Back pain under the right shoulder blade



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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For more information including a really instructive video, on Back Pain Upper Middle Shoulder Blades, go to:
Back Pain Upper Middle Shoulder Blades Special site with free instructive video and transcription on the topic of back pain upper middle shoulder blades.





This type of pain has many possible causes.

Referred pain- that is pain coming from internal organs - needs to be considered. For instance, the pain associated with esophagitis, stomach ulcers, and pancreatitis may cause pain under the right shoulder blade.

Any problem that causes irritation of the diaphragm can also cause shoulder blade pain. An example would be an ectopic pregnancy.

Pain from aortic dissection can also lead to referred pain to the upper spine and shoulder blades.

A viral respiratory infection could cause pleurisy (inflammation of the lining of the lung) that might cause pain in the back. Pneumonia and pulmonary emboli may also do this.

The most common “internal” cause for pain leading to the right shoulder blade is gall bladder disease.

The term for this is “biliary colic.”

Biliary colic is an ache in the upper abdomen, under the right rib cage. It occurs when gallstones interfere with the normal flow of bile from the gallbladder. Bile is produced in the liver and stored in the gallbladder. Bile passes from the gallbladder through the common bile duct into the small intestine, where it mixes with food. If a gallstone blocks the ducts, the flow of bile into the intestine is stopped. The smooth muscle in the wall of the bile duct contracts to try to move the stone, causing the pain of biliary colic.

A person with biliary colic usually complains of pain in the center of the upper abdomen just below the sternum (breastbone), or in the upper-right part of the abdomen. In some people, the abdominal pain spreads toward the right shoulder blade. People also experience nausea and vomiting.

Symptoms of biliary colic are especially common after fatty meals.

Ultrasound examination of the gall bladder is the diagnostic procedure of choice.

If the biliary colic is recurrent or persistent, surgery to remove the gallbladder (cholecystectomy) is recommended. This procedure can be done using an instrument called a laparoscope.

A growth or tumor on the ribs could also cause discomfort and should be ruled out by an X-ray or CT scan.

Disc herniation and arthritis in the neck can cause cervical radiculopathy (pinched nerve) and this can cause pain to be referred to the shoulder blades.

Pain in the upper or mid back can come from trigger points in the muscles of the back. Multiple muscle groups that support the spine can go into spasm and cause pain in the shoulder blade region. This is particularly common in people who have myofascial pain syndrome.

Trigger points in the upper part of the rectus abdominis (stomach) muscles can be responsible for pain across the mid back.

Obviously, the appropriate treatment depends on making the correct diagnosis.







For more information including a really instructive video, on Back Pain Upper Middle Shoulder Blades, go to:
Back Pain Upper Middle Shoulder Blades Special site with free instructive video and transcription on the topic of back pain upper middle shoulder blades.




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