The scapula is a three-dimensional triangular bone that connects the humerus and the collarbone. It owes its name to the external resemblance to a well-known tool - a garden shovel. The scapula cavity and the head of the humerus form the shoulder joint, which is the most flexible joint in the human skeleton.
Pain under the right scapula of the back of the back in most cases indicates the pathology of the articular elements of the shoulder, spine or paravertebral (paravertebral) structures. Other possible causes are damage to internal organs - the bronchi, lungs, kidneys and gallbladder. Persistent pain syndrome in the scapula area almost always indicates a serious problem that requires medical treatment and sometimes surgery.
Muscle tension and inflammation
A large number of muscles are attached to the scapula: subscapularis, coracohumeral, small and large rhomboid, deltoid. Most often it hurts under the right scapula because a stretch has occurred or an inflammatory process is developing.
Stretching the muscles can put a lot of stress on the back, lifting and carrying weights, sudden movements and prolonged uncomfortable posture of the body. However, as practice shows, in more than half of the cases the cause is excessive physical exertion by an unprepared person and improper exercise.
Symptoms of a stretch are as follows:
- acute pain of varying intensity;
- increased pain when rotating and tilting the body;
- relief during rest;
- swelling and bruising (with severe damage).
The basic principle of treatment for sprains is complete rest and the elimination of all stress. Immediately after the injury, you need to apply ice or a cold compress to the sore spot, if necessary, take a numbing pill.
With muscle inflammation - myositis - aching pain is concerned, which increases with pressure and movement. Sometimes there is a slight swelling and redness. Often the general condition worsens: body temperature rises, the head hurts, and small painful seals are felt in the muscles.
The causes of myositis are various, but most often it develops against the background of acute respiratory viral infections, influenza or tonsillitis. It should be noted that in the thoracic region the muscles inflame relatively rarely, since myositis is localized mainly in the upper back or lower back.
One of the varieties is myositis ossifying or fibrodysplasia - an extremely rare form of the disease. This congenital osteogenesis (bone formation) disorder develops rapidly and manifests itself in childhood.
Fibrodysplasia is the formation of ossified points in the muscle structure that gradually grow in size and damage surrounding tissue. The process of ossification (ossification) can be localized almost anywhere - near the spine, on the limbs or in the pelvic region.
Reference:myositis ossifying is incurable and does not even lend itself to surgical treatment. After elimination of the ossificates, they reform.
Myofascial syndrome
Muscle pain in the back is most common after headaches. Over 40% of people suffer from chronic pain syndrome, most of which are women.
Myofascial syndrome is a progressive disease characterized by the formation of trigger points (pain) in the muscles. The diameter of each point varies from 1 to 3 mm, the accumulation of points can create a painful area of 1 cm2. These points are formed under the influence of trauma and muscle tension.
A number of factors can cause this process:
- skeletal abnormalities - scoliosis (curvature of the spine to the left or right), pelvic asymmetry, shortening of one of the limbs, flat feet;
- back injuries;
- diseases of the spine - osteochondrosis, spondylarthrosis, as well as hernia and protrusion;
- long-term use of drugs - -blockers, cardiac glycosides, calcium antagonists, antiarrhythmic drugs, anesthetics;
- damage to connective tissue in autoimmune diseases - rheumatism, lupus erythematosus.
Biliary lithiasis
With pathologies of the gallbladder, the pain often radiates to the right scapula. This is due to a spasm of the smooth muscles when the walls of the bladder are irritated by the formed stones (stones). An attack of biliary colic usually occurs suddenly and is concentrated on the right side under the ribs.
Pain syndrome has a sharp, cutting character and in most cases occurs after the consumption of fatty, fried, spicy foods, alcoholic beverages. The cause of an attack can be intense physical exertion, nervous tension, or prolonged reclining.
If there is a blockage in the common bile duct, the pain is felt as dull and pulling. A concomitant symptom is heaviness in the abdomen on the right, as well as nausea turning into vomiting. An increase in body temperature is possible, sometimes to high values. With obstruction of the common bile duct and obstruction of the sphincter of Oddi, jaundice develops and the stool becomes discolored.
Treatment of cholelithiasis can be conservative and surgical. In the absence of complications, specific treatment is not carried out. Isolated stones can be removed by shock wave lithotripsy.
Subphrenic abscess
Back pain in the shoulder blades can be explained by the formation of a subphrenic abscess - an abscess located under the dome of the diaphragm. Most often it appears after abdominal surgery, when peritonitis develops. The causative agent can be staphylococcus, streptococcus, or E. coli.
The infection enters the body after partial or complete removal of the stomach, resection of the pancreas, suturing of the perforated ulcer, removal of the spleen. The cause can be inflammatory pathology of internal organs, open or closed abdominal trauma, as well as severe lung damage, osteomyelitis of the vertebral bones and ribs.
The first general symptoms appear - weakness, sweating and fever. The increase in body temperature can be maintained constantly or increase periodically. Then it begins to hurt in the upper third of the abdomen and the lower chest on the affected side. The pain syndrome of varying intensity often radiates under the scapula, shoulder or collarbone.
A characteristic sign of an abscess is shortness of breath, dry cough, hiccups, and increased pain when moving, breathing deeply, coughing, and sneezing. The patient breathes frequently and weakly, tries to assume a semi-sitting position.
Treatment of subphrenic abscess consists of surgical opening and drainage of the abscess, after which antibacterial, anti-intoxication, anti-inflammatory and restorative treatment is carried out.
Reference:if the operation is not performed in time, the abscess enters the abdominal and pleural cavities, which almost guarantees a fatal outcome.
