Pain under the right shoulder blade from the back

Contents

Causes of pain under the right shoulder blade from the back
Treatment of pain under the right shoulder blade from the back
- Diagnostics
- Modern treatments
Prevention of pain under the right shoulder blade at home
Popular questions and answers

Pain under the right shoulder blade from behind from the back most often occurs due to strong physical exertion, but it can also be a symptom of a variety of diseases. We deal with experts Larisa Neboga and Elena Orlova, what to do if the pain does not stop and how to treat it

Pain under the right shoulder blade can appear both due to excessive physical activity, and against the background of various diseases. Medical attention is usually sought for severe pain that makes it difficult to move and breathe freely. But moderate pain can also be dangerous, especially if it occurs regularly and lasts for a long time.

We spoke with our experts about the causes of pain under the right shoulder blade, how to diagnose and treat such symptoms, how to relieve pain, and when to see a doctor.

Causes of pain under the right shoulder blade from the back

There are musculoskeletal and reflected pains under the right shoulder blade. Musculoskeletal pain occurs due to physical activity and most often in people who lead a sedentary lifestyle. It happens that pain appears when a person abruptly lifts a heavy load or carries it in his right hand.

Reflected pain signals are given by some internal organ. Pain under the right shoulder blade can occur against the background of diseases of the digestive, urinary and respiratory systems. The most common causes of pain under the right shoulder blade will be discussed below.

osteochondrosis

In a person with osteochondrosis, the vertebrae become unstable, therefore they are easily displaced, causing pinching of nerve endings and muscle strain.¹. With osteochondrosis, pain under the right shoulder blade is most often dull and aching, aggravated by shaking, coughing, sneezing and awkward movements¹.

Intervertebral hernia

With a hernia, the functions of the intervertebral disc are disrupted – a cartilaginous plate that serves as a “shock absorber” for the vertebrae¹. The disc becomes less elastic and “bulges” out of the spine. As a result, the roots of the spinal nerves are compressed, and pain occurs. Pain under the right shoulder blade is usually observed with a hernia of the upper thoracic spine¹.

Cholelithiasis

In this disease, stones (calculi) form in the gallbladder, which can clog the bile ducts and damage the walls of the gallbladder, causing spasm and inflammation.³. This condition is called biliary colic. A common cause of colic is eating fatty foods or eating too much food.³. Sometimes the displacement of stones occurs due to physical exertion or shaking while driving.³.

Characteristic signs of colic – “bursting” pain in the right hypochondrium, which can give under the right shoulder blade and shoulder³. Attacks are often accompanied by nausea and vomiting and last from a few minutes to several hours.³.

Biliary Dyskinesia (Biliary Dyskinesia)

With JP, the bile ducts begin to contract too intensely or vice versa weakly. This pathology occurs in 10-20% of adults, most often in women.². Pain in JP is usually localized “under the pit of the stomach” and the right rib, but can be given under the right shoulder blade². Pain occurs irregularly, occurs during the day and at night and lasts from 30 minutes to several hours².

Chronic non-calculous cholecystitis

This is a chronic inflammation of the gallbladder, in which stones are not formed, but the outflow of bile into the duodenum is disturbed. With an exacerbation of the disease, patients complain of pain under the right rib, which often gives under the right shoulder blade or in the space between the shoulder blades. Along with painful sensations, nausea, belching, bitterness in the mouth may disturb. Attacks often occur after drinking alcohol, fatty foods, carbonated drinks.

pyelonephritis

In pyelonephritis, one or both kidneys become inflamed. The disease can be acute or chronic⁵. Patients with chronic pyelonephritis are concerned about pain in the lumbar region, weakness, fatigue, loss of appetite⁵. With inflammation of the right kidney, pain can be localized under the right shoulder blade. Acute pyelonephritis, in addition to pain, is accompanied by weakness, severe sweating and high fever – 39–40 ° C⁵.

Pneumonia

Pneumonia is characterized by chest pain associated with acute cough, fever, weakness, shortness of breath, and heavy sweating, especially at night.⁴. With right-sided inflammation, the pain may be focused under the right shoulder blade. Pain is aggravated by breathing and coughing⁴.

Treatment of pain under the right shoulder blade from the back

Depending on the cause, different specialists are involved in the treatment of pain under the right shoulder blade, including orthopedists, urologists, pulmonologists, and neurologists. In emergencies, surgery may be required, but most patients are treated conservatively in an inpatient or outpatient setting.

Diagnostics

For pain under the right shoulder blade, they usually turn to a therapist who collects an anamnesis, prescribes examinations and, if necessary, refers the patient to narrow specialists. A preliminary diagnosis is usually made on the basis of symptoms and examination results, and laboratory and instrumental methods are used to clarify:

radiography of the spine and chest organs to determine the condition of the vertebrae, to identify fractures and cracks in bone structures, neoplasms and foci of inflammation in the lungs;
Ultrasound of the abdominal cavity, which allows you to study the condition of the liver, gallbladder and ducts, detect stones, inflammation and changes in the structure of organs;
Ultrasound of the urinary system to exclude or confirm pyelonephritis and other kidney diseases;
CT and MRI of the spine – these methods allow you to diagnose osteochondrosis, intervertebral hernia, injuries and tumors of the spinal column;
ERCP – endoscopic examination of the biliary tract for the diagnosis of cholelithiasis and cholecystitis;
general and biochemical blood tests – to identify inflammation, determine the functional state of the kidneys, liver, gallbladder, pancreas;
general and bacteriological analysis of urine – with the help of these studies, an inflammatory process is diagnosed, an infectious agent is determined in diseases of the urinary system.

Patients with “bad” urine tests may be assigned additional studies – analyzes according to Zimnitsky and Nechiporenko. To assess the intensity of bile secretion and the composition of bile, duodenal sounding is used, and in case of pulmonological diseases, bronchoscopy.

Modern treatments

For the treatment of pain under the right shoulder blade, medicines, physiotherapy, massage, physiotherapy exercises are used. Surgery and intensive care may be required for biliary colic, exacerbation of cholecystitis, pneumonia, and the presence of tumors.

The tactics of conservative therapy are selected taking into account the diagnosis:

for the treatment of diseases of the biliary system, antispasmodics, antibacterial agents and drugs that stimulate the formation and secretion of bile are used;
patients with osteochondrosis and intervertebral hernia are prescribed non-steroidal anti-inflammatory drugs, with severe pain, blockades with anesthetics and glucocorticoids are performed, after relief of symptoms, vitamins of group B, muscle relaxants, chondroprotectors are prescribed¹;
with pneumonia, antibiotic therapy, drugs with expectorant and anti-inflammatory effects are prescribed.

Very often, non-drug methods are used to treat pain under the right shoulder blade. Patients with spinal pathologies will benefit from massage, yoga and swimming in the pool. People with chronic pyelonephritis, JP and chronic non-calculous cholecystitis in remission are prescribed spa treatment.

Prevention of pain under the right shoulder blade at home

To prevent pain under the right shoulder blade, doctors advise you to monitor your posture, avoid excessive physical exertion and strengthen your back muscles with exercise. People with chronic diseases of the biliary tract and kidneys should follow a diet, take medications and follow other medical recommendations.