What causes pain in the shoulder blades?


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Pain in the shoulder blades can be a sign of many diseases such as stretched muscles, spinal damage and heart attack. Even if the pain is weak and does not spread to the chest it is not necessary.

How can the shoulder blades hurt?

The pain can be felt in the shoulder blade and around it, in the middle between the shoulder blades and under them as well. The first conclusions can only be drawn after the pain that causes discomfort is located. Internal organs can also cause pain to the upper back because they are close to the nerves.

Pain in the shoulder blades can have different intensities and time. Weak pain that comes with numbness is usually a sign of physical muscle fatigue. Pulling is related to spinal pathology. Acute and severe pain especially under the shoulder blades is a sign of pathology of internal organs and it may require immediate medical attention.

Causes of shoulder pain

The causes can be divided into three main categories: disease of the spine, organ pathology and pain that may not be associated with internal organs of the body.

Spinal diseases

Pain caused by pathology of the vertebrae is usually pulling and long. It usually weak and for that reason a patient may ignore it for a long time and fail to realise that it is a symptom of serious problems. There are various diseases of the spine that cause pain that spreads to the shoulder blades, among them being:

  • Osteochondrosis of the cervical region – It is accompanied by numbness of fingers, stiffness of movements in the shoulders, frequent headaches. The nagging pain will be concentrated in the area of the shoulder blades and the base of the neck.
  • Intervertebral hernia – It is a protrusion of the intervertebral disc into the surrounding space. In the early stages of the disease, the pain is tolerable, although it causes discomfort and constrains movement. Running hernia causes intolerable pain and requires surgery because it may lead to loss of mobility.
  • Cyphosis and scoliosis, curved areas of the spine, including between the shoulder blades, can be damaged. The pain will increase when moving and it may spread to the back.
  • Protrusion (displacement) of the intervertebral disc in the cervical or thoracic section. It causes constant pulling pain and numbness due to nerve pinching. In the absence of treatment, it may begin to form a hernia in the affected region.
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Conditions of the spine are dealt with by a neurologist and an orthopaedist. After examining the symptoms, they can come up with various conclusions:

  • X-ray of the thoracic spine: The simplest pictures that will show the condition of bone tissue. If they do not show pathologies, it is likely that the problem is in the neighbouring organs;
  • An MRI of the thoracic region will show the clearest pictures. It is with the help of magnetic resonance imaging that it will examine the ligaments, intervertebral discs and surrounding soft tissues to find hernias, protrusions and pinching nerve endings.
  • A CT of the thoracic region will be helpful to determine bone damage or injury.

Not until the cause and location of the pathology is established, blood tests or intraarticular synovial fluid will not show much. However, you may be undergo general tests to establish the state of the body.

Diseases of internal organs

The pain in the back can originate from the chest in organs like heart, lungs, stomach and gall bladder. It can be confused with pain from osteochondrosis. All acute pain that originates from internal systems respond with a sharp pain that will be felt under the shoulder blades and between the ribs. You will experience symptoms such as feeling weak, dizziness and shortness of breath.

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The conditions below can cause pain in the shoulder blades:

  • Vascular and heart disease: Mild angina attacks are easily be treated using drugs. But if the pain in the chest and back does not subside, the pressure drops, the skin becomes pale – the probability of a heart attack is high, hence you need immediate medical check up.
  • Conditions of the digestive system: Exacerbation of stomach ulcers, pancreatitis and cholecystitis. Acute bouts of disease – perforation of ulcers, blockage of the bile duct – which will be accompanied by burning intolerable pain in the abdomen and on the shoulder blades.
  • Abnormalities in the kidneys: Pyelonephritis, renal colic. Pain concentrates in the lower part of the shoulder blades and lower back, accompanied by nausea, soreness when urinating and mildly elevated temperature.
  • Respiratory diseases: Pleurisy and pneumonia. Pain in the shoulder blades is accompanied with a rise in body temperature and cough. The main signs are usually fever and cough which are used to determine the pathology of the lungs. Usually these diseases develop after severe flu or SARS.

For acute conditions there may be heart attack, perforation of ulcers and cholecystitis attack. These are signs that require immediate medical attention. If the pain is bearable and you are sure that your back is alright, you should check the chest organs. It is ideal that you consult a therapist who will diagnose the problem and refer you to a right specialist. It is difficult to determine the pathology on your own.

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But if you know the disease that is causing discomfort then it is advisable that you consult highly specialized doctors such as gastroenterologist, cardiologist or pulmonologist. The examinations you need include:

  • Electrocardiogram and ultrasound of the heart: in case of suspected cardiovascular diseases.
  • Ultrasound of abdominal organs: Examination will show information about the kidneys, liver, pancreas, gallbladder.
  • Fluorogram or CT of lungs: to determine the state of the respiratory system.
  • Gastroscopy for suspected stomach ulcers.

Causes of pain in the exclusion of pathologies

What should you do if the spine is completely healthy and the abdominal cavity has no abnormalities but you continue to feel pain in your shoulder blades? Some of the causes include:

  • Shoulder injury: Dislocation or fracture.
  • Stretching of the back muscles due to high physical activity.
  • Wrong posture, excess weight, long stay in an uncomfortable position: All these leads to muscle tension, often asymmetrical, because of static overexertion of muscles.
  • An uncomfortable sleeper will also have a clamped posture and tension in the muscles.
  • Stress: It affects your well-being not directly, but indirectly. In nervous tension, we often slouch and take uncomfortable poses. It also leads to overexertion and back fatigue.

For shoulder injury or muscle sprain, you should consult a traumatologist. All the other causes will be eliminated much easier. It is important that you pay attention to the bed and how you position your body when you sleep. You should incorporate simple gymnastics into your daily routine so as to relax the muscles of the back. If all these remedies do not help, go to the doctor and don’t self-medicate.


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