Chest pain at the level of the shoulders may indicate back problems, pain in the internal organs and reflection of heart discomfort. To find out the cause, you must clearly explain the complaints to the doctor and undergo an examination. Depending on the diagnosis, treatment is prescribed. You should also look in detail at ways to treat back pain below the shoulders.
Breast anatomy
The shoulder girdle belongs to the thoracic spine and is located at the height of the thorax. It is necessary to study the anatomy of this area to understand which organs can bother the patient directly and indirectly.
The main anatomical elements include:
- The spine - consists of the spinal cord and vertebrae, intervertebral discs. It is an important part of the entire musculoskeletal system, it protects the spinal cord from damage.
- The right and left scapula belong to the bony structures of the upper shoulder girdle. They look like a triangle and are flat bones. This bone structure has many cavities and depressions. These are the attachment points of the ligaments, tendons and muscles. The blades have a high strength, so they can easily withstand constant static loads.
- The key is the bone that connects the scapula to the chest.
- Heart - responsible for the functionality of the cardiovascular system, pumps blood through the veins and arteries.
- The lungs are a paired respiratory organ responsible for gas exchange processes.
- Esophagus, stomach - belong to the digestive organs.
- Ribs - provide protective function of the chest. These are flat bones that attach to the spine behind and in front of the sternum.
The nature of pain
The shoulders are located on the back of the back and are close to the arm and the key. This is a paired triangular bone, to which the rhomboid and partially trapezoidal muscles are connected. These muscle groups make the upper shoulder girdle mobile. The scapulae are connected to each other by ribs to form a strong torso frame. Any discomfort in this area can lead to significant discomfort and limited mobility of the upper back. For this reason, the pain is not tolerable and you should consult a doctor immediately.
The variety of pain sensations is divided into several classifications:
- The pain and its character according to the location of the unpleasant sensations - in the middle of the shoulders, left or right, whether there is radiation to the chest or between the ribs, the pain is felt higher or lower.
- By the nature of the senses - unpleasant, sensations of attraction, acute pain, whining, radiation, pulse.
- The duration of the pain is episodic attacks, it is felt constantly, it increases sharply, unpleasant sensations appear after the physical activity.
Most often, pulling pains indicate problems with the spine and rarely signal other related problems.
Main reasons
Symptoms of pain below the shoulders occur due to such disorders:
- stomach pain (gastric ulcer, gastritis).
- digestive disorders (heartburn, esophageal reflux).
- disorders of the cardiovascular system (myocardial infarction, pericarditis).
- lung problems (bronchitis, pneumonia).
- degenerative disorders of the ridge, the spine.
- trauma, inflammation, sprains, myositis.
- neurological disorders.
In 90% of cases, as the statistics show, the discomfort in the shoulders is caused by back pain. The human spine is responsible for walking in an upright position, so it carries a significant load. A careful attitude towards one's health helps to improve well-being when physical inactivity and poor posture cause discomfort. The condition worsens with age.
Injuries
If the patient has bruises or sprains, pain below the scapula may occur with movement or strain. In the acute period, the pain is constant and is felt even at rest. Depending on the location of the injury, the pain appears on the left or right side of the shoulders. The most common types of injuries are bones or muscle corsets.
Other types of traumatic injuries:
- Damage. It is characterized by superficial pain. Most often, superficial soft tissues, the upper muscle layer and subcutaneous fat suffer from bruises. Unpleasant sensations appear below the shoulders and below, swelling occurs and a locally localized inflammatory process. Usually no special treatment is required. This pain goes away on its own within a few weeks.
- Fracture or crack - the pain is acute and has no reflection and is concentrated at the site of injury. Even the slightest movement of the hand causes torturous sensations. In such a situation, the patient is completely rested, so as not to aggravate the condition with a fracture.
- Dislocations, displacement of vertebrae. In this case, the pain will be located not only in the shoulder area, but also in the back at the level of the chest area. Often, the pain is due to compression of the nerve endings in the spinal canal, which indicates damage to the intervertebral discs.
The trauma is easily recognizable. During the movement, a crease is felt, swelling of the tissue is observed at the site of the bruise.
Osteochondrosis
The classic manifestation of osteochondrosis of the thoracic region is the intervertebral pain at the level of the ridge. Unpleasant sensations occur due to pinched nerve endings. With a lesion of the chest area in the upper part of the patient, he feels an acute scapula radiating to the hand. The rib depends on the damage to the specific nerve roots. When the blood vessels are compressed, there is an increase in pressure, headache and dizziness.
If the lower part of the chest area is affected, then the patient has unpleasant sensations in the lower back from the shoulder. It also gives the left or right hand, depending on the location of the pinched nerve. Over time, the pain becomes more intense, the patient begins to feel discomfort not only during physical activity, but also during the rest period. Difficult situation - the discomfort is felt around the clock, even at night. Protrusions or hernias often appear on the background of osteochondrosis.
