What does back pain in the shoulder blade area say?

Back pain in the shoulder blade area

Back pain in the shoulder blade area is a symptomatic feature of not only diseases of the spine, but also pathology of internal organs. Why see a doctor and a specialist who makes an appointment? An effective method of relieving discomfort.

If you are worried about back pain in the shoulder blade area, such symptoms may indicate a disease of the spine or shoulder girdle, nerve pathology, somatic diseases. Careful collection of patient anamnesis and complaints allows you to identify the cause of the problem and decide on further treatment.

Often, back pain in the shoulder blade area is the first sign of pathological changes in the body. And the definition of provoking factors allows you to prevent the occurrence of this disease at an early stage. The symptoms can occur on half of the body or spread to the arms, appearing during inhalation - all this is important when making a diagnosis.

Causes of pain and its localization

As a rule, discomfort in the shoulder blade area appears when moving. For example, prolonged static position of the body, awkward turns. In this case, pain under the scapula indicates damage.

Important!Localization of unilateral pain (on the left under the scapula or on the right) is rare. This is due to the symmetrical arrangement of the roots of the spinal cord.

Traumatic injuries

Painful sensations can signal muscle or bone damage. In this case, the symptoms are diffuse and have varying intensity. The pain arose suddenly and persistently.
Injuries that can cause pain to the shoulder blades:

  1. Cracks, cracks. Serious injury where the pain is concentrated directly in the scapula. These symptoms increase with minimal movement, so that the patient is unable to move.
  2. Bruises. The discomfort is superficial, it occurs due to damage to the muscular skeleton and is localized at the bottom of the shoulder blades. On examination, it is possible to detect signs of inflammation, swelling of tissues. Symptoms persist for 14-21 days.
  3. Subluxation or displacement of the vertebrae. Joint pain occurs below the shoulder blade or at its level. The discomfort can be exacerbated by nerve root compression.

With injury in the area of damage, soft tissue edema is observed, pain appears suddenly. Often cramps appear while moving.

Protrusion and hernia of the spine

With this pathology, the spinal cord and nerve roots are compressed, which is accompanied by impaired sensitivity and sharp pain under the right and left scapulae.

Possible placement discomfort:

  1. Back pain under the scapula on the left or right. Shows 6-12 disc lesions with possible involvement of the lumbar spine in pathological processes. Because the latter experiences an increase in stress, there is a high risk of developing a spinal hernia.
  2. Above the shoulder blades. The protrusion is localized in the cervical spine or segments 1-3. The discomfort becomes more pronounced with the movement of the head.
  3. Between the shoulder blades. Pain is observed when 3-6 segments of the spine are affected. It becomes clearer with a deep breath, twisting the body, kidnapping the upper limb to the side.

Note!With protrusion, the pain persists even at rest. This is due to nerve root compression and muscle spasm.


If the back is painful in the shoulder blade area, symptoms may indicate osteochondrosis of the thoracic spine. These symptoms occur due to entrapment of the spinal cord or nerve roots and deformation of the intervertebral disc. The disease gradually progresses, causing more and more symptoms.

Areas of discomfort are determined by the localization of the lesion:

  1. 2-6 segments. Discomfort is localized at the level of the shoulder blades, irradiation to the arms and neck is possible. Increased intracranial pressure, dizziness due to squeezing of blood vessels are possible.
  2. 6-12 segments. There is pain under the scapula in the left or right back and extends to the lower back.

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


This pathology is also characterized by the placement of unilateral pain syndrome. With spondyloarthrosis, there is a violation of mobility, a feeling of stiffness due to damage to the intervertebral disc and facet joints.

Symptoms depend on the neglect of pathological changes:

  1. Destruction of cartilage tissue. It develops against the background of reduced blood circulation and violation of the integrity of connective tissue. Cartilage elements become brittle - quickly damaged and slowly renewed. The condition is exacerbated by microtraum due to vigorous physical activity. In this case, the pain radiates to the shoulder blades and lower back.
  2. Deformation of the intervertebral disc. Tissue thickening is accompanied by movement disorders, as well as pain in the shoulder blades and back. Against this background, the destructive process is on the rise.
  3. Bone growth formation. Appears in the form of advanced spondyloarthrosis. They bring damage to blood vessels, muscle tissue, nerves, joints.

With spondyloarthrosis, pain occurs after physical exercise, and can be localized in the shoulder blade area or between them. At rest, the symptoms disappear.


It is accompanied by curvature of the spine in the transverse direction due to the tension of the muscles that support the posture. In this case, the spinal cord and nerves are compressed, discomfort is observed under the scapula.

