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 physical activity or stayed on a sketch.
Self-administration of sedatives when subscapularis pain occurs is absolutely unacceptable: such sensations of pain can be a sign of life-threatening conditions.
At the same time, attention and, often, urgent medical care, deserve not only acute pain, but also a dull ache under the blade of the left shoulder.
The nature of the pain and the accompanying symptoms help to suggest a particular disease. However, only a qualified physician, 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 blade of the left shoulder 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 vary.
Pathology of the musculoskeletal system and nerves
Diseases of the spine and muscular framework of the spine are a common cause of subscapularis pain in the left. The pain in such diseases is often one-sided.
- Osteochondrosis - the formation of osteophytes in the thoracic or cervical spine provokes traction pain on the left or right side, starting from the neck and upper back and ending with radiation 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, vomiting, sneezing / coughing. Often, with neuralgia, the sensitivity of the skin over the source of the pain also changes. Neuralgia provokes paresthesia in the form of goose bumps, while numb pain under the left shoulder often occurs with myocardial infarction, angina pectoris.
- Scapular-rib syndrome - is a "reward" for heavy physical work or activities related to long stay in one position (office workers). People complain of dull non-intense pain localized between the neck and shoulder, radiating under the scapula.
Important! The causes of pain under the blade of the left shoulder from back to back, which radiates to the arm and is of an urgent nature - osteochondrosis and angina pectoris - have a distinctive feature. With angina pectoris, the pain lasts up to 30 minutes, with osteochondrosis - a few days. In addition, an attack of angina pectoris is stopped by Nitroglycerin or other cardiac drugs.
Sometimes subscapularis pain is provoked by myositis (at the same time stiffness of movements and tension of certain muscle groups is observed), shoulder injuries (acute pain, always preceded by a fall, stroke, etc. ) or by oncology (pain mayoccur. periodically, not intensively). Bone tuberculosis, namely, scapular defeat, can not be ruled out.
Cardiovascular diseases
Cardiac pathology is one of the most dangerous, which can be diagnosed when the patient complains of subcutaneous pain. In this case, the pain in heart disease does not always start on the front surface of the chest (behind or to the left of it). The cause of pain under the blade of the left shoulder, in the area of the heart can be:
- Angina pectoris - pain pressed behind the sternum extends below the left scapula and clavicle, to the jaw and arm. The intensity of the pain decreases at rest, but the change of body position does not bring relief. With scapular-costal (vertebrogenic) syndrome, the situation with increased pain is radically opposite. Angina pectoris attack is leveled with nitroglycerin intake, with vertebral pain, manual therapy is excellent.
- Myocardial infarction is an acute, growing pain in the heart with a characteristic radiation to the left (including under the scapula) not stopped by cardiac glycosides. The patient experiences great fear, which does not happen with damage to the spine and nerve fibers. Immediate hospitalization required!
- Hypertensive crisis - often accompanied by severe 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 is reduced at rest and when the trunk is tilted forward. The pain arises in the area of the heart forward, radiating 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 shoulder blade. The rapid increase in pain requires an urgent call of the medical team.
Important! For both ischemic heart disease (angina pectoris, heart attack) and osteochondrosis of the cervix, numbness of the left tongue 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 severe condition is clearly pretended (psychogenic factor), the patient is often nervous, trembles, experiences fever and the feeling of a lump in the throat.
Respiratory diseases
Pain under the left scapula can cause the following lung diseases:
- Pneumonia - gives pain only when the inflammatory focus is near the pleural membrane. Painful sensations of low intensity arise periodically, have a localization of points, and are intensified by respiration.
- Pleurisy - unlike pneumonia, the pain is sharp, stabbing. Its intensity depends on the depth of breathing.
The accompanying pulmonary symptoms that accompany pain when inhaling under the left shoulder are shallow, rapid breathing, shortness of breath, fever. Hyperthermia can also occur with pericarditis. It is extremely rare for a slight rise in temperature to occur with severe neuralgia, myositis.
Important! Unlike heart disease, with pathology of the respiratory tract, the pain is accompanied by night sweats and cough (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 appearance is as follows:
- Peptic ulcer - severe cutting pain is always associated with food intake (appears before or immediately after eating), radiates to the scapula with nonspecific localization of the ulcerative process (posterior wall of the stomach or its cardiac part). The pain decreases after vomiting, taking acid-lowering medication. The perforation of the ulcer is accompanied by increased pain (like cutting with a knife), the patient presses the legs to the stomach and covers them with his hands.
- Pancreatitis - accompanied by severe pain of a girdle nature (included under the blade of the left shoulder). An attack is always accompanied by errors in nutrition (fatty foods, salty, fried, alcohol, hunger). Vomiting does not bring relief.
Important! 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
During the collection of the anamnesis, the doctor pays attention to the connection of pain with physical activity, food intake, stress, as well as specifies the chronic and recent concomitant diseases.
Assessing the nature of pain, the presence of certain symptoms specific to diseases of various organs allows you to narrow the range of causes in a specific system of the body - heart, lungs, musculoskeletal system, gastrointestinal tract. 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, 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 with which doctor should I contact?
Depending on the severity and nature of the painful sensations under the scapula, the accompanying symptoms, you should consult a doctor:
- urgent call for urgent care - severe pain with increasing intensity and a rapid deterioration of the general condition;
- traumatologist - getting an injury that provoked pain syndrome;
- cardiologist - with accompanying chest pain (continuous or periodic), shortness of breath, cyanosis;
- neurologist, orthopedist - pain under the blade of the left shoulder, aggravated by the elevation of the arm, there is a clear link between the appearance of pain and physical activity, degenerative pathology previously diagnosed of the spine;
- gastroenterologist - there is a link 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 an insignificant VSD and finds confirmation of an acute surgical pathology or oncological process. In the future, the doctor will schedule a consultation with a narrow profile specialist.
Preliminary treatment regimens
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 syndrome:
- For neurological pain, strong pain relievers are most often used;
- Spine and muscle pathology 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 diseases;
- If you suspect a gastrointestinal disease, it is advisable to take antispasmodics, medicines to lower the acid (with ulcers).
Only by eliminating the underlying disease does the patient escape from the pain under the scapula. In acute conditions, urgent hospitalization and intensive treatment is sometimes required.
Radicality of treatment depends on the nature of the disease and the duration of its course, therefore, at the first painful symptoms you should consult a doctor. On this depends not only the outcome of the disease, but the chances of a full recovery increase.
In severe cases, timely medical care saves the patient's life.