Scoliosis
Posture violation is the most common spinal condition that occurs at a young age. The first problems are already observed from the first grades of school - children do not control the correct posture and do not understand why adults require to sit evenly. Abnormal motor habits develop over time. A person sits in a position that is comfortable for him, but this position causes static muscle overload and the development of imbalance. If the spine remains in an anal position for a long time, then a curvature appears, which is full of consequences.
In adulthood, many people experience weakness - a state of low physical activity, when a person follows a purely sedentary lifestyle. The result is persistent back pain due to muscle weakness. If there is curvature in the chest area, then the pain is located in the shoulder area. Sometimes there is radiation discomfort in the area of the cervix. A characteristic difference of scoliosis is that one shoulder is higher than the other in an upright, relaxed position.
At the initial examination, the therapist can see the disease. It is necessary to treat the disease for a long time and with the help of an integrated approach. To alleviate the painful situation, you need to establish a lifestyle, stop being nervous and start moving. Under stress, muscle tone can increase, which will cause a deterioration in well-being. Massage helps a lot, it is also useful to conduct exercise therapy for the back.
Hernias and protrusions
The appearance of an intervertebral hernia is a serious condition characterized by protrusion of the spinal canal through the fibrous ring of the disc. The previous condition of the hernia is the protrusion. With the protrusion, the disc is partially damaged and the fibrous ring is stretched. Hernias occur during intense physical exertion due to heavy lifting. The hereditary factor plays an important role in their appearance. If the family has close relatives with hernias or protrusions, then they are very likely to appear with age in children.
If a hernia or protrusion is located at the level of the chest area, then pain occurs in the shoulder area. There is also a ray of pain in the arm or shoulder. The side depends on the specific stinging nerve roots. Painful shots are explained by the defeat of the nerve endings, which sting due to excessive compression in the back.
When the lower back is affected, back pain is given to the leg and when a cervical hernia occurs, the pain radiates to the head. In any case, a hernia requires complex treatment aimed at relaxing the back, relieving acute pain and eliminating muscle tightness. With hernias and protrusions, it is useful to conduct exercise therapy, to follow physiotherapy procedures. In rare and advanced cases, surgery is required.
Kyphosis
This is a curvature similar to scoliosis, but in the opposite direction. If with scoliosis the spine is curved to the right or to the left, then with kyphosis there is a strong bending of the upper shoulder girdle. One of the characteristic signs of the disease is a feeling of pain in the intercostal zone in the presence of external signs of pathology. It hurts below the left or right shoulder, depending on the nature of the curvature. Usually the pain appears on both sides and gives the hands, the neck. There are two main mechanisms for the formation of pathology:
- Neurogenic. When curvature occurs, degenerative processes occur in the spine, causing the nerve roots of the spinal cord to sting. There are pains in the area of the right and left scapula, which are given to the neck, wrist or arm, less often to the shoulder joint.
- Muscular. Being constantly in a hollow state causes muscle imbalance and overexertion. In the upper back, the muscles are tight, which causes hypertension and severe pain. The rest of the back muscles also suffer. Hypotension can occur in the lumbar region.
As a result, the vertebral artery is compressed, which causes a persistent violation of cerebral circulation. Gradually, there is a deterioration of well-being, there are dysfunctions in the work of internal organs. With such a patient, it is necessary to carry out complex work, including rehabilitation services, exercise therapy.
Spinal joint
Sometimes the development of spondylitis indicates pain in the right or left shoulder area. The disease is characterized by damage to the joints of the face and intervertebral discs. With the development of the disease, there is a loss of mobility, there is a feeling of stiffness, which is more pronounced in the morning.
The pathology manifests itself in various stages:
- Deformation and destruction of cartilage. If the blood circulation is weakened in this zone, then the integrity of the connective tissue is destroyed, due to which the joint disk becomes thinner. Bone and connective tissue repair procedures deteriorate significantly. Increased physical activity in this area leads to minor trauma.
- Further distortive changes occur. Seals appear on the disc, mobility deteriorates, leading to increased destruction of cartilage tissue. The patient may feel constant pain, even at rest.
- The final stage is ossification, the formation of osteophytes. These growths injure neighboring joints, tendons, muscles, and ligaments. In this case, surgery will be required.
A typical manifestation of spondylitis in the initial stage is the appearance of pain only during physical exercise. The discomfort at rest subsides, as there is no traumatic factor.
Intercostal neuralgia
This condition refers to disorders of the pneumogastric nerve. When a pathology occurs, an acute pain occurs, which shoots into the shoulder, ribs and chest. This type of pain is often confused with a heart attack. A characteristic difference is the lack of clear localization in the area of the heart. Unpleasant sensations intensify with inspiration. The pain is accompanied by a feeling of contraction. If the patient thinks he has angina, then after taking nitroglycerin, there is no relief.