Spinal scoliosis

Other symptoms of scoliosis:

  1. Change the shape of the chest. There is displacement of the ribs and spine, which causes damage to the spinal cord and its branches. Because of that, back pain is observed on the left side below the scapula or on the right side.
  2. Respiratory disorders. Because of the deformation of the chest, lung dysfunction is observed - one is compressed, the second seeks to make up for the gas exchange deficit.
  3. Violation of cardiac activity. As the spine is tilted, shortness of breath is present, the skin becomes pale, the heartbeat changes.

Note!Scoliosis is characterized by compression of the spinal cord, so the discomfort is localized between the shoulder blades or below it. The pathological focus has a clear outline and can spread to nearby areas only with muscle spasm.


Kyphosis is the curvature of the back of the spine, in which the shoulder girdle is pulled forward, a bow appearing. In this case, the pain is localized on the shoulder blades, bilateral, radiating to the neck, arms.

Spinal kyphosis

Mechanisms of pain formation in kyphosis:

  1. Muscular. The curvature of the spine leads to muscle tension of the collar zone and their spasm, which is accompanied by pain in the shoulder blades.
  2. Neurogenic. Against the background of the curvature of the spinal space, the distance between the vertebrae decreases. This leads to violation of the spinal cord branches and the occurrence of pain in the shoulder blade area, which can spread to the neck, collarbone, shoulders.

With kyphosis, the vertebral arteries are compressed, which leads to a deterioration of cerebral circulation, dysfunction of internal organs.


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

If left untreated, sciatica is accompanied by other symptoms:

  • burning pain in the back (under the shoulder blades and in the lower back) - indicates pinching of the roots of the spine;
  • lumbago with irradiation in the legs;
  • seizures;
  • violation of sensitivity in the back, lower back;
  • numbness along nerves (visible on lower legs, thighs, legs).


Inflammation of nerve fibers in this anatomical area can cause pain under the shoulder blades. The most common pathological cause is hypothermia.

Neuralgia causes pain in the shoulder blade area

Inflammation can affect structures such as:

  • Intercostal nerve. 1-4 pairs located along the lower edge of the affected ribs. The pain is localized below the shoulder blade and below it, in the lower chest, more rarely extending to the anterior part.
  • Supraspinatus and suprascapular nerves. Characterized by the appearance of pain in the shoulder blade area from behind in the clavicle area. Sometimes the symptoms extend to the shoulders.
  • Infraspinatus and subscapularis nerves. Discomfort is felt under the scapula on the left or right side. As the inflammation spreads to the muscles, the pain increases when you move the hand.

Note!With neuralgia, the pain is often unilateral - the symptoms are localized in the part that has experienced hypothermia.

Shoulder-scapular periarthrosis

It is characterized by inflammation of the shoulder joint and surrounding tissues. It is accompanied by movement disorders, which can be removed only after warming up the muscles.

With humeroscapular periarthrosis, discomfort is observed at the level of the shoulder blades and down. In the early stages, it occurs after intense physical activity, when the disease progresses - at rest. Other pathological symptoms:

  • numbness of the upper limbs;
  • Headache;
  • decreased spinal mobility.

Cardiac pathology

Pain under the shoulder blades may indicate heart disease. This is due to the fact that the branches of the parasympathetic trunk that connect to the spinal cord and nerve roots enter the organ. If there is pain under the left scapula from behind from behind, the symptoms may indicate a mild form of myocardial infarction. It can last for several days, increasing with movement and decreasing at rest.

Pain under the scapula and pain in the back of the sternum with heart disease

Other pathological signs:

  • burning sensation, pain in the back of the sternum;
  • heart rhythm disorders;
  • palpitations;
  • dyspnea;
  • dizziness;
  • nausea vomiting;
  • increased blood pressure.

Diseases of the digestive system

The mechanism of pain onset is similar to the previous cause - it spreads along nerve fibers. The localization of symptoms depends on the organ affected, the less often the discomfort is bilateral.

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

If the back hurts on the left side below the scapula, the development may be:

  • inflammation of the gastric mucosa;
  • pancreatitis (inflammation of the pancreas);
  • stomach ulcer.

In addition, with such pathology, there is nausea, vomiting, heartburn, belching, heaviness in the abdomen. If the ulcer is complicated by internal bleeding, there is pallor on the skin, decrease in blood pressure, weakness, darkening of the stool.

Discomfort under the right shoulder blade may indicate diseases such as:

  • duodenal ulcer;
  • hepatitis;
  • liver cirrhosis;
  • cholellitis.

