The liver hurts under the shoulder blade. Causes and treatment of pain under the right shoulder blade from the back

Pain under the scapula is a clinical sign of many pathological conditions, among which there may be gastrointestinal, cardiological, neurological diseases, as well as osteochondrosis, intervertebral hernia, bronchopulmonary pathology and others.

The pain symptom can vary in intensity and location - under the right or left shoulder blade, and sometimes limit a person’s motor activity. Pain under the shoulder blade is most often associated with skeletal muscle spasms due to tension or with pain reflected from the internal organs located in the scapular region.

Pain under the shoulder blade on the right

Pain symptom that manifests itself under right shoulder blade associated with the following diseases:

• Biliary colic with spasm of the bladder, ducts due to blockage with stones. The pain is sharp, cutting, localized under the right rib and radiating to the back under the shoulder blade.
• Pain under the shoulder blade on the right can be caused by a diaphragmatic abscess. The symptom is very acute, intensifies with inhalation, even not deep, and most often radiates to the right.
• Acute pyelonephritis begins with pain in the lumbar region, which subsequently spreads higher and radiates under the right shoulder blade. The purulent process in the right kidney is accompanied by painful urination, elevated temperature bodies.
• Myofascial syndrome is also the cause that provokes pain under the scapula on the right. These are chronic muscle pains associated with irritation of certain trigger points.
• Among the factors provoking pain symptom under the right shoulder blade, sometimes herpes is also found - herpes zoster. This is a viral disease that is not considered life-threatening, but it causes very severe, excruciating pain, burning numbness. Herpes is typical of a rash, itching, and muscle pain extending to the shoulder blade.
• Osteochondrosis is one of the reasons that often provokes radiating pain under the shoulder blades, including the right one.
• Right-sided pneumonia. Pain during pneumonia most often manifests itself in the acute stage; there may be increased body temperature and a feverish state.

If the pain radiates under the shoulder blade

Any pain symptom that “gives away” is called irradiation. The impulse of visceral pain can be so intense that the irritation of the primary nerve branch is rapidly transmitted along the chain to final branch, that is, far from the original source. The pain radiates under the shoulder blade most often from an organ affected by inflammation and can be provoked by the following reasons:

• Increased pressure in the intestines due to inflammation and ulcerative process. With an ulcer, the postbulbar portion of the duodenum radiates to the right under the scapula.
• Biliary colic (gall bladder, liver).
• Acute pain radiates under the left shoulder blade and during an attack of angina, when sensations of pressure and compression appear.
• Pericarditis may also present with referred pain under the shoulder blades.
• Dissection of the walls of the aorta (aneurysm) is manifested by severe substernal pain radiating to the neck, left side, shoulder, and under the scapula.
• Pneumothorax (spontaneous) – acute pain in the chest with reflection under the scapula, in the area of ​​the scapula.
• Exacerbation of pancreatitis.
• Renal colic.
• Acute musculoskeletal dorsalgia.
• Myocardial infarction.
• Osteochondrosis cervical spine spine.

Referred pain may be transient, but can also signal that an acute condition is developing that requires immediate medical attention. If the pain radiates under the shoulder blade and is not relieved by antispasmodics and heart medications, you should consult a doctor who will conduct an examination, differential diagnosis and prescribe adequate treatment.

Pain under the shoulder blades when inhaling

A painful symptom under the shoulder blade, which intensifies with inhalation, is a signal characteristic of the following pathologies:

• Dry pleurisy is an inflammatory process in the pleura, the lining of the lungs. The pain may intensify with bending and movement, and subside in a horizontal position or on the side. The accumulating fluid in the pleural cavity provokes swelling and pain under the shoulder blade when inhaling.
• Pericarditis is an inflammatory process in the pericardial sac of the heart; the disease is manifested by weakness, chest pain, which becomes more intense when inhaling.
• Pain under the shoulder blades when deep breath may indicate intercostal neuralgia, which manifests itself in the form of girdle pains that seem to tighten the chest.
• Diseases of the gallbladder, spasm, colic, may also be accompanied by a pain symptom associated with inhalation.
• Renal colic (pyelonephritis, kidney abscess) can also be accompanied by pain in the hypochondrium, so intense that it spreads throughout the epigastric region, extends under the scapula and intensifies with inhalation.

Aching pain under the shoulder blade

Aching pain under the shoulder blade is evidence of a chronic process both in muscle tissue, in the spine, and in internal organs, which can signal their pathologies with reflected pain.

Scapular-costal syndrome (SRS) is the most common cause of aching pain. This syndrome is characterized by vegetative pain - aches, aching sensations, dull pain, which are often associated with weather conditions. In a clinical sense, aching pain under the shoulder blade is not specific sign specific disease Therefore, differentiation of pain should be carried out by excluding threatening conditions. Often, the aching nature of pain in the area of ​​the shoulder blades can serve as the first signal of an attack of resting angina, and myocardial infarction can also be such a symptom, which does not always have a clearly defined clinical picture. However, the main factors that provoke aching pain are considered to be osteochondrosis, scoliosis, kyphosis and other degenerative, dystrophic pathologies of the spine.

In addition, aching pain under the shoulder blade can be caused by psychogenic factors, autonomic crises, and fibromyalgia. The most alarming symptom is one that is accompanied by nausea and vomiting, since this may be the beginning of an exacerbation of a stomach or duodenal ulcer.

Severe pain under the shoulder blade

Intensive strong pain under the shoulder blade - left or right - is a reason to seek medical help; often such a painful symptom cannot be relieved on your own, and it may also indicate life-threatening conditions. Severe pain under the shoulder blade can be caused by the following diseases:

• Dagger-like, sharp, shooting pain, which intensifies during inhalation and is reflected in the shoulder, may be a sign of spontaneous pneumothorax. Additional clinical symptoms pneumothorax are rapidly developing shortness of breath, tachycardia, drop in blood pressure, slow pulse, enlarged (compensatory) veins in the neck.
• Severe pain that radiates under the shoulder blade and is accompanied by arterial hypertension, indicates an exacerbation of osteochondrosis of the thoracic spine. Simultaneous back pain under the shoulder blade, headache and jump blood pressure- a clear symptom of infringement nerve endings in the cervical or thoracic region. The pain may intensify when turning the body, shoot through when bending or moving, and is not relieved by heart medications or sedatives.
• Severe pain under the shoulder blade may be associated with a perforated ulcer upper section stomach. If the perforation progresses quickly, the pain intensifies literally every minute, the general clinical picture ulcers are typical - acute pain with irradiation, vomiting is possible, cold sweat, bluishness of the face, characteristic posture - knees tucked to the chest.
• Hepatic (biliary) colic also manifests itself as severe pain radiating upward to the right, under the shoulder blade, in the neck and even in the area of ​​the right eye. Pain symptom associated with blockage bile ducts after eating fried, fatty foods.
• A purulent process in the area between the diaphragm and the organs below, a subdiaphragmatic abscess, is an acute condition that requires immediate medical attention. Developmental bacterial infection in this form can provoke general intoxication and sepsis. Essentially this is - purulent peritonitis, limited by the diaphragm, manifested by severe pain in the hypochondrium, radiating to the right - shoulder, under the scapula. Also typical hyperthermia up to 40 degrees, fever, nausea.

It is not recommended to endure a strong, radiating pain symptom for more than an hour; if it cannot be stopped by available means, you need to call emergency help.

Dull pain under the shoulder blade

The nature of the pain under the shoulder blades can vary from aching, dull to very intense, sharp. A dull pain under the shoulder blade indicates that the cause is most likely related to the muscular system, tendons and ligaments.

In clinical practice, there is data confirmed by long-term observations:

• 85-90% of all pain symptoms in the back and shoulder blades are caused by inflammation, sprains, muscle and tendon damage. ligamentous apparatus. As a rule, these pains are dull, aching in nature.
• 5-7% of pain symptoms in the back, under the shoulder blades, in the area of ​​the shoulder blades are associated with neurological pathologies ( radicular syndrome). These are intense, sharp pains.
• 3-4% are due to other reasons - diseases of the respiratory system, heart, gastrointestinal tract, biliary pathologies. The pain is usually intense, sharp and requires immediate medical attention.

Dull pain under the shoulder blade is most often a reflex, vertebrogenic syndrome, which is characterized by the following symptoms:

• The pain has a clear localization - under the right or left shoulder blade, in the middle of the back between the shoulder blades.
• The pain does not radiate to the limbs or other parts of the body.
• The pain is dull, aching in nature.
• The pain symptom intensifies with physical activity on damaged muscles and ligaments.
• The painful area is painful on palpation.
• No symptoms of disc prolapse and compression (radicular syndrome).
• Absence of vegetative-vascular disorders.

