The scapula is a three -dimensional triangular bone that connects the humerus and the collarbone. This name corresponds to the external resemblance to the famous tool - a garden shovel. The socket of the scapula and the head of the humerus form the shoulder joint, which is the most flexible joint in the human skeleton.
Pain below the right scapula from behind from behind in most cases indicates pathology of the articular elements of the shoulder, spinal space or paravertebral (paravertebral) structure. Another possible cause is damage to internal organs - bronchi, lungs, kidneys and gallbladder. Persistent pain syndrome in the scapular area almost always indicates a serious problem that requires medical treatment and sometimes surgery.
Muscle tension and inflammation
A large number of muscles are attached to the scapula: subscapularis, coracohumeral, small and large rhomboids, deltoids. Often pain under the right shoulder because a stretch has occurred or an inflammatory process is developing.
Muscle stretching can cause severe pressure in the buttocks, lifting and lifting weights, sudden movements and prolonged uncomfortable body position. Yet, as practice has shown, in more than half of the cases, the cause is excessive physical activity by unprepared people and improper training.
The symptoms of stretch marks are as follows:
- sharp pain of varying intensity;
- increased pain when turning the body and tilting the body;
- relief during rest;
- swelling and bruising (with severe damage).
The basic principle of sprain treatment is complete rest and elimination of stress. Immediately after the injury, you should apply ice or cold compresses to the sore spot, if necessary, take anesthetic pills.
With muscle inflammation - myositis - the anxiety of painful pain, which increases with pressure and movement. Sometimes there is slight swelling and redness. Often the general condition worsens: body temperature rises, headaches ache, and a small painful seal is felt in the muscles.
The causes of myositis are various, but often it develops against the background of acute respiratory viral infections, influenza or tonsillitis. It should be noted that in the thoracic region, the muscles become sparse, because myositis is localized mainly in the upper back or in the lower back.
One of the varieties is the Islamization of myositis or fibrodysplasia - a very rare form of the disease. This congenital disorder of osteogenesis (bone formation) develops rapidly and manifests itself in childhood.
Fibrodysplasia is the formation of oxidized spots in a muscle structure that gradually enlarge and injure the surrounding tissue. The process of oxidation (oxidation) can be localized almost anywhere - near the spine, on the limbs or in the pelvic area.
References:osiosification of myositis cannot be cured and should not even be used for surgical treatment. After removing the ossijil, it is re -formed.
Myofascial syndrome
Muscle pain in the back is most common after a headache. More than 40% of people suffer from chronic pain syndrome, most of whom are women.
Myofascial syndrome is a progressive condition characterized by the formation of trigger points (pain) in the muscles. The diameter of each point varies from 1 to 3 mm, the accumulation of points can create a painful area of 1 cm2. These points are formed under the influence of trauma and muscle tension.
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;
- spinal diseases - osteochondrosis, spondyloarthrosis, as well as hernias and protrusions;
- long -term use of drugs - β -blockers, cardiac glycosides, calcium antagonists, antiarrhythmic drugs, anesthetics;
- damage to connective tissue in autoimmune diseases - rheumatism, lupus erythematosus.
Cholelithiasis
With gallbladder pathology, pain often radiates to the right shoulder blade. This is caused by smooth muscle spasm when the bladder wall is irritated by calculi (stones) that form. Biliary colic attacks occur, in general, suddenly, and are concentrated on the right side below the ribs.
Pain syndrome has an acute cutting nature and in most cases occurs after consuming fatty foods, fried, spicy, alcoholic beverages. The cause of the attack may be strenuous physical exercise, nervous tension or prolonged leaning position.
If there is a blockage in the bile ducts, the pain feels like dull and exciting. The corresponding symptom is a feeling of heaviness in the abdomen on the right side, as well as nausea, turning into vomiting. A rise in body temperature is possible, sometimes to a high value. With normal bile duct obstruction and obstruction of the Oddi sphincter, jaundice develops and the feces becomes discolored.
Treatment of gallstone disease can be done conservatively and surgically. If there are no complications, specific therapy is not performed. Single stones can be removed using shock wave lithotry.
Subphrenic abscess
Back pain in the shoulder blade area can be explained by the formation of subphrenic abscesses - abscesses that are localized under the dome of the diaphragm. Often, it appears after abdominal surgery, when peritonitis develops. The causative agent can be staphylococcus, streptococcus or E. coli.
Infection enters the body after removal of part or all of the stomach, resection of the pancreas, sutures of perforated ulcers, removal of the spleen. The possible causes are inflammatory pathology of internal organs, trauma of the open or closed abdomen, as well as severe lung lesions, osteomyelitis of the bones of the spine and ribs.
Common symptoms first appear - weakness, sweating and fever. The increase in body temperature can be maintained continuously or increased periodically. Then began pain in the upper abdomen and lower chest from the affected part. Pain syndromes of varying intensity often radiate under the scapula, shoulder or collarbone.
The hallmarks of an abscess are shortness of breath, tuberculosis, hiccups and increased pain when moving, taking deep breaths, coughing and sneezing. The patient breathes frequently and shallowly, trying to assume a half -sitting position.
Treatment of subphrenic abscess consists of surgical opening and drainage of the abscess, followed by antibacterial, anti-poisoning, anti-inflammatory and rehabilitative therapy.
