Shoulder blade pain can be confusing because the causes aren't always evident. This symptom can be a sign of something significant like a heart attack or lung cancer, or something as straightforward as sleeping wrong or bad posture while working.
There are lots of other possible causes, varying from degenerative disc disease, to arthritis, to gallbladder illness, and even shingles. What should you know if you are experiencing pain around your shoulder blades (your scapulae), what concerns might your medical professional ask, and what examinations might she suggest?
Before discussing symptoms, it aids to define what area we are talking about when describing the shoulder blades. The shoulder blades - medically known as the scapulae - are the triangular-shaped bones of your upper back that stick out and become a lot more visible when you extend your elbow towards your back. The shoulder blades have lots of functions, one of which is to sustain essential movements of the shoulder.
Discomfort around the shoulder blade can be due to multiple causes. It might result from inflammation in the scapula itself or referred pain from other areas of the body. Which shoulder blade is impacted is an important question, as some conditions are more probable to affect the left shoulder blade, and others more likely to influence the right.
Possible Causes
Pain in the shoulder blades can be related to inflammation or trauma to the shoulder area itself, or may instead be because of referred pain from various other regions of the chest and also abdominal area. Because of this, pain experienced in this area can be something as simple as a slight muscle strain, or as significant as a heart or lung condition or cancer.
Some problems are more probable to cause referred pain to the shoulder blades on one side. For instance, gallbladder illness may trigger referred pain in the right shoulder, whereas heart conditions are most likely to cause referred pain to the left shoulder blade.
Musculoskeletal Causes
One of the most usual causes of shoulder blade pain is a muscle strain. Short-term overuse of your arms and upper torso may be experienced in your scapula. This discomfort might be accompanied by pain in other muscle groups, such as your shoulder or back, yet can also be felt only in your shoulder blade. Even something as simple as sleeping in the wrong position (especially extended sleeping on one side) could be a cause of this pain.
In general, muscular tissue pressures commonly feel "like a pulled muscle". They also are more likely to be the case if you've begun a new workout program, done lifting that you are not accustomed to, or slept in a new or different bed. Longer standing discomfort may be related to problems such as fibromyalgia or myofascial pain syndrome.
Other muscular conditions that may cause shoulder blade pain include rotator cuff tears as well as a problem known as snapping scapula syndrome. Snapping scapula syndrome is significant for having symptoms of cracking and popping (crepitus) along the inner side of the shoulder blade. Many people with this disorder also have instability of their shoulders, accompanied by shoulder pain.
Bone and Joint Related Causes
Bone problems such as fractures are uncommon in the shoulder blade as the scapulae are considered a few of the most hardened bones in the body to fracture. It's not likely that you would have a scapular fracture without remembering the cause. Causes generally consist of falls or high-speed motor vehicle crashes. The bony portion of your scapula may be affected without a background of injury if you have a history of cancer.
Osteoporosis might affect your shoulder blades, shoulders, or neck, causing shoulder blade discomfort.
Arthritis may lead to pain in the shoulder blades in more than one way. The scapula may be directly included, or you might be experiencing referred discomfort from arthritis in other areas of your chest, including your spine, shoulder, or ribs.
Lastly, compression of nerves in the neck by collapsed or displaced discs or spinal stenosis may result in referred discomfort to the shoulder blades. With disc disease, you may have pain in your neck or numbness and tingling down your arm into your hands. The location of pain in the shoulder blades connected to cervical disc illness is actually being evaluated for its capacity to help medical professionals recognize the area of nerve compression requiring surgery.
Heart-Related (Cardiac) Causes
While pain in the shoulder blades occurs much less frequently than pain in the chest, pain that takes place in the shoulder blades alone has been well documented in individuals having heart attacks. Heart attacks, especially in females, need to be taken into consideration with any type of discomfort in the torso.
Conditions such as pericarditis (inflammation of the lining of the heart), or aortic dissection may be experienced as discomfort in the left shoulder blade alone. If you are uncertain regarding the cause of your pain and have any kind of risk factors for heart disease, seek instant medical attention.
Chest Wall (Skin and Soft Tissue) Relevant Causes
Shingles, an infection caused by the very same virus that causes chickenpox, may cause shoulder blade pain. The discomfort usually is a burning or tingling pain. While shingles generally involve a rash that occurs around the affected nerve, the pain frequently comes before the outbreak by a couple of days, making the diagnosis difficult at first.
Lung-Related (Pulmonary) Causes
A reasonably massive percent of individuals with lung cancer and mesothelioma experience discomfort in their shoulders or shoulder blades. Pancoast tumors are a kind of lung cancer that grows on the tops of the lungs, and typically triggers pain in the shoulders, shoulder blades, and arms, rather than the much more typical symptoms of lung cancer.
Lung conditions such as pulmonary emboli (blood clots in the legs that break off and travel to the lungs) or a pneumothorax (a collapsed lung) are also possible reasons.
