Pain under the right shoulder blade occurs in pathologies of bone structures (scoliosis, osteochondrosis, cracks and fractures), damage to the liver and gallbladder (calculous cholecystitis, hepatitis, biliary dyskinesia), respiratory diseases (pneumonia, pleurisy, pneumothorax). Diagnostic search includes ultrasound, radiological and invasive techniques, which are complemented by laboratory research methods. You can eliminate pain in the right subscapular region with the help of analgesics and antispasmodics. A complex of drug treatment and physiotherapy is prescribed to eliminate the causes of pain.
Diseases of the musculoskeletal system are the most common causes of pain on the right under the scapula. Improper gait and posture, prolonged sitting and a sedentary lifestyle - all this leads to damage to the structures of the spinal column and causes noticeable pain. Discomfort under the right shoulder blade is noted when the thoracic spine or muscles located in this area are damaged. Main etiological factors:
Scapular injuries are rare, accounting for no more than 5% of all injuries of the shoulder girdle, but they can also cause pain under the right shoulder blade. With bone cracks, a person experiences sharp pains of moderate strength, but movements in the shoulder joint are preserved. A fracture of the scapula is accompanied by severe edema and hematoma, crepitus, acute pain, aggravated by movement.
Pain under right shoulder blade
The irradiation of unpleasant sensations from the right hypochondrium to the area of the scapula is due to the peculiarities of the innervation of these structures and their anatomical proximity. Symptoms are aching, dull, stabbing, or throbbing. Soreness can be clearly localized under the right shoulder blade or spread over a large area of the back. The most common pain syndrome is provoked by:
An ulcer of the duodenum or antrum of the stomach, as a rule, causes radiating pain under the right shoulder blade, in contrast to a defect in the body of the stomach, which provokes similar sensations on the left. For the disease, hungry or nocturnal discomfort is typical, which decreases or completely disappears after eating. The pain is complemented by nausea, vomiting that brings relief, sour belching and constant heartburn.
With the localization of the protrusion on the right, pain can be felt in the subscapular area on the same side. Discomfort occurs with straining, physical exertion, flatulence. A person is faced with moderate dull painful sensations that last several hours and disappear when the hernia is spontaneously reduced into the abdominal cavity. With the progression of a hernia of the white line of the abdomen, when the protrusion becomes irreducible, pain is constantly experienced.
Right-sided focal lesions of the lungs and pleura, especially if they are located closer to the back, are often manifested by pain in the corresponding subscapular region. Discomfort has a clear relationship with specific respiratory symptoms: cough, expectoration of sputum, shortness of breath. Basically, pain occurs in an acute process: pneumonia, dry and exudative pleurisy, exacerbation of tuberculosis. Symptoms are accompanied by fever and general malaise.
Pain under the right shoulder blade occurs with surgical diseases of the chest. Severe pain radiating to the back develops with pulmonary infarction. They are accompanied by hemoptysis, impaired function of external respiration, and a state of shock. Right-sided tension pneumothorax is characterized by gradually increasing pain in the chest and near the scapula.
In the inflammatory process in the right kidney, irradiation of pain in the lower back is more often noted, but they can also occur under the scapula. Painful sensations in pyelonephritis are of moderate intensity, they are constantly disturbed, their character does not change after eating or physical activity. At the same time, a person notices dysuric disorders, an increase in body temperature, and a change in the color of urine.
Pathological processes in the dermis of the subscapularis also cause pain and discomfort, but the sensations are superficial, which distinguishes them from deep radiating pain in somatic diseases. Possible causes of pain are boils and carbuncles, neoplasms (basal cell carcinoma, melanoma). Occasionally, an unpleasant sensation occurs when foci of chronic diseases (psoriasis, atopic dermatitis) are localized under the right shoulder blade.
Pain under the right shoulder blade is disturbing in diseases of various organs and systems, which requires the involvement of several specialists and careful differential diagnosis. During a physical examination, the doctor detects skin manifestations, signs of injury or curvature of the spine, which can provoke pain in the subscapularis. For diagnostics, instrumental methods are the most informative:
Instrumental studies are supplemented by laboratory methods. In the hemogram, special attention is paid to leukocytosis and an increase in ESR as nonspecific signs of infection. A biochemical blood test is informative for verifying the syndrome of cytolysis and cholestasis in pathological processes in the liver and gallbladder. An increase in acute phase parameters confirms the presence of active inflammation.
The detection of kidney damage is based on the results of a clinical analysis of urine, a study of the concentration function according to Zimnitsky, and a study of the cellular composition according to Nechiporenko. If necessary, the diagnostic complex is supplemented with a bacteriological method - sputum, feces, urine or other biological material is cultured on nutrient media.
Therapeutic exercises for back pain
Without establishing the cause of pain in the water with the right shoulder blade, the doctor cannot give specific recommendations. If the patient's condition is satisfactory, the examination is carried out on an outpatient basis, standard analgesics of the group of non-steroidal anti-inflammatory drugs or antispasmodics are prescribed to alleviate the pain syndrome. If, in addition to pain, the state of health deteriorates sharply, the person is immediately hospitalized.
After finding out the origin of pain under the right shoulder blade, complex medical treatment is carried out. Most diseases are subject to outpatient therapy, but during a period of severe exacerbation of a chronic process, it is advisable to take a course in a hospital. Drugs are selected based on the localization of violations:
Pharmaceutical treatment of the causes of pain under the scapula on the right is supplemented with non-drug methods. This is especially important in diseases of the spinal column, the correction of which requires the wearing of supporting corsets, traction therapy, kinesiology taping and exercise therapy. According to strict indications, massage and manual therapy are performed. With functional changes in the bile duct, methods of acupuncture, ozocerite applications, and inductothermy are effective.
Surgical methods are appropriate for serious injuries of the scapula and bones of the shoulder girdle, when open reposition of bone fragments and osteosynthesis are indicated. In orthopedic practice, surgical interventions are resorted to with compression of the spinal cord, accompanied by unbearable pain. Among the minimally invasive methods, puncture vaporization of the disc, microdiscectomy are popular.
With hepatic colic, biliary peritonitis, perforation or bleeding from a duodenal ulcer, emergency assistance from abdominal surgeons is required. In case of pulmonary infarction, pulmonary hemorrhage and tension pneumothorax, the participation of specialists in the field of thoracic surgery is necessary. Treatment of skin neoplasms is carried out by oncodermatologists who combine surgical, chemotherapeutic and radiation treatment.