Pain below the right or left scapula indicates nerve in specific areas. Numbness and convulsions are not typical of this pathological process. Given the specificity of the symptoms of the disease, the specialist will make a diagnosis without any problems. The treatment consists of the use of injectable B vitamins and myotropic drugs (muscle relaxants). Treatment of intercostal neuralgia should be done by a neurologist.
Causes of pain below the left shoulder from behind the back - heart disorders
Often, back pain indicates a heart disorder. Because back pain is a phenomenon of reported pain that indicates coronary heart disease, myocardial infarction or pericarditis. If there is a sudden pain with a knife, which increases with physical exercise, but there are no symptoms of spinal diseases, you should urgently visit a cardiologist for consultation. Self-medication or procrastination can bring the situation to a critical stage.
The most common causes of heart discomfort, which cause pain under the left shoulder from behind the back:
- Myocardial infarction. In addition to the radiation, the patient feels pain in the area of the heart muscle. The causes of the pathology are related to obstruction of large arteries and veins by a thrombus. If the thrombotic plate breaks and blocks the vascular flow around the heart, a heart attack will occur. In this situation, one must act quickly, otherwise the patient will die. The main cause of the pathology that has arisen is atherosclerosis, erythrocyte adhesion, platelets with increased coagulation.
- Ischemic heart disease or angina. According to information from a medical article, a sudden onset of coronary heart disease is developing. There is a dull pain, which is of a paroxysmal nature. The attack is easily stopped by taking nitroglycerin. The disease requires further medical attention, because it can appear at the most unexpected moment. If the attack lasts more than a few hours and the medicine does not help, you should call an ambulance. In addition to the discomfort in the heart, the patient's breathing becomes a reality, shortness of breath occurs, which is aggravated by physical exertion.
- Pain below the left shoulder from behind the back may indicate the development of a pericarditis attack. The pathology is characterized by the accumulation of fluid with inflammatory damage to the serous membrane of the heart. Diagnosis includes screening for inflammatory markers, including rheumatic tests. Pericarditis is often a complication of a previous infectious disease, including upper and lower respiratory tract respiratory diseases. Long-term, complex treatment is performed.
Diseases of the respiratory system
In the presence of prolonged respiratory disease, the patient may eventually experience radiation pain in the shoulder area. Most often, complications are caused by such diseases:
- Chronic or acute bronchitis. In the early stages, the disease is characterized by a dry cough. Gradually, the irritation of the larynx increases and a wet cough appears. If the disease has developed in the context of SARS, then there is an increase in body temperature. The disease does not require special treatment, as long as you observe bed rest, drink more warm liquid. Rarely, antipyretics and antibiotics may be needed.
- Pleurisy. If the patient complains of severe chest pain with possible radiation, cough, shortness of breath and fever, then the specialist should rule out or confirm this disease. Pleurisy is characterized by inflammation of the pleural effusions, followed by accumulation of liquid sputum in the pleural cavity. The disease is difficult to bear. Comprehensive treatment with antibiotics and anti-tuberculosis drugs is required.
- Pneumonia. It often develops as a complication of SARS. Pneumonia is characterized by a severe course, accompanied by cough, shortness of breath, chest pain on inhalation and severe fever. The disease is confirmed by a chest x-ray and can be treated with antibiotics.
Diseases of the gastrointestinal tract
All disorders of the gastrointestinal tract that cause discomfort in the shoulder area are reflected in the nature of pain. What problems may arise:
- Gastritis or stomach ulcer. If there is a reflection of the pain syndrome, then the patient feels an unpleasant discomfort in the lower chest area (the lower part of the shoulders on both sides). It may seem like muscle aches. With an attack of stomach pain, a burning sensation in the solar plexus can be felt at the same time. Diseases are treated in a complex way, drugs are used to reduce acidity, therapeutic agents (proton pump inhibitors). If a bacterial pathogen is detected, antibiotics are prescribed.
- Esophageal reflux, heartburn. The discomfort appears in the chest area, often radiating to the shoulder area. The cause of the pathology is the return of the contents of the stomach to the esophagus. Unpleasant sensations are associated with the irritating effect of hydrochloric acid on the esophagus. There is a sour flare-up, a feeling of a lump in the throat. In rare cases, vomiting occurs. To prevent an attack, you should limit the consumption of fried, spicy and fatty foods. In symptomatic treatment, antacids are used that reduce the acid based on magnesium and aluminum hydroxide.
Syntactic point of view
Unpleasant sensations in the shoulder girdle are most often associated with an exacerbation of diseases of the musculoskeletal system. Less often, heart disorders, neurological problems, diseases of the stomach and respiratory system lead to discomfort. To learn more about the causes of back pain, it is recommended that you read the corresponding article on our website.