Typical causes that provoke aching, dull pain under the shoulder blades are the degenerative process in intervertebral discs(osteochondrosis) of the cervical spine in the C5-C7 zone. Besides, Blunt pain may be a consequence of the inflammatory process in the intervertebral joints, a signal of a developing severe pathology - ankylosing spondylitis (ankylosing spondylitis). Often, dull pain is a sign of arthrosis, hidden injury to the intervertebral joints, spondylosis, and scoliosis.

Among the reasons that provoke a pain symptom under the shoulder blade of an aching, dull nature, there are diseases of the internal organs:

• Pleurisy.
• Chronic bronchitis.
• Pneumonia in chronic form.
• Atony of the gallbladder is dyskinesia of the hypotonic type.
• Chronic pyelonephritis (sclerotic process renal tissue).
• Oncological process in the liver and pancreas in the initial stage.
• Also, a dull pain under the shoulder blade on the left often signals a developing cardiovascular pathology - pericarditis, myocarditis.
• The pain symptom increases gradually, intensifies in stressful situations, with concomitant infectious and viral diseases. Also, latent bronchitis often manifests itself in an atypical form, pneumonia, when the pain increases only when coughing or if you go to bed on the “unhealthy” side.

Sharp pain under the shoulder blade

The sharp nature of the pain in the area of ​​the shoulder blades, under them, indicates a serious, sometimes life-threatening, condition.

The reasons that cause sharp pain under the shoulder blade may be the following:

• Dissecting wall of the thoracic aorta (aneurysm). The pain is sharp, intense, radiating along the spine, most often to the left, in the shoulder, under the shoulder blade.
• The initial stage of pleurisy. The pain is sharp, acute, intermittent, often localized under the right or left shoulder blade in the area of ​​fluid accumulation in the pleura. If pleurisy is accompanied by intercostal neuralgia, the pain becomes girdling.
• Spontaneous pneumothorax, which manifests itself as a sharp pain under the shoulder blade (referred from the chest). The condition is characterized by severe shortness of breath and acrocyanosis.
• Attack acute pancreatitis. The disease is accompanied by a sudden sharp pain in the epigastrium with reflection to the left in the chest, shoulders, heart area, under the shoulder blade.
• Myocardial infarction is most often characterized by increasing pain, but it can manifest itself as sharp, intense pain that quickly spreads from the chest, radiating to the left into the shoulder, jaw, under the shoulder blade, and into the back.

Pain behind the shoulder blades

The pain behind the shoulder blades, between them, as a rule, is not intense, so a person does not pay attention to the symptom, considering it temporary, transient. Failure to timely determine the cause, the factor that provokes such pain, can lead to the development of chronic, difficult-to-treat diseases.

Persistent, persistent pain between the shoulder blades and under them is most often caused by muscle tension, which in turn is explained by professional specifics - sedentary work in an office, at a sewing machine, driving a car, and so on. Typically, pain in the back under the shoulder blades is not associated with life-threatening pathologies or even with degenerative changes in the spinal column, since the thoracic region is not mobile, it is quite stable and stable. Most often, disorders, changes, and less often inflammation, affect the muscular system of the interscapular region; ligaments and tendons can also be stretched.

Pain of this type, associated with muscles, is characterized by a feeling of heaviness and tension, which quickly disappears with active movements (exercises), massage or warming up.

Pain, which is caused by damage, stretching of the tendons, is felt differently, it causes a feeling of aching under the shoulder blades, often the pain symptom is reflected in the heart area. The person also complains of numbness in the hands, a tingling sensation, and “crawling goosebumps.” It is not possible to neutralize such pain with heart medications, but you can get rid of it and do it quite simply:

• Change your body position periodically, preferably every half hour. If the work is sedentary, you need to stand up, walk around, make circular movements with your arms and shoulders, bring your shoulder blades together and spread them apart.
• It is advisable to devote 20-30 minutes daily to stretching exercises for the muscles of the interscapular area, and for general muscle tone of the body. Regular exercise will help prevent muscle spasms and pain in the back of your shoulder blades.
• It is necessary to periodically massage the shoulder-scapular area and collar area.
• You can periodically perform next exercise: Place a small (tennis) ball on the floor, lie on it with your upper back and “roll” the ball, passing it vertically and between your shoulder blades.

If a pain symptom from the back under the shoulder blades is accompanied by a cough, low-grade fever, pain increases with breathing, cough reflex, you should consult a doctor and be examined to exclude diseases of the bronchopulmonary system.

Nagging pain under the shoulder blades

The nagging nature of the pain is most often due to increased muscle tone due to pinched nerve roots. The reason why nagging pain develops under the shoulder blades may be myofascial syndrome, as well as osteochondrosis of the cervical spine, less often intervertebral hernia with protrusion.

Degenerative changes that reduce the height of the intervertebral foramina, causing displacement of the vertebrae to the right or left, are accompanied by inevitable pinching of nerve endings. Unlike intercostal neuralgia, which is characterized by acute symptoms and girdle pain, dystrophic pathologies of the spine develop more slowly and are accompanied by aching, nagging, constant pain.

In addition, nagging pain under the shoulder blades can be caused by scapulocosteal, scapulocosteal syndrome - SRS. In addition to painful sensations, a person clearly hears a specific sound - crunching. Also typical for LRS are referred pains that spread to the shoulder, neck, and often to the back of the head. The course of the disease is long, it recurs, but the prognosis is quite favorable.

Pain under the shoulder blade when moving

Severe, intense pain that increases with movement or breathing indicates compression of the nerve roots. Compression is caused by muscle spasms, hernia, protrusion and provokes pain under the shoulder blade when moving.

The causes of such pain are most often associated with diseases and conditions:

• Neuropathy of the thoracic and suprascapular nerve as a result of overexertion (sports), trauma, viral disease.
• Intercostal neuralgia, typical symptoms of which are sharp, girdling pain, aggravated by movement, interfering with breathing and bending. The pain is paroxysmal and one-sided; during the peak of the pain, the person “freezes” and finds it difficult to take a breath. Intercostal neuralgia is a consequence of advanced, undiagnosed thoracic osteochondrosis. The thoracic area of ​​the spine is stable; disc deformation develops over a long period of time and is accompanied by unexpressed periodic dull pain, which can also intensify with movement. Due to the non-specificity of symptoms and not expressed pain, osteochondrosis of the sternum is often “masked” as symptoms of other diseases - cardiological, bronchopulmonary. The acute stage of the disease is compression of the intercostal nerves, in which the intensity of pain depends on body position and motor activity.

Any referred pain is aggravated by movement. Radiating pain is associated with diseases of the lungs, heart, gastrointestinal tract, and gall bladder. Such symptoms require differential diagnosis.

Constant pain under the shoulder blade

If the pain is constant, this is direct evidence of a developing inflammatory process either in the musculoskeletal tissue or in the internal organs.

Reasons that provoke constant pain under the shoulder blade:

• Osteochondrosis of the cervical spine, which is accompanied by constant, dull, one-sided pain. The feeling of aching pain begins from the lower part of the back of the head, spreads down to the middle of the back and shifts towards the deformed vertebrae, reflected under the shoulder blade, less often - in the arm. The pain may periodically subside with warming and massage.
• The onset of intercostal neuralgia may not be typical and may not be accompanied by acute symptoms. Constant pain and a burning sensation under the scapula may indicate osteochondrosis of the thoracic region, which in the acute stage turns into intercostal neuralgia, that is, compression of the nerve roots.
• Muscle hypertonicity due to chronic static tension is also expressed in the form of constant pain in the back, under the shoulder blades. This symptom is typical for many professions associated with monotonous movements or postures - drivers, office workers, students.
• Constant pain under the shoulder blade may indicate inflammation of the hollow organ located in the area of ​​the shoulder blades. Such pain is often the first signal of a stomach ulcer or perigastritis.
• Constant intense, girdling pain, reflected under the shoulder blade, is also characteristic of herpes zoster - herpes zoster, herpes. The pain begins in the chest and lasts until the underlying cause is neutralized.

Pain when coughing under the shoulder blade

• Pain when coughing under the shoulder blade, in the back - typical sign bronchopulmonary diseases.
• Pleuropneumonia is a complex pathology accompanied by intense or aching pain, depending on the stage of development. The pain increases with the cough reflex.
• Tracheitis (inflammatory process in the mucous membrane of the trachea). The pain starts from the upper, middle part of the chest, and can radiate to the back, under the shoulder blades when coughing. The nature of the pain symptom is sharp, stabbing; if the cough subsides, the symptom also becomes less intense.
• Tuberculosis – infectious pathology bronchopulmonary system, in which symptoms can develop both long and quickly. Main visible sign Tuberculosis is considered to be a persistent cough for 1-1.5 months with sputum production, hyperthermia, and chest pain. If the disease is unilateral, the pain intensifies when coughing and is reflected in the back, under the shoulder blade.
• Oncological process in the lung, malignant tumor. Pain is evidence late stage process, often terminal. The pain can be reflected in the shoulder girdle, in the neck, in the back and under the shoulder blade. Painful sensations increase with coughing and deep breathing.
• Pain when coughing under the shoulder blade may accompany lobar pneumonia– an acute, life-threatening condition in which there is a very heat body, stabbing pain that increases with coughing, lack of air.

