Pain under the right shoulder blade

Pain under the right shoulder blade is one of the types of radiating pain, which tends to be localized far from the true source of the pathology.

A person can feel such reflected pain in any area of the body where the nerve roots associated with the main inflamed area are located.

Painful sensations are transmitted via autonomic nerve fibers from the source of the disease to the spinal cord and are reflected in certain innervation locations. Repercussion syndrome develops (reflection in Latin is repercussio), which can sometimes cause difficulties in the diagnostic sense, although at present almost all irradiating pains are well studied and an experienced doctor will be able to understand the real cause of the pain symptom. There is no internal organ under the right shoulder blade that can hurt, become inflamed, therefore the causes of painful manifestations can be the following:

Causes of pain under the right shoulder blade

1. Osteochondrosis of the cervical or thoracic spine. In chronic cases of the disease, degenerative changes in the vertebral processes can provoke pinching of nerve endings, manifested by pain under the right shoulder blade.
2. Trauma or damage to the trapezius muscles in the right shoulder area. Pain under the right shoulder blade occurs when static (sitting, standing), less often when walking.
3. Subdiaphragmatic abscess (purulent inflammation under the dome of the diaphragm, purulent peritonitis). Diaphragmatic-hepatic peritonitis is characterized by chronic pain radiating to the right, including under the scapula.
4. Compression injury of the right suprascapular nerve. This injury is characterized by intermittent pain under the scapula and diffuse, diffuse pain throughout the entire shoulder bend.
5. Pyelonephritis, renal colic. The pain is acute and quickly spreads from the lower back upwards towards the right hypochondrium and under the right shoulder blade.
6. Hepatic (biliary) colic, cholecystitis. The pain is provoked by a strong spasm in the ducts or gall bladder due to blockage of the bile ducts by a calculus. The pain sensations are acute, paroxysmal, the localization of pain is quite clear - under the right rib with reflection in the area of the scapula, collarbone or shoulder.
7. Adhesions after right-sided pleurisy. Pain under the right shoulder blade is a residual phenomenon that goes away during the process of adhesion resorption.
8. Acute pancreatitis with damage to the head of the pancreas. With such localization of the inflammatory process, pain most often radiates to the right and is reflected in the area of the right hypochondrium and under the scapula.
9. Right-sided myofascial syndrome. Chronic muscle pain that can move and radiate to the area under the right shoulder blade.

The causes of pain under the right shoulder blade can be varied, so the nature of the pain is important: the pain can be strong, sharp, nagging, transient or chronic.

How to recognize pain in the right shoulder blade?

Severe pain under the right shoulder blade may indicate the following diseases:

• Acute vertebrogenic radiculopathy or compression of nerve roots with right-sided displacement of intervertebral discs (intercostal neuralgia). This disease is secondary, developing against the background of chronic compression of nerve endings in the area of their exit - in the "tunnel". The so-called "tunnel" is formed from various structures - osteophytes, hernia, articular tissue. The longer the pathological process of degeneration of intervertebral discs lasts, the smaller the lumen in the tunnel becomes, the blood supply to the nerve endings is disrupted, swelling and pain symptoms appear, including reflected severe pain under the right shoulder blade.
• Pancreatitis in the acute stage is accompanied by characteristic girdle pains, as a rule, they radiate evenly under both shoulder blades. However, with inflammation of the head of the pancreas, the pain spreads mainly to the right and is felt as a shooting pain in the area of the right shoulder blade. The general pain symptom is constant and does not subside when changing body position, does not increase with tension, inhalation or coughing.
• Cholecystitis in the acute stage is the main cause of pain reflected in the right shoulder blade. The symptom is so characteristic that many patients with a chronic disease already know that inflammation has begun. In addition to pain radiating upward to the right, acute cholecystitis is accompanied by fever, nausea, vomiting and often yellowing of the skin.
• Hepatic colic is very similar to an attack of cholecystitis, it is also accompanied by severe pain under the right shoulder blade, but there is no nausea, vomiting, or hyperthermia.
• Spontaneous pneumothorax (traumatic perforation of the pleura) is characterized by sudden, clearly expressed pain in the middle of the chest radiating to the scapular region.

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Dull pain under the right shoulder blade

• Nephritis or chronic pyelonephritis in the II stage of the process, when changes in the renal tissue are of a sclerotic nature. The pain is felt periodically, as a pulling, dull, radiating to the lower back or to the upper part of the body. In the case of a right-sided process, the pain symptom radiates under the right shoulder blade. In addition to pains that are not obvious in the clinical sense, the disease is accompanied by painful urination, subfebrile body temperature, and, less often, nausea.
• Chronic cholecystitis also manifests itself with dull pain sensations that may occur in attacks, but do not cause obvious discomfort to the patient. The pain radiates to the epigastrium (under the spoon) and simultaneously "extends" under the shoulder blade.
• Causes of dull pain in the area of the right shoulder blade are various malignant processes localized in the internal organs located on the right. Tumors of the liver, pancreas, right kidney or right lung can manifest as periodically occurring dull pain under the right shoulder blade.
• Initial stage liver cirrhosis, which, in addition to the characteristic clinical picture, manifests itself in the form of dull right-sided pain, reflected under the shoulder blade.