Abdominal and Pelvic Causes
You might be surprised to hear that stomach or even pelvic troubles can cause shoulder blade discomfort, yet this is fairly usual. Irritation of nerves that pass along the base of the diaphragm (the muscles that divide the chest cavity from the stomach cavity) can trigger pain, which seems like it has come from your shoulder or shoulder blade. You may have heard people talk about having shoulder or shoulder blade discomfort after surgery. When gas is injected right into the abdominal cavity during laparoscopic surgery, it usually irritates nerves along the bottom of the diaphragm leading to shoulder discomfort post-operatively.
Some problems which might create shoulder blade discomfort consist of gallstones, peptic ulcer disease, acid reflux, liver disease. With these conditions, the referred pain is frequently to the right shoulder blade. The pancreas becomes part of the gastrointestinal system. However, pancreatitis is more likely to trigger discomfort in the left shoulder blade.
Malignancy (Cancer)
In addition to lung cancer, various other tumors entailing the chest, such as lymphomas, or abdomen cancers such as esophageal cancer, stomach cancer, liver cancer, or pancreatic cancer may cause shoulder blade pain. Bone metastases to the shoulder blades may occur with cancers such as breast cancer, lung cancer, esophageal cancer, and colon cancer.
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Diagnosing Back Pain Near Shoulder Blades
Your physician will begin by taking a solid background and doing a physical examination. Lots of causes of shoulder blade discomfort can be detected based upon your history. The doctor will certainly carry out a careful physical exam, yet studies suggest that it's typically hard to diagnose the source of shoulder blade discomfort based upon physical exam alone. Other tests and studies might include:
- Radiological Researches
Radiologic studies may include a chest X-ray, a CT scan of your chest or various other areas of your body, an MRI of your chest or various other areas, and/or a PET scan if you have a background of cancer. Keep in mind that a regular chest X-ray might miss a few of the causes, and breast X-rays are standard in about one out of 4 people with lung cancer.
- Heart Tests
If your physician is at all concerned that your pain may be originating in your heart, examinations such as an EKG or stress test might be recommended. It is worth repeating that heart pain, especially in females, might only be noted in your shoulder blades.
- Stomach exams
Tests such as a top endoscopy may be done to evaluate your stomach and small intestine. In an endoscopy, you are given a medicine to make you exhausted, and a tube is threaded via your mouth and right into your esophagus and stomach, enabling a medical professional to visualize these areas carefully. An ultrasound might be done to examine your gallbladder, and a CT might be done to take a look at your liver and pancreas.
- Bloodwork
Blood tests might additionally be done. Liver function tests may be done to look for inflammation of your liver. Examinations might likewise be done to look for inflammatory forms of arthritis and other connective tissue illness.
Questions Your Doctor May Ask
While some questions may be unique to your health history and circumstance, in most cases, be prepared to answer:
- Which shoulder blade is painful? Your right shoulder blade, your left shoulder blade, or both?
- For how long have you had the pain?
- Did the discomfort begin progressively or suddenly?
- Have you changed your workout routine lately?
- Do you take part in tasks that often cause pain in the shoulder or shoulder blade? For example, tennis, golf, swimming, basketball, tennis, racquetball?
- Is the discomfort on the same side of your body you sleep on?
- How would you describe your discomfort? Is it sharp or dull, surface (on the surface) or deep, burning or achy, stabbing, or steady?
- What makes the discomfort even worse? For instance, do certain activities, a deep breath, or consuming make the pain worse?
- What makes the discomfort better?
- What other symptoms have you been having? As an example, shortness of breath, pain in various other regions of your body, coughing, upper body discomfort, hoarseness, unusual fat burning, or abdominal discomfort.
- Do you, or have you ever smoked?
Treatment for Back Pain Near Shoulder Blades
The treatment of shoulder blade discomfort will depend on the underlying source of the pain. If shoulder discomfort is connected to a muscle strain, the acronym RICE may be helpful:
- Rest;
- Ice;
- Compression;
- Elevation (this can be rather tough, but locating a positional in which you are extra comfortable may assist).
For musculoskeletal shoulder blade discomfort that continues, heat or physical therapy may be handy. If there are no reasons that you can't take anti-inflammatory medications, treatment with Advil (ibuprofen) or Aleve (naproxen) might likewise reduce discomfort. Stretching and/or massage have also been useful for some people.
For other causes for the pain, treatment must attend to the underlying cause, such as radiation, bone-modifying drugs, or chemotherapy for cancer-related pain.
When to Call Your Medical professional
If you have shoulder blade discomfort that persists more than a few days, it is essential to see your physician - even if you have participated in activities that you suspect has triggered your discomfort. If your pain is extreme or is accompanied by symptoms of chest pain, shortness of breath, or if you just have a feeling that something important is wrong, call 911 or your doctor immediately.
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