Stitching pain under the shoulder blade

The feeling of stabbing pain in the back and under the shoulder blade is most often caused by an inflammatory process in the pleura, especially if the interpleural ligament is shorter than normal. The cough with the syndrome is frequent, mild, but constant. Cough, as well as stabbing pains under the shoulder blade in this condition, it intensifies during a conversation, deep inhalation or exhalation, as well as under loads, sometimes insignificant. The painful tingling symptom may increase with prolonged walking or running.

Most often, the stabbing nature of the sensations is not considered a sign of serious pathologies; often such pain goes away without treatment, on its own. However, systematic tingling under the shoulder blade that does not disappear within 2-3 weeks is a reason to consult a doctor.

As a rule, stabbing pains are not caused by diseases of the skeletal or muscular system and are not associated with the spine. Most often, the cause of such symptoms is bronchopulmonary, cardiological and neurological diseases. In addition, the following pathologies may be factors that cause tingling in the area of ​​the shoulder blades:

• Beginning perforation of a gastric ulcer.
• Vegetative-vascular syndrome.
• Osteochondrosis of the cervical spine with pinched nerve roots without protrusion or hernia.
• Intercostal neuralgia in the initial stage.
• Atypical development of myocardial infarction.
• Spasm of the bile ducts.
• Atypical course of pyelonephritis.

Stitching pain under the scapula requires careful differential diagnosis, therefore painful sensations accompanied by nausea, hyperthermia, and surges in blood pressure should not be ignored. Must pass comprehensive diagnostics and find out the cause of the pain.

Pain and burning under the shoulder blade

The burning sensation is characteristic feature deformed spine, since most often (80-90%) back pain is associated with the musculoskeletal system.

• One of the most common causes that provoke pain and burning under the scapula is osteochondrosis of the cervical, less often the thoracic, spinal column. The pain begins in the neck and spreads as a burning, aching sensation downwards, often under the shoulder blade area. This is due to compression of the nerve roots by displaced vertebral processes. The pain is usually not intense, constant and varies depending on body position and movements.
• In addition, a burning sensation under the shoulder blade can be caused by an attack of biliary (liver) colic, or blockage of the bile ducts.
• Renal colic and exacerbation of pyelonephritis quite often radiate under the scapula and are accompanied by acute, burning pain. Such symptoms are very intense, especially when blood pressure drops, and therefore require emergency care.
• Pain and burning under the shoulder blade is one of the signs of reflux esophagitis in the acute stage.
• Intercostal neuralgia is often accompanied by a feeling of tingling, burning in the pinched area, and girdle pain radiating to the heart and back.

Pain under the shoulder blade when breathing

A painful symptom that intensifies with inhalation and is localized under the scapula can be caused by the following diseases:

• Stretching of muscles, ligaments of the interscapular region, pain from overexertion.
• Renal colic, which often manifests itself as shooting pain upwards, increasing with deep breathing. Most often, this symptom develops in the right hypochondrium, spreads upward, then radiates to the lower back and back.
• Pain when inhaling under the shoulder blade is a typical sign of intercostal neuralgia, when the nature of the pain is so strong that the person literally freezes. Every breath brings unbearable, sharp pain.
• Pain that occurs during deep breathing, often when inhaling, radiating to the back, to the area of ​​the scapula, may indicate an exacerbation of cholecystitis, biliary colic.
• Often the factor causing such pain can be injury, both visible and hidden. A rib fracture is not always accompanied by severe pain; a bruise is often accompanied by a fracture, but the person endures discomfort. The only sign of a hidden rib injury extending under the scapula may be pain when inhaling and coughing.

Girdle pain under the shoulder blades

Paroxysmal, girdling pain under the shoulder blades is a typical symptom of intercostal neuralgia. Compression of nerve endings by deformed vertebrae (discs) provokes severe pain, which can begin on one side of the body and move, as if in a circle, along the location of the intercostal spaces. The symptom is reflected in the lower back, in the back, is accompanied by difficulty breathing and intensifies with awkward turning, bending, physical activity. Pain can also increase under stress.

Girdle pain radiating to the back and shoulder blades can serve as a signal of exacerbation of pancreatitis. This condition is characterized by severe pain, fever, cold sweat, and cyanosis of the skin.

Perforation (perforation) of a stomach ulcer (cardial part of the wall), as a rule, radiates pain to the subclavian region, but can often manifest itself in the form of girdle pain.

It should be noted that there are no exact diagnostic criteria for spinal pain, so any pain, especially acute pain that lasts for several hours, requires urgent medical attention.

Burning pain under the shoulder blade

Burning pain under the shoulder blade is a sign of osteochondrosis, pinching, and compression of the nerve roots. Often such pain is disguised as cardialgia, it is especially similar to attacks of angina at rest or clinical manifestations of myocardial infarction.

How to distinguish what burning pain under the shoulder blade means?

Angina attack:

• The pain is pressing, squeezing, spastic in nature.
• The pain symptom is most often localized in the chest area, on the left, it can spread higher, be reflected under the shoulder blade, in the arm, in the jaw, in the neck.
• Objective external cause causing pain - stress, emotional tension, exercise stress.
• The pain rarely lasts more than 15 minutes.
• The pain symptom is relieved by taking nitroglycerin and other cardiac medications (after 5-10 minutes).
• The pain may subside with rest.
• The pain is independent of movement.

Burning pain under the shoulder blade when pinched is directly related to movement, activity, posture, and does not subside after the use of cardiac medications. It can be treated with nonsteroidal anti-inflammatory drugs, spinal straightening, and other methods.

Pain in the spine under the shoulder blades

Most often, pain in the spine under the shoulder blades is not actually associated with diseases of the skeletal system, that is, the spinal column. The most common causes of such pain are neuralgia and myalgia. A number of compression-ischemic conditions, diseases of the peripheral nervous system, intercostal neuralgia and other factors are the root cause of pain under the shoulder blades in the spine.

Scroll possible factors associated with stretched tendons, muscles, inflammation of nerves:

• Plexitis is a neuropathy of the brachial nerve. This is an inflammatory process in nerve plexus, causing damage to the muscle tissue of the interscapular region, reduces the sensitivity of the skin on the surface of the shoulder and median nerve. Clinically, neuritis of the brachial nerve (brachial plexus) manifests itself in paresis, peripheral partial paralysis of the arm due to atrophy of the internal brachial, deltoid and biceps muscles, the arm can hang like a whip, the pain is spontaneous, shooting, radiating under the scapula.
• Intercostal neuralgia, which is characterized by a sharp girdle pain, which is most often one-sided, spreading around the chest. Pain in the spine under the shoulder blades is often the peak of the disease; it is so intense that it is difficult for the patient to take a breath.
• Compression of the dorsalis scapulae - the dorsal nerve of the scapula, which innervates the rhomboid muscles, the muscle that controls the movement of the shoulders and shoulder blades.

It is quite difficult to check and determine what causes the pain in the spine under the shoulder blades on your own, but it is possible to carry out primary differentiation. A typical sign of neurological diseases of the interscapular region is pain in the “Napoleon pose” - crossing the arms in front, on the chest. If the pain is accompanied by an increase in temperature, a drop in blood pressure, tachycardia, or a general serious condition, you should not engage in self-diagnosis and treatment, you should immediately call a doctor.

Pain in the muscles under the shoulder blade

In order to determine what causes pain in the muscles under the shoulder blade. It is necessary to accurately describe the nature of the pain and all the accompanying symptoms. As a rule, muscle pain in the upper back is deep, pulling, aching in nature; any shooting pain is a sign of pinched nerve roots, and not inflammation of muscle tissue. Muscle symptom It can occur spontaneously, without apparent explicable reasons, but most often it develops against the background of overwork, after physical exertion or static tension of the body. Reasons that may be a factor provoking pain in the muscles under the shoulder blade:

• Overstrain of the muscles of the interscapular region. This is typical occupational syndrome associated with performing monotonous work or static body posture. Drivers, office workers, students, anyone who is forced to sit, stand in the same position during the day, or perform repetitive actions with one hand (painters, builders), sooner or later face muscle pain in the back and between the shoulder blades. Also, a similar symptom may appear in pregnant women whose spine is subject to increased stress due to changes in posture (the stomach increases) and weight gain.

Myositis is an inflammatory disease accompanied by muscle pain. Myositis may be caused by the following factors:

• Drafts, severe hypothermia of the back and neck.
• Chronic muscle tension of a professional nature.
• Back injury, including hidden (bruise).
• Acute respiratory infections (ARVI, acute respiratory infections).
• Overexertion due to intense training (sports), ill-distributed load, incorrect pre-warm-up.

