Pain left 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.

Click here: Second Opinion Arthritis Treatment Kit

Shoulder blade pain is a common condition.

Because of the complexity of the shoulder joint, movements make the shoulder extremely vulnerable to sprains, strains, tears and inflammation of the capsules, muscles, ligaments and bursa.

The shoulder joint is actually made up of three joints and one “articulation”, where the head of the humerus (the long bone of the upper arm), meets the acromion, a part of the shoulder blade (scapula).

There are 4 main muscles that are involved in most shoulder motion. They are called the rotator cuff muscles. It is these muscles that are most vulnerable to tears, strains, sprains and inflammatory processes.

Proper evaluation of shoulder disorders will consist of various tests involving the movement of the arm through all range of motion (ROM), and neurological evaluation to see if there is any nerve involvement. X-rays and MRI scans may be ordered.

A bursa is a small sack of fluid that allow tendons and ligaments to glide smoothly. They can become swollen, inflamed or even infected. In an acute shoulder bursitis, the patient generally complains of pain related to movement of the arm, and the pain is generally worse at night. The patient will have difficulty in sleeping on the affected side. Pain and tenderness is generally located at the point of the shoulder.

Pains that occur along the top of the shoulder, and radiates into the side of the upper arm into the deltoid muscle, and further down the arm, into the fingers, may be due to a pinched nerve, which originates in the neck.

Pains that occurs over the shoulder blade area can be due to muscle spasm involving the trapezius and adjacent muscles. The spasm can be brought on by overuse or trauma to the muscle. Pain from a pinched nerve in the neck also causes pain to radiate into and between the shoulder blades.

Pains that occur under the shoulder blade may be a warning that the pain is not in the shoulder, but can be due to a disorder of internal organs. The side that the pain is located on can give a clue as to which organs are affected and causing the pain. Pain under the left shoulder blade can be a signal that there is a problem with the stomach or other abdominal structures (ulcers, pancreatitis, ectopic pregnancy) or in the chest (myocardial infarction [heart attack], pericarditis, pleuritis, pneumonia, pulmonary embolus, aortic dissection). Pain under the right shoulder blade can be a signal of a gall-bladder inflammation or gallstones. Or it can relate to liver disease, or a problem with the duodenum.

There can of course be many other problems that can affect the shoulders and cause pain of minor or major proportions. Here are just some of those problems that are most apt to affect the shoulder:

1. Rotator cuff syndrome that can either be a strain/sprain, or a tendon tear.
2. Muscles that are not part of the rotator group can be torn or strained.
3. Tendons and ligaments can be torn or strained.
4. Osteoarthritis of the shoulder joint.
5. Rheumatoid arthritis (RA) of the shoulder joint.
6. Fractures
7. Bursitis
8. Primary or metastatic cancer involving the upper end of the humerus.

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