of cartilage origin. It should be noted that when chondroma is localized in the scapula, the tumor often degenerates into malignancy. Due to the high risk of malignancy, such formations are thoroughly eliminated.
Chondrosarcoma, like chondroma, is formed by cartilage tissue, but it is malignant and widespread. Its development is accompanied by increasing pain and swelling in the affected area.
Chondrosarcoma occurs in people of all ages, even in children, but the greatest percentage is in middle age - between 40 and 60. Mostly men get it. The main method of treatment is to remove the tumor, if surgery is not possible, chemotherapy and radiation therapy are used.
Ewing's sarcoma is one of the most aggressive malignancies, prone to early metastasis. It affects children and young adults, manifested by severe symptoms - pain, swelling and redness.
Because the tumor is highly invasive, both surgical and therapeutic treatment are performed. Both before and after surgery, chemotherapy and radiation are given, with the use of high doses and certain medications. The prognosis of the disease is conditionally unfavorable.
Pain below the right shoulder blade can be a completely harmless symptom or a sign of a serious medical condition. To relieve pain and prevent possible dangerous complications, you need to be examined and consulted by a specialist. Based on its results, the doctor will prescribe treatment and make the necessary recommendations. Be healthy!