Myositis is one of the most harmless causes of pain in the area of ​​the shoulder blades; the pain symptom will be relieved by massage, hot rubbing, and taking anti-inflammatory drugs. Myositis, accompanied by a purulent process in the muscles, is more dangerous, this is due to acute infection, which can cause an abscess, an abscess in a certain area of ​​the back. This condition is characterized by an increase in body temperature, intense pain, redness, swelling in the area where pus accumulates. Purulent myositis is treated as conservative methods, and through minor surgical intervention.

Throbbing pain under the shoulder blade

Pulsation in the back, under the shoulder blades, may be associated with non-life-threatening causes, but it can also be a sign of a developing serious illness. Periodic throbbing pain under the scapula is most often caused by a protrusion of the disc, its loss from the boundaries of the contour of the vertebral body, and developing compression of the nerve endings. It should be noted that protrusion represents the initial stage of an intervertebral hernia, when the fibrous ring remains intact and is not destroyed, but the process of its destruction has already begun. A bulging disc, which can be stopped and prevented from developing, is manifested by periodic shooting pain or throbbing in the part of the back where the displacement occurs. Protrusion of the vertebrae of the thoracic spine, PMD (protrusion of intervertebral discs) over time can transform into intervertebral hernia, which in turn manifests itself in intense pain and more severe symptoms. The etiology of protrusions is associated with degenerative processes in the spine - osteochondrosis, and the factors that contribute to the development of deformity are known to many of us:

• Sedentary lifestyle, physical inactivity, static body tension.
• Professional risks – sports, specialization features.
• Age over 50 years.
• Poor nutrition (excess salts).
• Excess body weight.
• Bad destructive habits - alcohol abuse, smoking.
• PMD - protrusion of the intervertebral discs of the thoracic region is manifested by nagging pain in the initial stage, with the development of the disease the pain becomes intense, radiating to the area of ​​the scapula, causing a sensation of pulsation.

Throbbing pain under the scapula is the beginning of radiating pain, when the transmission of a nerve impulse occurs pointwise, gradually. Painful sensations are tolerable, but require differential diagnosis, since pulsation may be associated with atypical development of pathological processes in the internal organs - lungs, heart, stomach, gallbladder.

Pain under the shoulder blade after vaccination

Preventive vaccinations are one of the most harmless reasons that provoke painful sensations in the back, in the area of ​​the shoulder blades.

Pain under the shoulder blade after vaccination is usually associated with diphtheria vaccination. Often the injection site swells, the skin is hyperemic, and the area under the shoulder blade hurts. However, this condition does not last more than 2-3 days; usually, on the second day, all discomfort subsides.

Pain under the shoulder blade after vaccination is caused by the body’s reaction to the introduced strains, viruses, bacteria, which are used to “train” the immune system to resist harmful microorganisms. The administered vaccines consist of weakened agents, so there is no need to worry about complications. Local reaction in the form of pain under the shoulder blade - this is an absolutely normal phenomenon, which indicates that the process of “getting to know each other” has taken place. You should not rub, wet the area in the scapular area, lubricate it with painkillers or use warming procedures. As a rule, before vaccination, the doctor carries out explanatory work and informs the person in detail about possible unpleasant complications and actions in such cases.

Pain under the shoulder blade during pregnancy

The pregnancy period is often accompanied by atypical sensations for the expectant mother. These conditions are caused hormonal changes, as well as an enlargement of the uterus and displacement of nearby organs. Also, the reason that can cause pain under the shoulder blade during pregnancy is often excessive stress on the spine. If before conception a woman had a history of osteochondrosis, then pregnancy will only aggravate the deformation of the discs and provoke periodic pain in the back, under the shoulder blades.

In addition, factors that provoke pain in the scapular region may be:

• Intercostal neuralgia, aggravated by colds, stress, and physical activity.
• Latent pneumonia or pleurisy.
• Sprain of the ligamentous apparatus, which is associated with increased production a specific hormone - relaxin.
• Shift of the center of gravity forward (stomach enlarged), tension in the muscular system.
• Rarely - exacerbation of pyelonephritis.

It should be noted that transient nagging pain under the scapula during pregnancy is most often not a threatening symptom, because every woman undergoes a comprehensive examination before registration and is then subject to constant dispensary observation. Preliminary ultrasound, x-ray or fluorography, blood tests, urine tests, and so on, enable the gynecologist to foresee possible complications in advance and take action. As a rule, subtle, nagging pain in the back and under the shoulder blade disappears after the 20th week of pregnancy; in other cases, a woman should consult a doctor and undergo additional diagnostics to avoid unnecessary worries.

Acute pain under the shoulder blade

Acute pain symptoms develop suddenly and are characterized by intensity and increasing pain. Acute pain under the shoulder blade can be associated with the following diseases:

• Biliary colic, attack of acute cholecystitis. The pain “starts” on the right side under the ribs, is acute and is reflected in the right shoulder, under the shoulder blade, neck, often in the lower back. The symptom is caused by a narrowing of the bile ducts, their blockage by an advancing stone. Reason similar condition can be either ingestion of fatty, fried foods, or infection, nervous or physical fatigue.
• Acute pain under the shoulder blade can be a signal of a penetrating gastric ulcer (“covered” perforation) with adhesions spreading into the pancreas. The disease is accompanied by a constant sensation of pain, periodically increasing acute pain, often girdling, reflected up under the shoulder blade or down into the lower back.
• Carrying out orthopedic tests.
• Identification of accompanying symptoms.
• Exclusion of acute conditions, life-threatening diseases.
• Exclusion or confirmation of the psychogenic etiology of pain.
• Direction to to a specialist to prescribe additional examinations - chest X-ray, spine, CT, MRI, cardiac ultrasound, cardiogram, bronchoscopy, FGDS, blood tests, urine tests, and so on, depending on the specifics of the disease.

It should be remembered that diagnosing pain under the shoulder blade is the prerogative of a doctor; not a single reference book or source can help a person accurately determine the source of a pain symptom or establish its specific cause in absentia.

Treatment of pain under the shoulder blade

The problem that the treatment of pain under the scapula solves is not limited to the relief of pain symptoms. Of course, acute pain needs pain relief and relief, as well as life-threatening conditions - ulcer perforation, myocardial infarction, spontaneous pneumothorax and others.

But the main goal in therapy is to eliminate the root cause, so the treatment of pain under the scapula directly depends on the diagnostic results, the patient’s condition, his age, and concomitant pathologies.

If the pain in the shoulder blade area is associated with myalgia or muscle strain, you can relieve it at home with the help of a reasonable load, performing a set of exercises, warming up, and warming up the muscles.

All other conditions caused by diseases of the internal organs require the presence of a doctor who will choose the method and method of treating pain under the shoulder blade and the underlying disease. Therapy can be either conservative or surgical, for example, in the case of perforation of an ulcer or blockage of the bile ducts. In addition, various procedures may be prescribed, such as reflexology, massage, heating, and possibly spinal traction.

You should pay attention to alarming, threatening symptoms that signal emergency conditions, These include:

• Angina pectoris.
• Gastrointestinal erosive processes.
• Bronchopulmonary diseases.
• Myocardial infarction.
• All cardiac pathologies.
• Pyelonephritis, renal colic.
• Spontaneous pain under the shoulder blade, acute.

Essentially, the task preventive actions– this is the prevention of relapses of pain, reducing the risk of exacerbation of the identified pathology.

In addition, if the symptom is associated with a neurological factor, muscle spasms, preventing pain under the scapula are simple rules:

• Control static tension, perform a variety of exercises to help relieve muscle tension.
• Regular exercise, keeping the muscle corset in good shape.
• Avoiding hypothermia and drafts.
• Attending massage sessions and physiotherapeutic procedures.

Pain caused by osteochondrosis is also prevented by reasonable physical activity, performing a complex of physical therapy, and taking certain medications that restore the structure of bone and cartilage tissue.

Pain under the shoulder blade from the back is the body’s response to an external influence and the damage it causes, or to a serious illness. Syndrome on the right side of the back often manifests itself as a result of diseases of organs that seem to be completely unrelated to this part of the body. When the syndrome is temporary, stops quickly and does not appear later, there is nothing to worry about. If it is observed for a long time, causes real discomfort, intensifies, and becomes regular, then there is a need to urgently conduct an examination in a medical institution, since the consequences of such phenomena often become dire.

Manifestations of pain under the right shoulder blade

To determine the danger of the syndrome, it is necessary to accurately determine the factors that caused it. The symptoms that accompany this phenomenon allow us to narrow down the search for causes. However, they are often characteristic of many completely various diseases, and an accurate determination can only be obtained after careful analysis by medical professionals.

Attention! If you feel pain under your right shoulder blade, do not delay going to the doctor. By forgetting the conditions of its origin, you complicate the treatment of the syndrome.

The causes of pain below the shoulder blade are commonplace and harmless. But this statement is very relative.

Stiffness of the body, uncomfortable posture, overexertion, and monotonous movements for a long period often subsequently cause aching pain.