Sharp pain under the right shoulder blade

This is usually an attack of hepatic colic, acute cholecystitis or a symptom of gallstone disease. Also, acute pain under the right shoulder blade may indicate a hypertonic form of gallbladder dyskinesia. Hyperkinetic dysfunction of the bile ducts can be provoked by both food and neurological, psychoemotional factors. Stress, emotional overload, violation of nutritional rules (overeating, spicy, fried or fatty) dishes are the main causes of biliary dyskinesia, which is accompanied by periodic paroxysmal pain in the epigastrium with irradiation to the left or right, more often to the upper right part of the body. The pain spreads to the back, under the right shoulder. Acute pain under the right shoulder blade can intensify when inhaling, bending. As soon as the provoking factor is eliminated, the pain goes away. In addition to the pain symptom, the patient has characteristic neurological signs – irritability, increased fatigue, poor sleep, sweating.

Sharp pain under the right shoulder blade

This sign is a typical symptom of the final stage of a subphrenic abscess, when the sensation sharply intensifies with a strong breath and is reflected in the shoulder and right shoulder blade.

Also, sharp pain in the lower lobe of the scapula can be one of the signs of renal colic or purulent infiltrate in the right kidney with pyelonephritis. The pain symptom spreads to the iliac region, in the hypochondrium, often under the scapula. In addition to pain, purulent pyelonephritis is accompanied by a feverish condition, frequent and painful urination.

Hepatic colic is a sharp, acute pain that occurs most often at night. The painful sensations are acute and spread to the right shoulder, often radiating through the shoulder blade to the neck. If the colic lasts more than 4-5 hours, the pain spreads throughout the abdominal area, accompanied by nausea and vomiting, which indicates an acute clinical picture requiring hospitalization.

Stabbing pain under the right shoulder blade

These are usually transient sensations that are not associated with serious pathological disorders in the internal organs. Most often, stabbing pain is a symptom of neurological disorders in osteochondrosis of the cervical or thoracic spine. Unlike pain of a similar nature on the left side, which may indicate life-threatening cardiac diseases, right-sided transient pain is provoked by an uncomfortable posture, a sharp turn or physical overexertion. However, stabbing pain can also be a sign of spasm of the walls of the bile ducts and the onset of an attack of hepatic colic or exacerbation of cholecystitis. Therefore, if the pain recurs, increases or "spills", its nature changes within 1-2 hours, you should consult a doctor or call an ambulance.

Aching pain under the right shoulder blade

These pains are most likely associated with changes in the structure of the spine or with spasms of the muscular system of the shoulder girdle. Osteochondrosis of the cervical spine is characterized by aching, pulling sensations, which can slightly increase with a change in body position or with a static, constant load (the same pose). The pain can appear in the morning after sleep and goes away during the day after moderate distributed movements. Also, the pain symptom is relieved by heat or rubbing, which indicates a spastic cause of pain. For all other diseases, pulling pain under the right shoulder blade is not typical. An exception may be malignant tumor processes of internal organs - the liver, right kidney, head of the pancreas or right lung. Since oncological diseases develop hidden and manifest themselves in the initial stages with minor, in the clinical sense, implicit symptoms. Also, pyelonephritis can be accompanied by reflected upward pulling pains, but, as a rule, this is atypical and rare.

Constant pain under the right shoulder blade

This is a clear symptom of biliary dyskinesia of the hypotonic type. Dyskinesia of the bile ducts in this form is much more common in clinical practice than the hyperkinetic form, especially in women and children. The pain develops gradually in the area of the right hypochondrium and can be reflected upwards into the right shoulder and under the shoulder blade. The pain symptom does not cause severe discomfort, as many patients note - it is bearable. Such a constant nature of pain is "habitual" for those who suffer from gallbladder diseases. In comparison with an exacerbation of the process or an attack of cholecystitis, constant pain under the right shoulder blade is tolerated by patients much easier and does not require urgent treatment. However, the wave-like course of the underlying disease can increase and move from the remission stage to the acute phase, so everyone who feels chronic radiating right-sided pain should undergo a comprehensive examination and begin treatment as soon as possible. The main danger of undiagnosed nagging pain in the upper right part of the body can be gastroduodenitis, acute cholecystitis, gallstone disease

Burning pain under the right shoulder blade

It may indicate both pinched nerve roots due to osteochondrosis and serious pathologies that require immediate treatment. These include right-sided pneumonia, which often develops asymptomatically in the initial stage and may manifest as periodic burning pain under the right shoulder blade. Also, such pain may indicate an atypically developing angina pectoris, which is characterized by left-sided reflected pain, but in some cases, irradiation under the right shoulder blade is also found. The very nature of the pain, which in clinical practice is called causalgia (from causis - burns and algos - hurts), indicates inflammation and/or damage to the peripheral nerve processes. Thus, burning pain under the right shoulder blade can occur either with pinched nerve roots or with atrophy of nearby tissues, which is typical for pneumonia or angina pectoris - angina pectoris.