References:if the operation is not performed in a timely manner, the abscess penetrates into the abdominal cavity and pleura, which almost guarantees a fatal outcome.
Fun
Pain near the scapula can lead to broncho-pulmonary disease-pneumonia or bronchitis, which is complicated by pleurisy. In this case, it can be painful below and above the scapula. However, the main sources of pain are the chest and upper abdomen.
Pleurisy is always a complication of other diseases, including malignant neoplasms. It can be caused by a bacterial, viral or fungal infection, trauma and chest surgery.
In some cases, pleurisy develops against the background of autoimmune diseases - scleroderma, rheumatoid arthritis, lupus erythematosus, vasculitis, as well as pulmonary thromboembolism, myocardial infarction, pancreatitis.
In 25% of patients with pleurisy, a malignant tumor is diagnosed - mesothelioma or metastasis from other organs (mammary glands, ovaries). Metastatic pleurisy usually has mild symptoms and is often manifested only by pain in the back of the sternum.
When a large amount of exudate has accumulated, a puncture should be made for its emptying or drainage. Depending on why the pleurisy develops, specific treatment is prescribed. It can include antibiotics, steroids, anti-inflammatory drugs. This form of tuberculosis is treated with special drugs.
Urolithiasis
Stone formation in the urinary system most often occurs in middle -aged people - from 25 to 50 years. The disease progresses in different ways: in some, the symptoms are limited to one unpleasant episode, while others complain of the onset of a common disease. In some cases, urolithiasis has a long and protracted duration.
The main symptom is renal colic when the ureters are blocked. The localization of the pain syndrome depends on the location of the stone, and its intensity depends on its size. Pain in the right scapula occurs when the right kidney is affected. If the stone is lower, then the lower back or lower abdomen is painful.
The typical symptoms of urolithiasis are frequent urging and a burning sensation when urinating, fever, and nausea.
Treatment methods can be done conservatively and surgically. Often, an operation is required, the instructions for its implementation are:
- big Rock;
- development of renal failure;
- localization of calculus in the kidney, renal pelvis or ureter;
- purulent pyelonephritis.
Surgery can be open or endoscopic. Shock wave lithotripsy is the most gentle method to reduce the percentage of postoperative complications.
During operation, the rock is crushed using a reflector that emits electro-hydraulic waves. After crushing, stone and sand particles are excreted in the urine. Sometimes their movement along the ureter causes renal colic, which is easily stopped with medication.
References:any operation is not a guarantee of the absence of recurrence. Therefore, complex therapy must be carried out, which can last for several years.
Intercostal neuralgia
Intercostal neuralgia (thoracalgia) is characterized by severe symptoms and is most often indicated by stabbing pain in the ribs, in the front and in the back. It can seem intermittent or annoying. Pain syndrome feels painful, burning or dull, but is always difficult to bear.
A hallmark of neuralgia is a sharp increase in pain when inhaling, changing body position or sneezing. Often, during a painful attack, muscles twitch, sweating increases, the skin turns red or, conversely, becomes pale. Numbness occurs at the site of damage to the nerve endings.
The direct cause of pathology is pinching of nerve roots, which is facilitated by various factors and diseases:
- osteochondrosis;
- spondylitis;
- ankylosing spondylitis;
- primary and metastatic tumors;
- stomach disorders (gastritis);
- age -related changes in blood vessels;
- metabolic diseases;
- chest trauma;
- the flu, SARS;
- hypothermia and drafts;
- prolonged or severe nervous stress;
- high physical activity;
- unsuccessful body rotation, prolonged stay in a static position.
References: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 add to the pain.
The main direction of treatment is the relief of pain syndrome, for which nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed. For severe pain, therapeutic blockage with anesthetics and steroids is performed. To increase the level of CNS excitability, sedatives are used.
Specific therapies depend on the origin of the neuralgia and may include antivirals, antihistamines, and muscle relaxants.
Neoplasm
Bone tumors in the scapula are very rare and can be benign and malignant. The first includes osteomas and chondromas, the last - chondrosarcoma and Ewing's sarcoma. Osteomas are characterized by slow growth and good travel. It affects children and young people from the age of 5 to 20 years.
Osteomas can grow asymptomatically and manifest themselves only when the surrounding structures - nerve roots and blood vessels - are compressed. Treatment is only surgery, practically no relapse.
Chondroma is a benign tumor that originates from cartilage tissue. It should be noted that when a chondroma is localized in the scapula, the tumor often degenerates into malignant. Because of the high risk of violence, such formations are radically removed.
Chondrosarcoma, like chondroma, is formed by cartilage tissue, but it is violent and widespread. Its growth is accompanied by increased pain and swelling in the affected area.
Chondrosarcoma occurs in people of all ages, even in children, but the largest percentage is in middle age-from 40 to 60. Most men suffer from it. The main treatment method is tumor removal; if surgery cannot be performed, 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, manifesting itself in severe symptoms - pain, swelling and redness.
Because the tumor is very aggressive, surgical treatment and therapy are carried out. Before and after surgery, chemotherapy and radiotherapy are performed, and with the use of high doses and some medications. The prognosis of this disease is not conditionally poor.
Pain under the right shoulder blade can be a completely harmless symptom or indicate a serious illness. To relieve pain and prevent possible complications, you need expert consultation and examination. Based on the results, the doctor will prescribe treatment and give the necessary recommendations. Be healthy!