The syndrome can occur as a result of body movement when the back muscles are not prepared for this action. Pulling up, trying to reach something with your hands is reflected by prolonged debilitating pain. In this case, a painful sensation can radiate from the right back to the lower back, affect the arms and legs, and be observed in the area of ​​the right shoulder blade.

Back pain between the shoulder blades can appear suddenly. It occurs as a result of sneezing, laughing or coughing. It is caused by a lack of oxygen, a person’s desire to inhale more air and is accompanied by pain in the right side. If such a phenomenon is not systematic, it is not dangerous for the body.

And yet, even short-term pain in the scapula area, which goes away on its own, leaves its mark. It can be caused by a serious disease of one of the internal organs or pathology in the spine. Very often, the main reason for long and difficult treatment is patients’ careless attitude towards their health and untimely access to a doctor.

Types and causes of pain

Almost every person can be characterized by the pain they feel. But only a specialist is able to identify the original source and determine why the right shoulder blade hurts. At the same time, he will need research, special equipment and, possibly, consultation with doctors whose specialty is completely unrelated to back diseases.

The probable causes of pain are determined by its type.

Acute

If acute back pain is expressed as burning and tingling, spinal pathologies can be excluded as a cause. Here the factor is almost always hidden in the internal organs. More precisely, in their diseases.

As a rule, the right shoulder blade often hurts in people with abnormally functioning cardiovascular system. The syndrome is inherent in diseases digestive tract, manifests itself in pathologies of the rectum. He is called:

• Dyskinesia of the gallbladder.
• Cholelithiasis.
• Acute cholecystitis.
• Liver colic.

Hepatic colic is characterized by unbearable pain that permeates every part of the body, and the shoulder blade is no exception.

Each of these diseases has its own symptoms, which appear later. In this case, the person becomes irritable, quickly gets tired, begins to sweat profusely, and experiences problems with sleep and appetite.

The pancreas, which has undergone an inflammatory process, becomes the cause of an acute painful sensation reflected in both shoulder blades. If the pathology affects the head of the pancreas, then the pain in the right shoulder blade is felt more strongly.

The right shoulder blade hurts due to a subphrenic abscess. Acute pain under the ribs is caused by an abscess in the area of ​​the diaphragm and liver. An abscess is caused by complications of peptic ulcers and is the result of unsuccessful surgery. The pain syndrome manifests itself during inhalation and radiates to the right shoulder and scapula.

Acute pain in the shoulder blade area results from falls, injuries and bruises. In addition to external damage, fractures and internal damage are possible. In this case, consulting a doctor is simply necessary.

Aching

Spinal diseases are often to blame for aching, nagging pain in the area of ​​the shoulder blades. The symptom is sometimes expressed by tingling in the back. One of the most common diseases that cause aching pain is osteochondrosis. The disease is common in people with a sedentary lifestyle. In addition, the causes are often hidden in neurological diseases and can be caused by a pinched nerve.

Low physical activity and monotonous work cause many health problems

Most dangerous factor What is causing the nagging pain under the right shoulder blade is a tumor. The difficulty of eliminating the syndrome is complicated by the fact that the place with the greatest concentration of pain does not indicate the source of the pathology, but is only its echo.

Aching pain is caused by:

• chronic pancreatitis;
• pneumonia;
• bronchitis;
• cirrhosis;
• hepatitis.

The cause of this symptom may be cholecystitis. This disease is characterized by shooting pain in the chest, radiating to the shoulder blades.

At first glance, cholecystitis has nothing to do with the right shoulder blade

The aching pain caused by pyelonephritis appears as if the area of ​​the back above the shoulder blade is on fire. The phenomenon is caused by an inflammatory process developing in the right kidney.

Note: Aching pain affecting the right shoulder blade is an important symptom that helps identify osteochondrosis and spondylosis.

In addition, aching pain is caused by cholelithiasis. The diagnosis of the disease is confirmed by nausea and vomiting, yellowness of the skin and fever.

Dumb

One of the main factors causing dull pain under the right shoulder blade is a spasm of the muscles acting on the scapular nerve. Otherwise, the causes of this syndrome are in many ways similar to aching pain and careful research is required to clarify the diagnosis.

Severe pain in the scapula from below is caused by displacement of the intervertebral discs and intervertebral hernia.

Diagnostics and treatment procedures

Acute pain lasting more than two hours is a reason to consult a doctor. The same actions are required by a progressive, intensifying pain syndrome. Preliminary diagnosis is carried out by a therapist. Based on its conclusions, the question of the advisability of more in-depth research. Ultrasound and tests make it possible to narrow the search for factors causing pain. Based on the results obtained, the therapist refers the patient to specialists in cardiology, nephrology, urology, etc.

If you are sure that the pain is caused by inflammatory processes in the spine, therapy begins with localizing and calming the inflamed area. Treatment is provided with analgesics, anti-inflammatory drugs, chondroprotectors and corticosteroids.

Back pain, concentrated on the right shoulder blade and caused by neurological diseases, is relieved with the help of appropriate ointments, gels and patches that have an analgesic and warming effect.

Severe pain, manifested by a fracture of the neck of the scapula or caused by a subdiaphragmatic abscess, is the reason for surgical intervention. In case of an abscess, the reason for emergency surgery is a possible rupture of the abscess with its contents entering the abdominal cavity, which can result in peritonitis and create a serious threat to the patient’s life.

To relieve the patient from pain caused by the consequences infectious diseases, antibiotics are used. For nagging pain caused by pathologies of the liver, kidneys and gall bladder, the patient must undergo a course of treatment with analgesics and antispasmodics. You can get rid of acute pain caused by urolithiasis only after removing the stones.

Painful sensations in the back are associated with disturbances in the psycho-emotional state. Here, sedatives are used for treatment.

Post-medication procedures

After drug treatment and relief from pain in the area of ​​the right shoulder blade, the patient is recommended to undergo a course of therapy aimed at restoring the immune system and strengthening the musculoskeletal system in the chest, neck and spine. These procedures help minimize relapse of the disease.

To start practicing therapeutic exercises, you need to make sure that the source of pain is completely eliminated, and the pain itself is reduced to a minimum. Any physical activity is carried out exclusively with the permission of a doctor and is carried out in the presence of a specialist.

Preventive measures

Since pain in the shoulder blades can be caused by many factors of different nature, there is no clearly defined prevention of this phenomenon. You can avoid back pain in the area of ​​the right shoulder blade if:

• prevent exacerbation of diseases of internal organs and ensure their timely treatment;
• avoid a sedentary lifestyle;
• prevent hypothermia of the body;
• devote time to physical education;
• participate more often in preventive examinations.

Any pain under the right shoulder blade and in the back area should not be ignored. Application folk remedies without the supervision of a doctor and self-medication in this case is completely excluded, since these methods often aggravate the disease and lead to serious consequences.

The scapula is a three-dimensional triangular bone that connects the humerus and collarbone. It owes its name to its external resemblance to a well-known tool - a garden shovel. The glenoid cavity of the scapula and the head of the humerus form the shoulder joint, which is the most mobile in the human skeleton.

Pain under the right shoulder blade from the back in most cases indicates pathologies of the articular elements of the shoulder, spinal column or paravertebral (paravertebral) structures. Other possible causes are damage to internal organs - bronchi, lungs, kidneys and gall bladder. Persistent pain in the scapula area almost always indicates a serious problem that requires medical and sometimes surgical treatment.

Muscle strain and inflammation

A large number of muscles are attached to the scapula: subscapularis, coracobrachialis, rhomboid minor and major, deltoid. Most often it hurts under the right shoulder blade because there is a sprain or an inflammatory process develops.

A muscle strain can be caused by putting a lot of stress on the back, lifting and carrying heavy objects, sudden movement and long stay bodies in an awkward position. However, as practice shows, in more than half of cases the cause is excessive physical activity. unprepared person and improper exercise performance.

The symptoms of a sprain are:

• sharp pain of varying intensity;
• increased pain when turning and bending the body;
• relief during rest;
• swelling and hematomas (in case of severe damage).

The main principle of treating sprains is complete rest and avoidance of any stress. Immediately after an injury, apply ice or cold compress, if necessary, take a painkiller tablet.

When there is inflammation of the muscles - myositis - you are bothered by aching pain that increases with pressure and movement. Sometimes there is slight swelling and redness. Often worsens general state: body temperature rises, headache, small painful lumps are felt in the muscles.

The causes of myositis are varied, but most often it develops against the background of ARVI, influenza or tonsillitis. It should be noted that in the thoracic region the muscles become inflamed relatively rarely, since myositis is localized mainly in the upper back or lower back.

One of the varieties is myositis ossificans or fibrodysplasia - an extremely rare form of the disease. This congenital disorder of osteogenesis (bone formation) develops rapidly and manifests itself in childhood.

Fibrodysplasia is the formation of ossified points in the muscle structure, which gradually enlarge and injure surrounding tissues. The process of ossification (ossification) can be localized almost anywhere - near the spine, on the limbs or in the pelvis.