Osteochondrosis and pain under the right shoulder blade

Osteochondrosis. Pain under the right shoulder blade may be one of the symptoms of a cervical deforming process or osteochondrosis of the thoracic spine. This is typical for everyone who is associated with sedentary office work, especially typical for schoolchildren or students. With such a static posture, there is constant compression of the nerve endings, which results in chronic pain, reflected in the direction of the shift of the intervertebral discs. The pain can be aching, pulling in nature, radiating to the neck or shoulder, as well as under the right shoulder blade. The symptom intensifies with awkward turns, movements, often in the morning hours after sleep. Often, osteochondrosis and pain under the right shoulder blade are accompanied by numbness of the fingers, headache. Also, one of the causes of such pain can be S-shaped scoliosis of the thoracic spine.

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Pain in the right shoulder blade

Pain radiating to the right shoulder blade is a sign of the following diseases:

Gallstone disease	Acute, paroxysmal pain, with nausea, vomiting, elevated body temperature, feverish state, yellowing of the skin
Spontaneous traumatic pneumothorax	Sharp, acute pain in the chest area, radiating to the shoulder blade area (under the shoulder blade)
Cholecystitis in the acute stage	Pain in the right hypochondrium, spreading to the epigastric region. The pain radiates to the area between the shoulder blades, under the right shoulder blade, to the right shoulder, to the chest. The pain lasts from several hours to several days.
Renal colic, pyelonephritis	Paroxysmal pains, sharp, cutting character, radiating to the lower back. As the syndrome develops, the pain radiates upwards, if the right kidney is inflamed, there are purulent infiltrates, the pain radiates under the right shoulder blade.
Pancreatitis in the acute stage, inflammation of the head of the pancreas	The pain occurs suddenly and is constant. The symptom spreads through the epigastric region and radiates to the sternum, often under the right shoulder blade and into the shoulder.

If the pain radiates to the right shoulder blade and its intensity increases, you should call for emergency medical care, especially for conditions accompanied by hyperthermia within 38-40 degrees.

Aching pain under the right shoulder blade

Aching pain in the area of the right shoulder, in the shoulder blade and under it, may indicate a chronic process that develops in organs distant from the shoulder blade. Radiating (reflected) pain, not intense, is a typical sign of a latent inflammatory process in the liver, kidneys, gall bladder or pancreas. Often, aching pain under the right shoulder blade does not encourage people to see a doctor, while patients try to use various home treatments and only aggravate the pathological process. Diagnosis of aching reflected pain is often difficult, since the clinical picture is not manifested, and the main pain symptom is relieved by "folk" methods - rubbing, warming, massage. Oncological diseases, which can develop over the years and manifest themselves in periodic aching, radiating pain symptoms, also pose a danger. Detected at early stages, many oncologic processes can be stopped, acute pain symptom is, unfortunately, a sign of the terminal stage. Aching pain under the right shoulder blade can be a signal of such diseases:

• Chronic cholecystitis.
• Chronic pyelonephritis.
• Gallstone disease in the initial stage.
• Liver disease, including cirrhosis or hepatitis.
• Chronic pancreatitis.
• Osteochondrosis.
• Chronic bronchitis.
• Latent pneumonia or pleurisy.
• Tumor processes.

Treatment of pain under the right shoulder blade

Treatment of pain under the right shoulder blade is impossible without examination and identification of the root cause. Such pain sensations are of a reflected nature, which means that the real source of the disease is located at a distance from the shoulder blades, especially since there are no internal organs in this area that could provoke pain. In order to cure a painful symptom, whatever its nature - acute pain or pulling, dull pain, you need to contact the following doctors:

• Neurologist.
• Vertebrologist.
• Traumatologist.
• Cardiologist.
• Gastroenterologist.

The first step, of course, may be a visit to the local doctor, who will conduct an initial examination, collect anamnestic information and decide which specialist to refer the patient to. X-rays, general blood and urine tests, and possibly initial analgesic therapy to relieve the pain symptom will also be prescribed. In case of acute symptoms, when the pain is accompanied by high temperature, vomiting, fever, you should call a doctor at home or an ambulance.