Pain under the left shoulder blade is observed in musculoskeletal pathology (osteochondrosis, myofascial syndrome, injuries), heart diseases (myocardial infarction, angina pectoris, rheumatic and non-rheumatic carditis), gastrointestinal diseases (pancreatitis, stomach ulcer). Rare causes of a symptom include damage to the spleen, abscesses, and skin neoplasms. Diagnostic methods are selected based on the underlying syndrome: X-ray, ultrasound and endoscopic studies are used. To relieve pain, analgesics are prescribed, after which medical or surgical treatment of the underlying disease is carried out.
The pathological condition develops with thoracic osteochondrosis or intervertebral hernia. Less commonly, radicular pain occurs with spondylolisthesis, ankylosing spondylitis. Acute pain in the projection of the left scapula is noted when the 3rd-6th thoracic roots are involved in the process, discomfort directly under the scapula indicates the localization of damage in the 7th-8th vertebrae. Usually there is a spread of pain from the scapula to the lateral surface of the chest and intercostal spaces.
Violations of posture and a long stay in an uncomfortable position lead to constant muscle tension. The syndrome is manifested by pain in the area of the scapula on the left, when the load goes mainly to this side. Discomfort is felt by the patient as deep and moderately intense. At first, pain is experienced only during movement, loads, but over time it becomes constant. Sometimes there are radiating pains in the forearm or left hand.
Intense pain develops after a crack or fracture of the scapula, bruising of soft tissues over this area. If the integrity of the bone is preserved, the pain is moderate, the person can take deep breaths and move freely. With traumatic damage to the bone structures, sharp pains occur, the mobility of the arm and shoulder girdle is often limited. When changing position or pressing on the injured area, a sharp pain is felt.
Pain under left shoulder blade
Purulent inflammation of the skin surrounding the left shoulder blade is accompanied by intense pain, which, as a rule, is clearly localized. In the process of maturation of the boil, “pulling” sensations arise, which are aggravated by palpation of the inflammation zone or its rubbing with clothes. After the breakthrough of the tire and the release of the necrotic rod, the pain decreases. With a carbuncle, pain is more intense, and the general condition of the patient often worsens.
Damage to the heart is a typical cause of pain under the left shoulder blade, which is associated with the proximity of the anatomical location and the peculiarities of innervation. In this case, the symptoms are accompanied by pain behind the sternum of a different nature, a feeling of fading or interruptions in the work of the heart. Tachycardia and other rhythm disturbances are usually detected. Pain under the scapula manifests itself:
Girdle pains that pass from the left hypochondrium to the subscapular region are observed in acute pancreatic inflammation. In addition to the pain syndrome, patients are worried about debilitating vomiting with impurities of bile and mucus, tension in the abdominal muscles. Movements intensify painful sensations, so a person tries to lie on his side motionless.
In chronic pancreatitis, irradiation of pain under the shoulder blade indicates an exacerbation of the process. Often, violations are provoked by errors in the diet - a plentiful feast, alcohol intake. The pains are paroxysmal in nature, sometimes spreading not only to the subscapular, but also to the precordial region. Symptoms are combined with nausea, flatulence, steatorrhea.
Pain under the left shoulder blade is a sign of localization of the defect on the back wall of the stomach, closer to the back. Unpleasant sensations appear within 20-5 minutes after the end of the meal. The earlier symptoms occur, the higher the ulcer is located. Discomfort becomes more severe when eating sour, spicy or fried foods. To reduce the intensity of pain, patients induce vomiting.
Soreness and a feeling of fullness in the left subscapular area occurs with splenomegaly due to infectious, autoimmune or myeloproliferative processes. With a gradual increase in the organ, periodic discomfort develops with heaviness in the affected area, and a rapid change in the size of the spleen is accompanied by sharp cutting pains that radiate under the left shoulder blade.