Help: myositis ossificans is incurable and cannot even be treated surgical treatment. After the ossifications are removed, they form again.

Myofascial syndrome

Pain in the muscles of the back is the most common after headaches. Chronic pain syndrome affects more than 40% of people, most of whom are women.

Myofascial syndrome is a progressive condition characterized by the formation of trigger (pain) points in the muscles. The diameter of each point varies from 1 to 3 mm; a cluster of points can create a pain zone measuring 1 cm2. These points are formed under the influence of trauma and muscle strain.

A number of factors can provoke this process:

• skeletal anomalies - scoliosis (curvature of the spine to the left or right), pelvic asymmetry, shortening of one of the limbs, flat feet;
• back injuries;
• diseases of the spine - osteochondrosis, spondyloarthrosis, as well as hernias and protrusions;
• long-term use of medications - β-blockers, cardiac glycosides, calcium antagonists, antiarrhythmic drugs, anesthetics (Novocaine, Lidocaine);
• damage to connective tissue due to autoimmune diseases - rheumatism, lupus erythematosus, etc.

Cholelithiasis

With pathologies of the gallbladder, pain often radiates to the right shoulder blade. This is due to a spasm of smooth muscles when the walls of the bladder are irritated by the formed concrements (stones). An attack of biliary colic usually occurs suddenly and is concentrated on the right side under the ribs.

An attack of biliary colic can last from 15–20 minutes to several hours

The pain syndrome is acute, cutting in nature and in most cases occurs after eating fatty, fried, spicy foods, alcoholic drinks. The cause of the attack may be heavy physical exertion, nervous strain, or prolonged stay in an inclined position.

If there is a blockage of the bile duct, the pain is felt as dull and pulling. Associated symptom There is heaviness in the abdomen on the right, as well as nausea, turning into vomiting. It is possible to increase body temperature, sometimes to high values. When the common bile duct is blocked and the sphincter of Oddi is obstructed, jaundice develops and the stool becomes discolored.

Treatment of cholelithiasis can be conservative and surgical. In the absence of complications, specific therapy is not carried out. Single stones can be removed using shock wave lithotripsy.

Subphrenic abscess

Back pain in the area of ​​the shoulder blades can be explained by the formation of a subdiaphragmatic abscess - an abscess localized under the dome of the diaphragm. Most often it appears after abdominal operations in the abdominal cavity when peritonitis develops. The causative agent may be staphylococcus, streptococcus or E. coli.

The infection enters the body after partial or complete removal of the stomach, resection of the pancreas, suturing of a perforated ulcer, or removal of the spleen. The cause may be inflammatory pathology of internal organs, open or closed injury abdomen, as well as severe lung damage, osteomyelitis of the vertebral and costal bones.

Appear first general symptoms– weakness, sweating and fever. Elevated body temperature can be constant or rise periodically. Then it begins to hurt in the upper third of the abdomen and lower chest on the affected side. Pain syndrome varying intensity often radiates under the scapula, shoulder or collarbone.

A characteristic sign of an abscess is shortness of breath, dry cough, hiccups and increased pain when moving, taking a deep breath, coughing and sneezing. The patient breathes frequently and shallowly and tries to assume a semi-sitting position.

Treatment of subdiaphragmatic abscess consists of surgical opening and drainage of the abscess, after which antibacterial, anti-intoxication, anti-inflammatory and restorative therapy is carried out.

Help: if the operation is not performed in time, the abscess breaks into the abdominal and pleural cavity, which almost guarantees death.

Pleurisy

Pain near the shoulder blade can be caused by bronchopulmonary diseases - pneumonia or bronchitis, complicated by pleurisy. In this case, pain may occur both under 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 malignant neoplasms. Its cause may be bacterial, viral or fungal infection, injuries and operations on the chest organs.

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 (breast, ovaries). Metastatic pleurisy usually has mild symptoms and often manifests itself only as aching behind the sternum.

If a large amount of exudate accumulates, it is necessary to do puncturing or drainage to evacuate it. Depending on why pleurisy developed, specific treatment is prescribed. It may include antibiotics, steroids, and anti-inflammatory drugs. The tuberculosis form is treated with Rifampicin, Isoniazid, Streptomycin.

Urolithiasis disease

The formation of stones in the urinary system most often occurs in middle-aged people - from 25 to 50 years. The disease progresses in different ways: for some, symptoms are limited to a single unpleasant episode, while others complain of regular exacerbations. In some cases, urolithiasis has a chronic, protracted course.

The main symptom is renal colic, when the ureter becomes blocked. The localization of the pain depends on the location of the stone, and the intensity depends on its size. Pain in the right shoulder blade occurs when the right kidney is damaged. If the stone is lower, then the lower back or lower abdomen hurts.

Severe pain under the right shoulder blade is often observed with renal colic, complicating the course of urolithiasis

Typical symptoms of urolithiasis are frequent urge and burning when urinating, increased body temperature, nausea.

Treatment methods can be conservative or surgical. Most often, surgery is required; the indications for it are:

• large stones;
• development of renal failure;
• localization of the stone in the kidney, renal pelvis or ureter;
• purulent pyelonephritis.

Surgery can be open or endoscopic. The most gentle method to reduce the percentage of postoperative complications is shock wave lithotripsy.

During the operation, stones are crushed using a reflector emitting electro-hydraulic waves. After crushing, stone particles and sand are excreted along with urine. Sometimes their movement along the ureter causes renal colic, which is easily relieved with medications.

Note: any operation does not guarantee the absence of relapses. Therefore, it is necessary to carry out complex therapy, which can last for several years.

Intercostal neuralgia

Intercostal neuralgia (thoracalgia) is distinguished by severe symptoms and most often manifests itself as acute, piercing pain in the ribs both in the front and on the back. It may appear periodically or be a constant concern. The pain syndrome can be aching, burning or dull, but always difficult to bear.

A characteristic sign of neuralgia is a sharp increase in pain when inhaling, changing body position or sneezing. Often, during a painful attack, muscles twitch, sweating increases, and the skin turns red or, conversely, turns pale. Numbness occurs at the site of damage to the nerve endings.

The immediate cause of the pathology is pinched nerve roots, which is facilitated by various factors and diseases:

• osteochondrosis;
• spondylitis;
• Bekhterev's disease;
• primary and metastatic tumors;
• disruption of the stomach (gastritis);
• age-related changes in blood vessels;
• metabolic disease;
• chest injury;
• influenza, ARVI;
• hypothermia and drafts;
• prolonged or severe nervous stress;
• high physical activity;
• poor body rotation, prolonged stay in a static position.

Information: Intercostal neuralgia is characterized by pain that lasts 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 main direction of treatment is pain relief, for which anti-inflammatory non-steroidal drugs (NSAIDs) are prescribed - Diclofenac, Ibuprofen, Nimesulide, Piroxicam. For severe pain, therapeutic blockades with anesthetics and steroids are performed. To increase the threshold of central nervous system excitability, sedative medications are used.

Specific therapy depends on the origin of the neuralgia and may include antivirals, antihistamines and muscle relaxants.

Neoplasms

Bone tumors in the scapula are very rare and can be either benign or malignant. The former include osteoma and chondroma, the latter – chondrosarcoma and Ewing's sarcoma. Osteoma is different slow growth and a favorable current. It mainly affects children and young people from 5 to 20 years old.

Osteoma can grow asymptomatically and manifest itself only when there is compression of surrounding structures - nerve roots and blood vessels. Treatment is surgical only, there are practically no relapses.

Chondroma is benign tumor, originating from cartilage tissue. It is worth noting that when a chondroma is localized in the scapula, the tumor often degenerates into a malignant one. Due to the high risk of malignancy, such formations are removed radically.

Chondrosarcoma, like chondroma, is formed by cartilage tissue, but is malignant and widespread. Its growth is accompanied by increasing pain and swelling in the affected area.

Chondrosarcoma occurs in people of any age, even in children, but the largest percentage occurs in middle age - from 40 to 60. Mostly men suffer. The main method of treatment is removal of the tumor; if surgery is not possible, chemotherapy and radiotherapy are performed.

Ewing's sarcoma is one of the most aggressive malignant tumors, prone to early metastasis. It affects children and young people and causes severe symptoms such as pain, swelling and redness.

Since the tumor is highly aggressive, both surgical and therapeutic treatment. Both before and after surgery, chemotherapy and radiotherapy are performed, using high doses and several drugs. The prognosis of the disease is conditionally unfavorable.

Pain under the right shoulder blade can be a completely harmless symptom or indicate a serious illness. To get rid of pain and prevent possible complications, you need specialist consultation and examination. Based on its results, the doctor will prescribe treatment and give the necessary recommendations. Be healthy!