Causes of other symptoms

The following factors can also cause pain in the shoulder blades:

  1. Uncomfortable bed. In particular, a mattress that collapses and sleeps on the left side can cause pain in the opposite side, as the spine bends and the roots are pinched.
  2. Vegetovascular dystonia. It is accompanied by a drop in blood pressure, shortness of breath, impaired cardiac activity, and sometimes back pain in the shoulder blade area.
  3. Polio. Infectious diseases in which pain in the shoulder blades is neurogenic.
  4. Fun. With inflammation of the pleura, symptoms occur due to the friction of the pieces with each other. The peak of pain occurs with deep breathing.
  5. Renal pathology. Characterized by aching, stabbing pain under the right shoulder blade. In addition, there is a discoloration of urine, urine output.
  6. Drunk. Discomfort occurs when excess toxins or decay products accumulate in the body with a background of flu or due to serious poisoning. It is accompanied by chills, muscle aches, fever.
  7. Subphrenic abscess. Pain under the shoulder blades is observed during inhalation, arising from the accumulation of pus in the upper abdominal cavity.
  8. Mental disorder. Sometimes mental disorders are accompanied by discomfort in the back, but the mechanism of its development has not been studied.

Kind of pain

The nature of the pain in the shoulder blade area may vary. Depending on these criteria, it is possible to bear the possibility of illness and determine the cause of discomfort:

  1. Shooting, sharp, arises when turning the body or moving. Special for pinched nerves. This feature makes it possible to distinguish it from pain in gallstone disease - with this diagnosis, the discomfort is persistent and does not depend on movement.
  2. Cutting, dull pain of varying intensity. May indicate neuralgia, arthritis.
  3. Throbbing, sore, or burning. Such pain in the shoulder blade area indicates disease of the internal organs. These symptoms arise as a result of compression of the nerve root, with its movement becoming more pronounced.
  4. Choking pain at shoulder blade level or below. Special for spinal hernias. Often accompanied by numbness in the arms or legs, lumbago.

Which doctor should I go to?

If a painful sensation appears in the shoulder blade area, you should make an appointment with a neurologist. The doctor will perform an examination, set the diagnosis and determine treatment tactics. If there is a detection of pathology of internal organs, he will refer to a specialist of a narrow profile - gastroenterologist, cardiologist, orthopedist (depending on the diagnosis).


To determine the cause of pain in the shoulder blade area, patients are given the following diagnostic procedures:

  1. Clinical study of blood, urine. They show inflammatory changes, aid in the diagnosis of somatic diseases.
  2. X-ray examination, CT. They allow you to detect the curvature of the spinal space, injuries and consequently, osteochondrosis.
  3. Ultrasound. It is used to identify the pathology of internal organs.
  4. ECG. Be informed if heart disease is suspected.
  5. MRI. Reflects the state of the spinal space, shoulder girdle, internal organs. The area of research is determined by the physician depending on the diagnosis recommendation.

Note!Pain below the shoulder blade often indicates a neurological abnormality. Therefore, CT and MRI are the "gold standard" in determining the cause of symptoms.

Treatment features

The goal of treatment is not only to relieve pain, but also to eliminate the factors that cause its appearance. While seeking medical help, pain syndrome is relieved in parallel, as well as the appointment of etiological treatment aimed at eliminating the underlying disease.
Therapy programs can include the following methods:

  1. Medical treatment. To relieve pain, medications from a number of analgesic and anti-inflammatory drugs are used. Depending on the cause of the symptoms, antibacterial agents, diuretics, gastroprotectors, etc. can be used.
  2. Physiotherapy. Helps speed recovery from somatic pathology, to strengthen the spine. To relieve pain in the shoulder blade area, electrophoresis, UHT, and warm -up procedures were used.
  3. Sort. Helps relieve muscle cramps, improves posture, relieves painful sensations. It is prescribed for problems with the spine. Sometimes the intervention of an osteopath or chiropractor is required.
  4. Gymnastics. Shown during the recovery period. A set of exercises is selected for each patient individually, depending on the established diagnosis.

How to avoid discomfort in the shoulder blade area?

Every patient who has undergone further treatment is advised to follow a number of preventive measures. They are needed to prevent the disease from recurring.
It is important to follow these rules:

  • create good conditions for sleep - choose orthopedic pillows and mattresses of moderate rigidity to support the physiological position of the spine;
  • watch your posture;
  • follow the principles of proper nutrition;
  • trying to prevent exacerbation of chronic pathology;
  • quit addiction (smoking, drinking alcohol);
  • Visit your doctor regularly for preventative checkups.

Pain in the shoulder blades can be caused by somatic and neurological causes. In the latter case, the symptoms arise markedly and clearly. With a somatic origin, pain grows gradually and persists for a long period of time, independent of body movements.
Analgesics can be used to relieve unpleasant symptoms. However, in order to eliminate the pain sensation completely, it is important to undergo a complete treatment aimed at eliminating the underlying pathology. Only a doctor can undergo a proper course of therapy after a complete examination.