Somewhat less often, surgical pathologies of the spleen become the cause of pain: rupture, heart attack, volvulus. In this case, cutting or throbbing pains are noted with irradiation under the scapula, which are aggravated by the slightest movement. Therefore, the patient takes a forced position: lying on his left side or on his back with his knees pressed to his stomach. The clinical picture is complemented by a sharp drop in blood pressure, tachycardia. In the absence of adequate anesthesia, shock occurs.
Left-sided focal processes in the lungs often cause pain in the projection of the scapula. Discomfort is aggravated by deep breaths, laughter and conversation, coughing attack. The pains are varied in nature: sharp, stabbing, dull, pressing. They are accompanied by fever, shortness of breath and other typical respiratory symptoms. Most often, pain under the left shoulder blade is experienced by patients who develop:
Patients with pain under the left shoulder blade are first referred for a consultation with an orthopedic traumatologist. If there is no violation of the musculoskeletal system, other specialists are involved in the diagnostic search: a neurologist, a cardiologist, a surgeon, etc. To establish the causes of pain, a full range of instrumental studies is assigned, which includes:
An important role in the diagnosis is played by laboratory methods of examination. A clinical blood test shows signs of inflammation or impaired hematopoietic processes. Indicators of acute phase proteins and proteinograms are informative in case of possible damage to the heart or an autoimmune process. Specific myocardial markers are evaluated for anginal pain.
For the diagnosis of gastrointestinal diseases, a coprogram is performed: the presence of pancreatitis is indicated by a high content of undigested food particles, an increase in the number of striated muscle fibers and starch grains. In inflammatory processes of the lungs and pleura, bacteriological seeding of the biomaterial is necessary, followed by a test for the sensitivity of isolated microorganisms to antibiotics.
Massage of the back and subscapular region
Given the variety of causes that manifest as pain under the left shoulder blade, it is extremely difficult for a doctor to make recommendations before identifying the underlying pathology. At the time of the examination, it is desirable to reduce the load on the back muscles in order to exclude banal fatigue and overstrain, which can cause a persistent pain symptom complex. With unbearable sensations, analgesics are used and the patient is immediately hospitalized.
The treatment plan is selected only after a complete diagnosis and determination of the etiological factors of pain under the scapula on the left. If the patient suffers from severe discomfort, anti-inflammatory drugs and muscle relaxants are recommended, which quickly stop painful sensations. With severe pain, therapeutic blockades, the introduction of narcotic analgesics are effective. Taking into account the disease, a mode of physical activity is selected.
Drug therapy is prescribed by a specialist of the appropriate profile. For pain against the background of heart damage, the cardiologist prescribes antianginal and antiarrhythmic drugs, antiplatelet agents and anticoagulants, antihypertensive drugs. Diseases of the bronchopulmonary system require the participation of a pulmonologist and the use of antibiotics, expectorants, specific anti-tuberculosis drugs.
In case of gastrointestinal pathologies, a suitable diet is selected, therapy is supplemented with enzyme preparations, prokinetics, antacids and antisecretory drugs. In neurology, neurometabolic agents, B vitamins, drugs that improve microcirculation and rheological properties of blood are shown to eliminate radicular syndrome.
For violations of posture, other problems with the spine, non-drug methods are actively used: traction therapy, therapeutic massage, exercise therapy. Among physiotherapeutic methods, balneotherapy (sulfide and radon baths), mud therapy, and reflexology are popular. It is possible to increase the effectiveness of drug treatment with the help of electrophoresis of drugs directly to the affected area.
Surgical methods are indicated for the ineffectiveness of conservative treatment or for acute life-threatening pathologies, when delay is dangerous for the life and health of the patient. The second group of operations includes methods of stenting, angioplasty and shunting in case of myocardial infarction, assistance of abdominal or thoracic surgeons in case of injuries, purulent processes, internal bleeding.
Planned surgical interventions are often prescribed in neurosurgery for severe radicular syndrome, intervertebral hernia. To eliminate pain associated with compression of nerve structures, microdiscectomy and laser vaporization of the disc are performed. In rare cases, they resort to stabilizing operations on the spine (interbody fusion, application of the Halo apparatus, transpedicular fixation).