Pleurisy
Pain near the scapula can cause bronchopulmonary diseases - pneumonia or bronchitis, complicated by pleurisy. In this case, it can hurt both under and on the scapula. However, the main source of pain is the chest and upper abdomen.
Pleurisy is always a complication of another disease, including malignant tumors. It can be caused by bacterial, viral, or fungal infection, trauma, and chest surgery.
In some cases, pleurisy develops against the background of autoimmune diseases - scleroderma, rheumatoid arthritis, lupus erythematosus, vasculitis, as well as pulmonary thromboembolism, myocardial infarction, pancreatitis.
In 25% of patients with pleurisy, a malignant tumor is diagnosed - mesothelioma or metastases from other organs (mammary gland, ovaries). Metastatic pleurisy usually has mild symptoms and often manifests itself only as pain behind the breastbone.
When a large amount of exudate accumulates, it is necessary to pierce for its evacuation or drainage. Depending on the reason why pleurisy has developed, specific treatment is prescribed. It can include antibiotics, steroids, anti-inflammatory drugs. The form of tuberculosis is treated with special drugs.
Urolithiasis disease
The formation of stones in the urinary system occurs most often in people of middle age - from 25 to 50 years. The disease progresses in different ways: in some, symptoms are limited to a single unpleasant episode, while others complain of regular exacerbations. In some cases, urolithiasis has a chronic and prolonged course.
The main symptom is renal colic when the ureter is blocked. The location of the pain syndrome depends on the location of the stone, and its intensity depends on its size. Pain in the right scapula occurs when the right kidney is affected. If the stone is lower, the lower back or lower abdomen hurts.
Typical symptoms of urolithiasis are frequent urge and a burning sensation when urinating, fever, and nausea.
The method of treatment can be conservative and surgical. Most often, an operation is necessary, the indications for its implementation are:
- large stones;
- the development of renal failure;
- localization of the stone in the kidney, pelvis or ureter;
- purulent pyelonephritis.
Surgery can be open or endoscopic. Shock wave lithotripsy is the mildest method to reduce the percentage of postoperative complications.
During the operation, the stones are crushed by means of a reflector which emits electro-hydraulic waves. After grinding, the stone particles and sand are excreted in the urine. Sometimes their movement along the ureter causes renal colic, which is easily stopped with medication.
Reference:not every operation is a guarantee of the absence of relapses. Therefore, complex therapy is necessarily carried out, which can last for several years.
Intercostal neuralgia
Intercostal neuralgia (thoracalgia) is characterized by severe symptoms and most often manifests as a sharp, piercing pain in the ribs, both in the front and back. It can appear intermittently or permanently disturbing. Pain syndrome is painful, burning, or dull, but still difficult to bear.
A characteristic sign of neuralgia is a sharp increase in pain when inhaling, changing the position of the body or sneezing. Often, during a painful attack, the muscles contract, sweating increases, the skin reddens or, on the contrary, turns pale. Numbness occurs at the site of damage to nerve endings.
The immediate cause of the pathology is the pinching of the nerve roots, facilitated by various factors and diseases:
- osteochondrosis;
- spondylitis;
- ankylosing spondylitis;
- primary and metastatic tumors;
- upset stomach (gastritis);
- age-related changes in blood vessels;
- metabolic disease;
- chest trauma;
- influenza, SARS;
- hypothermia and drafts;
- prolonged or severe nervous stress;
- high physical activity;
- unsuccessful body tour, prolonged stay in a static position.
Reference:Intercostal neuralgia is characterized by pain that lasts from a few seconds to three minutes. During this time, the patient tries not to breathe or move, so as not to increase the pain.
The main direction of treatment is the relief of pain syndrome, for which nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed. For severe pain, therapeutic blockages with anesthetics and steroids are performed. To increase the threshold of CNS excitability, sedatives are used.
Specific treatment depends on the origin of the neuralgia and may include antivirals, antihistamines, and muscle relaxants.
Tumors
Bone tumors of the scapula are very rare and can be both benign and malignant. The former include osteoma and chondroma, the latter - chondrosarcoma and Ewing's sarcoma. Osteoma is characterized by slow growth and a favorable course. It mainly affects children and young people aged 5 to 20.
Osteoma can grow asymptomatically and only manifest when the surrounding structures - nerve roots and blood vessels - are squeezed. The treatment is only surgical, there are hardly any relapses.
Chondroma is a benign tumor originating in cartilage tissue. It should be noted that when the chondroma is localized in the scapula, the tumor often degenerates into a malignant tumor. Due to the high risk of malignancy, these formations are drastically removed.
Chondrosarcoma, like chondroma, is made up of cartilage tissue, but it is malignant and widespread. Its growth is accompanied by increased pain and swelling in the affected area.
Chondrosarcoma occurs in people of any age, even in children, but the largest percentage is in the middle age - from 40 to 60 years. Most men suffer from it. The main method of treatment is removal of the tumor; if the operation cannot be performed, chemotherapy and radiation therapy are performed.
Ewing's sarcoma is one of the most aggressive malignant tumors prone to early metastasis. It affects children and young people, manifests itself in severe symptoms - pain, swelling and redness.
Since the tumor is very aggressive, surgical and therapeutic treatment is performed. Before and after the operation, chemotherapy and radiation therapy are carried out, and with the use of high doses and several drugs. The prognosis of the disease is conditionally unfavorable.
Pain under the right shoulder blade can be a completely harmless symptom or indicate serious illness. To get rid of the pain and prevent possible complications, you need a specialist consultation and examination. Based on its results, the doctor will prescribe treatment and give the necessary recommendations. To be in a good health!