Severe pain under the right shoulder blade may indicate the following diseases:

• Acute vertebrogenic radiculopathy or pinched nerve roots due to right-sided displacement of intervertebral discs (intercostal neuralgia). This disease is secondary, developing against the background of chronic compression of nerve endings in the area of ​​their exit - in the “tunnel”. The so-called “tunnel” is formed from various structures - osteophytes, hernia, articular tissue. The longer the pathological process of intervertebral disc degeneration lasts, the smaller the lumen in the tunnel becomes, the blood supply to the nerve endings is disrupted, swelling and pain symptoms appear, including severe reflected pain under the right shoulder blade.
• Pancreatitis in the acute stage is accompanied by characteristic girdle pains, as a rule they radiate evenly under both shoulder blades. However, when the head of the pancreas is inflamed, the pain spreads mainly to the right and is felt like a lumbago in the area of ​​the right shoulder blade. The general pain symptom is constant and does not subside when changing body position, does not increase with tension, inhalation or coughing.
• Cholecystitis in the acute stage is the main cause of pain referred to the right shoulder blade. The symptom is so typical that many patients with a chronic disease already know that inflammation has begun. In addition to pain radiating upward to the right, acute cholecystitis is accompanied by fever, nausea, vomiting and often yellowing of the skin.
• Hepatic colic is very similar to an attack of cholecystitis; it is also accompanied by severe pain under the right shoulder blade, but there is no nausea, vomiting, or hyperthermia.
• Spontaneous pneumothorax (traumatic perforation of the pleura) is characterized by sudden, pronounced pain in the middle of the chest with irradiation to the scapula.

Dull pain under the right shoulder blade

• Nephritis or chronic pyelonephritis in stage II of the process, when changes in the renal tissue are sclerotic in nature. The pain is felt periodically, like a pulling, dull, radiating to the lower back or top part bodies. With a right-sided process, the pain symptom radiates under the right shoulder blade. In addition to pain that is not clinically obvious, the disease is accompanied by painful urination, low-grade body temperature, and less commonly, nausea.
• Chronic cholecystitis also manifests itself as dull pain, which can occur in paroxysms, but does not cause obvious discomfort to the patient. The pain radiates to the epigastrium (under the stomach) and at the same time “stretches” under the shoulder blade.
• The causes of dull pain in the area of ​​the right shoulder blade are various malignant processes localized in the internal organs located on the right. Tumors of the liver, pancreas, right kidney, or right lung may manifest as intermittent dull pain under the right shoulder blade.
• Liver cirrhosis in the initial stage, which, in addition to the characteristic clinical picture, manifests itself in the form of dull right-sided pain, reflected under the scapula.

Sharp pain under the right shoulder blade

This is usually an attack of hepatic colic, acute cholecystitis or a symptom of cholelithiasis. Also, acute pain under the right shoulder blade may indicate a hypertensive form of gallbladder dyskinesia. Hyperkinetic dysfunction of the bile ducts can be provoked by both nutritional and neurological, psycho-emotional factors. Stress, emotional overload, violation of dietary rules (overeating, spicy, fried or fatty foods) are the main causes of ADHD, which is accompanied by periodic paroxysmal pain in the epigastrium, radiating to the left or right, often to the upper right part of the body. The pain spreads to the back, under the right shoulder. Acute pain under the right shoulder blade may intensify when inhaling or bending over. As soon as the provoking factor is eliminated, the pain goes away. In addition to the pain symptom, the patient has characteristic neurological signs - irritability, increased fatigue, poor sleep, sweating.

Sharp pain under the right shoulder blade

This sign is a typical symptom of the final stage of a subdiaphragmatic abscess, when the sensation sharply intensifies with a strong inhalation and is reflected in the shoulder and right shoulder blade.

Also, sharp pain in the area of ​​the lower lobe of the scapula may be one of the signs of renal colic or purulent infiltration in the right kidney with pyelonephritis. The pain symptom spreads to the iliac region, hypochondrium, and often under the scapula. In addition to pain, purulent pyelonephritis is accompanied by fever, frequent and painful urination.

Hepatic colic is a sharp, acute pain that occurs most often at night. The pain is acute and spreads to the right shoulder, often radiating through the shoulder blade to the neck. If colic lasts more than 4-5 hours, the pain spreads throughout the abdominal area, accompanied by nausea and vomiting, which indicates an acute clinical picture that requires hospitalization.

Stitching pain under the right shoulder blade

These are, as a rule, quickly passing sensations that are not associated with serious pathological disorders in internal organs. Most often, stabbing pain is a symptom of neurological disorders due to osteochondrosis of the cervical or thoracic spine. Unlike pain of a similar nature on the left side, which may indicate life-threatening cardiac diseases, transient pain on the right side is provoked by an uncomfortable posture, a sharp turn or physical strain. However, stabbing pain can also be a sign of spasm of the walls of the bile ducts and the onset of an attack of hepatic colic or exacerbation of cholecystitis. Therefore, if the pain recurs, increases or “spreads”, its character changes within 1-2 hours, you should consult a doctor or call emergency help.

Nagging pain under the right shoulder blade

These pains are most likely associated with changes in the structure of the spine or with spasms muscular system shoulder girdle. Osteochondrosis cervical area the spinal column is characterized by aching, pulling sensations, which may intensify slightly when changing body position or under static, constant load (the same posture). The pain may appear in the morning after sleep and goes away during the day after moderate, distributed movements. Also, the pain symptom is relieved by heat or rubbing, which indicates a spastic cause of pain. For all other diseases, nagging pain under the right shoulder blade is uncharacteristic. An exception may be malignant tumor processes internal organs - liver, right kidney, head of the pancreas or right lung. Since oncological diseases develop latently and manifest themselves in the initial stages with minor, in a clinical sense, implicit symptoms. Pyelonephritis can also be accompanied by referred upward pulling pains, but, as a rule, this is atypical and rare.

Constant pain under the right shoulder blade

This is a clear symptom of hypotonic type of diarrhea. Dyskinesia of the bile ducts in this form in clinical practice is much more common than the hyperkinetic form, especially in women and children. The pain develops gradually in the area of ​​the right hypochondrium and can be reflected upward into the right shoulder and under the shoulder blade. The pain symptom does not cause severe discomfort, as many patients note - it is tolerable. This constant nature of pain is “habitual” for those who suffer from gallbladder diseases. Compared to an exacerbation of the process or an attack of cholecystitis, constant pain under the right shoulder blade is tolerated by patients much more easily and does not require urgent treatment. However, the wave-like course of the underlying disease can increase and move from the remission stage to the acute period, therefore, anyone who experiences chronic radiating right-sided pain should undergo a comprehensive examination and begin treatment as soon as possible. The main danger of undiagnosed nagging pain in the right upper part of the body can be gastroduodenitis, acute cholecystitis, cholelithiasis

Burning pain under the right shoulder blade

It may indicate both infringement of the nerve roots due to osteochondrosis, and serious pathologies requiring immediate treatment. These include right-sided pneumonia, which often develops asymptomatically in the initial stage and can manifest itself as periodic burning pain under the right shoulder blade. Also, such painful sensations may indicate atypically developing angina; it is characterized by left-sided referred pain, but in some cases there is also irradiation under the right shoulder blade. The very nature of the pain, which in clinical practice is called causalgia (from causis - burns and algos - hurts), indicates inflammation and or damage to the peripheral nerve processes. Thus, burning pain under the right shoulder blade can occur either when nerve roots are pinched or when nearby tissues atrophy, which is typical for pneumonia or angina pectoris - angina pectoris.

Osteochondrosis and pain under the right shoulder blade

Osteochondrosis. Pain under the right shoulder blade may be one of the symptoms of a cervical deforming process or osteochondrosis of the thoracic spinal column. This is typical for anyone involved in sedentary office work; this symptom is especially typical for schoolchildren or students. With such a static position, there is constant compression of the nerve endings, which results in chronic pain, reflected in the direction of displacement of the intervertebral discs. The pain can be aching, pulling, radiating to the neck or shoulder, as well as under the right shoulder blade. The symptom intensifies with awkward turns and movements, often in the morning after sleep. Often osteochondrosis and pain under the right shoulder blade are accompanied by numbness in the fingers and headache. Also, one of the causes of such pain may be S-shaped scoliosis of the thoracic spinal column.

Pain in the right shoulder blade

The pain radiates to the right shoulder blade - this is evidence of the following diseases:

Cholelithiasis	Acute, paroxysmal pain, with nausea, vomiting, elevated body temperature, fever, icteric skin color
Spontaneous traumatic pneumothorax	Sharp, acute pain in the chest area, radiating to the scapula area (under the shoulder blade)
Cholecystitis in the acute stage	Pain in the right hypochondrium, spreading to the epigastric region. The pain radiates to the area between the shoulder blades, under the right shoulder blade, in the right shoulder, in chest. The pain lasts from several hours to several days.
Renal colic, pyelonephritis	Paroxysmal pain, sharp, cutting in nature, radiating to the lower back. As the syndrome develops, the pain radiates upward if it is inflamed right kidney, there are purulent infiltrates, the pain radiates under the right shoulder blade.
Pancreatitis in the acute stage, inflammation of the head of the pancreas	The pain occurs suddenly and is constant. The symptom spreads across the epigastric region and radiates to the sternum, often under the right shoulder blade and into the shoulder.

If the pain radiates to the right shoulder blade and its intensity increases, you should call an emergency medical care, this is especially true for conditions accompanied by hyperthermia within 38-40 degrees.

Aching pain under the right shoulder blade

Aching pain in the area of ​​the right shoulder, in the scapula and under it, may indicate a chronic process that develops in organs distant from the scapula. Radiating (referred) pain that is not intense is a typical sign of a latent inflammatory process in the liver, kidneys, gall bladder or pancreas. Often, aching pain under the right shoulder blade does not encourage people to see a doctor, while patients try to use various home treatments and only aggravate the pathological process. Diagnosis of aching, referred pain is often difficult, since the clinical picture is not manifested, while the main pain symptom is relieved by “folk” methods - rubbing, warming, massages. Oncological diseases, which can develop over years and manifest themselves as periodic aching, radiating pain symptoms, also pose a danger. Identified on early stages, many oncological processes can be stopped, an acute pain symptom is, unfortunately, a sign terminal stage. Aching pain under the right shoulder blade can be a signal of the following diseases:

• Chronic cholecystitis.
• Chronic pyelonephritis.
• Cholelithiasis in the initial stage.
• Liver diseases, including cirrhosis or hepatitis.
• Chronic pancreatitis.
• Osteochondrosis.
• Chronical bronchitis.
• Latent pneumonia or pleurisy.
• Tumor processes.

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Pain under the right shoulder blade from the back can occur for several reasons. The scapula is a flat triangular bone located at the top of the back. Knowing the cause of pain under the scapula, you can cope with the pathology with the help of selected therapeutic therapy.

Painful symptoms can occur for a number of reasons. Often the painful sensations go away on their own, but in some cases they can be prolonged. This can happen due to the presence of serious pathologies.

In any case, discomfort does not bring pleasure, and besides pain, people are constrained in their usual movements.

Pain under the right shoulder blade from the back most often begins due to the following factors:

pinched nerve roots;

tenderness under the right shoulder blade due to an unacceptable position during night rest; herpes zoster;

osteoarthritis;

due to fractures on the side of the back in the area of ​​the scapula;

cuff injuries (rotator cuff) in the area shoulder joint;

pathological processes in muscle tissue.

The problem in question is quite common occurrence among people engaged in active work, having unnatural loads that lead to stretching of muscle tissue, accompanied by pain symptoms.

Pain under the right shoulder blade from the back can occur due to playing tennis.

Unpleasant symptoms are caused by similar movements associated with work profile and sports life.

Often pain under the right shoulder blade from the back goes away on its own, but in some cases it can be prolonged

It is important to know: Very often, pain under the shoulder blade occurs in golfers, tennis players and other athletes.

Pinched nerve root

When an unhealthy feeling occurs during the movement of the arm, pinched nerves are a common cause. Under these conditions unpleasant painful sensitivity radiates to the area under the right scapula.

In addition, there is a burning sensation in the extremities of the hands and fingers. Often, such symptoms do not leave the body for many months.

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Important to remember! A prolonged sensation of pain under the right scapula bone, manifested from the back, should not be ignored. You should seek support from a medical institution to rule out more serious pathologies.

Pinched nerves most often occur after a cervical hernia occurs. between the vertebrae. The spinal column consists of vertebrae, between them there are discs that serve as shock absorbers for the body.

Each vertebra has a hole, which, when all the vertebrae are assembled into a single column inside it, forms a niche for spinal cord, the nerve endings come from it.

If the external fibrous membrane(with the release of gel-like contents from the outside), a hernia forms in the intervertebral disc, which compresses the nearby nerve roots.

If the hernia is localized in the cervical region, it is accompanied by painful symptoms throughout the entire limb, including the scapula. Additionally noted: frequent pain in the head, decreased muscle strength, numbness, colic in the fingers, burning sensation.

Unnatural position during night rest

When you wake up in the morning, sometimes you feel unbearable pain in the joints of your shoulder bones. More often this occurs due to the fact that during sleep the human body remained in an unacceptable position for a long time.

Sometimes this happens due to a high pillow with the head thrown back. Resting in this position is the basis for pain under the scapula.

Joint dislocation or fracture

Accidents, sports injuries that lead to dislocation or fracture of the shoulder blades are special causes for painful symptoms, with increased pain with movement. Additionally, swelling and pallor of the tissues in problem areas are observed.

Ringworm (shingles)

Considered pathology is provoked viral disease chickenpox. This disease may appear many years after recovery, causing pain throughout the body. Then rashes with fever, headache, and flu-like symptoms appear.

Osteoarthritis

The main manifestation of this disease is sensitive, painful symptoms in the joints. Due to the thinning of the cartilage, the bones separate from each other, causing pain.

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Osteoarthritis of the shoulder girdle is very rare, but is a provocateur of a chronic painful symptom on the side of the right and left shoulder blade bones and under them on the back.

Rotator cuff in the shoulder joint: its undermining

Athletes are very familiar with this type of injury. Playing this sport sometimes leads to accidental damage several or one muscle in the areas of the shoulder joint, which is manifested by pain, including in the middle of the back.

Problem fabrics

The pain syndrome, localized on the right side under the scapula, is caused by unhealthy tissue covering the muscle mass. These changes cannot be treated without the intervention of specialists.

Causes of pain under the right shoulder blade, according to the nature of its intensity

Due to the ambiguous appearance of the pain syndrome, additional diseases body, the nature of painful sensations has different intensities.

Painful qualifications of the syndrome:

• spicy;
• blunt;
• cutting;
• pricking;
• pulling;
• burning.

If there is acute pain under the right shoulder blade

Acute pain syndrome most often worsens during inspiration. The reasons for this sensation may be: an attack of hepatic colic, an exacerbation of cholecystitis, as well as a pathological malfunction of the gallbladder and its ducts.

Osteoarthritis of the shoulder girdle is very rare, but is a provocateur of a chronic painful symptom on the side of the right and left shoulder blade bones and under them on the back.

What ailments does dull pain under the right shoulder blade indicate?

Dull pain under the scapula on the right side is accompanied by:

• nephritis, pyelonephritis chronic course, with additional, painful urination, high fever;
• chronic cholecystitis;
• the onset of an outbreak of liver cirrhosis;
• malignant tumors localized to the right-sided organs inside the body.

Sharp pain under the right shoulder blade

Painful tingling under the right scapula, most often there is no reason for serious worries, this symptomatology manifests itself due to physical overload muscle mass during steep movements.

Unpleasant sharp sensations on the right side of the back, appearing from a subdiaphragmatic abscess, with the manifestation renal colic, purulent inflammatory processes in the right kidney.

In some cases, tingling may be a warning sign of nerve damage., which is provoked by osteochondrosis. Increased tingling warns of spasms in the walls of the bile ducts, or exacerbation of cholecystitis.

Nagging pain under the right shoulder blade

Mostly, the symptoms in question occur with unnatural changes in the structure of the spinal column, with spasm of muscle tissue in the shoulder band. In some cases, this indicates possible right-sided oncological processes in the body.

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Note: When considering a painful feeling under the right scapula, there is no need to exclude gastrointestinal disorders, neurology, emotional disruptions - all these reasons can send pain signals.

Burning pain under the right shoulder blade

A burning sensation can warn of pathological abnormalities, that require immediate medical attention. This may be a harbinger of an outbreak of angina pectoris, pneumonia, soft tissue atrophy, and nerve pinching.

Causes of constant pain under the right shoulder blade

When the pain is constant, this is a sign of bile duct dyskinesia of the hypotonic type. Initially, symptoms appear in the right hypochondrium, then are felt under the scapula bone, extending to the shoulder. The patient experiences unbearable, painful discomfort.

You cannot tolerate a painful condition caused by cholecystitis or gallstone disease. You should seek support from doctors at the first manifestations, then there is a possibility of avoiding radical method treatment.

The causes of constant pain are strong and aching in nature with additional symptoms.

Which doctor should I consult if I have pain under my right shoulder blade?

When there is pain under the right scapula bone, a consultation is required medical worker. The local doctor will refer you to the necessary specialized expert. This may concern the profile of cardiology, gastroenterology, neurology, vertebrology, traumatology.

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The therapist selects a specialist after the patient’s complaints, radiography, and laboratory tests.

Important to remember!

You cannot tolerate a painful condition caused by cholecystitis or cholelithiasis. You should seek support from doctors at the first manifestations, then there is a chance of avoiding a radical treatment method.

Pain on the right side, under the scapula, which lasts more than three days, cannot be relieved with painkillers. You need to visit the clinic to find out the exact cause. After diagnosis, the specialist will prescribe adequate treatment to eliminate the causes.

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