The scapula is a three-dimensional triangular bone that connects the humerus and the clavicle. Its name derives from the similarity to the appearance of the well-known tool, the garden shovel. The scapula fossa and the humeral head constitute the shoulder joint, which is the most flexible joint in the human bones.
In most cases, pain under the right scapula indicates disease in the joint components of the shoulder, spine, or paravertebral (paravertebral) structures. Other possible causes are damage to internal organs-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 strain and inflammation
A large number of muscles are attached to the scapula: subscapularis, coracobrachialis, rhomboid muscles, and deltoids. In most cases, it will be painful under the right scapula because of the development of stretching or inflammatory processes.
Muscle stretching can cause severe pressure on the back, lifting and bearing weights, sudden movements, and prolonged uncomfortable postures. However, practice shows that in more than half of the cases, the reason is that unprepared people consume excessive energy and exercise improperly.
The symptoms of stretching are as follows:
- Severe pain of varying intensity;
- Pain worsens when turning and tilting the body;
- Relief at rest;
- Swelling and bruising (severe damage).
The basic principle of treating sprains is to rest completely and eliminate any stress. Immediately after injury, apply ice or cold compress to the painful area, and take anesthetics if necessary.
With muscle inflammation-myositis-the worry of pain increases with stress and exercise. Sometimes there will be slight swelling and redness. The general condition usually worsens: body temperature rises, head pain, small painful seals in the muscles.
There are many causes of myositis, but the most common is in the context of acute respiratory virus infection, influenza or tonsillitis. It should be noted that in the chest area, muscles are rarely inflamed, because myositis is mainly located in the upper or lower back.
One of the variants is myositis ossificans or fibrodysplasia-an extremely rare disease. This congenital osteogenesis disorder (bone formation) develops rapidly and manifests itself in childhood.
Fiber dysplasia is the formation of ossification points in the muscle structure, which gradually expand and damage the surrounding tissues. The ossification process (ossification) can be located almost anywhere-near the spine, limbs or pelvic area.
refer to:Myositis ossificans is incurable and not even suitable for surgical treatment. After removing the ossification, they form again.
Myofascial syndrome
The most common thing after a headache is back muscle pain. More than 40% of people suffer from chronic pain syndrome, and most of them are women.
Myofascial syndrome is a progressive disease characterized by the formation of trigger (pain) points in the muscles. The diameter of each acupuncture point varies from 1 to 3 mm, and the accumulation of acupuncture points will produce a pain area of 1 square centimeter. These acupuncture points are formed under the influence of trauma and muscle strain.
Many factors can trigger this process:
- Skeletal abnormalities-scoliosis (spine bending to the left or right), asymmetry of the pelvis, shortening of one of the limbs, flat feet;
- Back injury
- Spinal diseases-osteochondrosis, spondyloarthropathy, and hernias and herniation;
- Long-term use of drugs-β-blockers, cardiac glycosides, calcium antagonists, antiarrhythmic drugs, anesthetics;
- Damage to connective tissue in autoimmune diseases-rheumatism, lupus erythematosus.
Cholelithiasis
For gallbladder lesions, the pain usually radiates to the right scapula. This is due to the formation of stones (calculi) that irritate the bladder wall and smooth muscle spasm. The onset of biliary colic usually occurs suddenly and is concentrated on the right side under the ribs.
Pain syndrome is acute, cutting, and in most cases occurs after eating fatty, fried, spicy food and alcoholic beverages. The cause of the attack may be intense physical exertion, nervousness or prolonged oblique posture.
If the bile duct is blocked, the pain will feel dull and stretched. The accompanying symptoms are a heaviness in the right side of the abdomen, and nausea, which turns into vomiting. An increase in body temperature is possible and sometimes increases. With blockage of the common bile duct and sphincter of Oddi, jaundice develops and stools become discolored.
The treatment of gallstone disease can be conservative and surgical. In the absence of complications, no specific treatment is given. Shockwave lithotripsy can be used to remove individual stones.
Subphrenic abscess
Back pain in the scapula area can be explained by the formation of a subdiaphragmatic abscess-an abscess located below the dome of the diaphragm. In most cases, it appears after abdominal surgery, when peritonitis develops. The pathogen can be Staphylococcus, Streptococcus or Escherichia coli.
After partial or complete removal of the stomach, removal of the pancreas, suture of the perforated ulcer, and removal of the spleen, the infection enters the body. The reasons may be inflammatory pathology of internal organs, open or closed abdominal trauma, and severe lung disease, osteomyelitis of vertebrae and ribs.
The general symptoms appear first-weakness, sweating and fever. Elevated body temperature can remain constant or increase periodically. Then start pain in the upper third of the abdomen and lower chest from the affected side. Pain syndromes of varying intensities usually radiate to the scapula, shoulder, or below the collarbone.
One characteristic of an abscess is shortness of breath, dry cough, hiccups and movement, deep breathing, increased pain when coughing and sneezing. The patient breathes frequently and shallowly, trying to adopt a semi-sitting position.
The treatment of subdiaphragmatic abscess includes surgical opening and drainage of the abscess, followed by antibacterial, anti-poisoning, anti-inflammatory and repair treatment.
refer to:If the operation is not timely, the abscess will break into the abdominal and pleural cavity, which almost guarantees a fatal result.
pleurisy
Pain near the scapula can cause bronchopulmonary disease-pneumonia or bronchitis, with pleurisy. In this case, it will hurt both below and above the shoulder blades. 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 infections, trauma, and chest surgery.
In some cases, pleurisy develops in the context of autoimmune diseases-scleroderma, rheumatoid arthritis, lupus erythematosus, vasculitis and pulmonary thromboembolism, myocardial infarction, pancreatitis.
In 25% of patients with pleurisy, a malignant tumor-mesothelioma or metastases to other organs (breast, ovary) is diagnosed. Metastatic pleurisy usually has mild symptoms and usually manifests as pain behind the breastbone.
When a large amount of exudate accumulates, puncture or drainage is required. Depending on the cause of the development of pleurisy, specific treatments are prescribed. It can include antibiotics, steroids, and anti-inflammatory drugs. The form of tuberculosis is treated with special medicines.
Urolithiasis
The formation of stones in the urinary system most often occurs in middle-aged people between 25 and 50 years of age. The disease develops in different ways: in some cases, the symptoms are limited to one unpleasant episode, while others complain of regular deterioration. In some cases, urolithiasis has a chronic, long-term 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 the intensity depends on the size of the stone. When the right kidney is affected, there will be pain in the right shoulder blade. If the stone is low, the lower back or lower abdomen will be painful.
The typical symptoms of urolithiasis are frequent impulse and burning sensation when urinating, fever and nausea.
Treatment methods can be conservative and surgical. In most cases, an operation is required, and the instructions for its realization are:
- big Stone;
- The development of renal failure;
- Localization of stones in the kidney, renal pelvis or ureter;
- Suppurative pyelonephritis.
Surgery can be open or endoscopic. Shockwave lithotripsy is the gentlest method to reduce the percentage of postoperative complications.
During the operation, the stone is crushed by a reflector that emits electro-hydraulic waves. After being crushed, the stones and sand are excreted with urine. Sometimes their movement along the ureter can cause renal colic, which can easily be stopped by medication.
refer to:There is no guarantee that there will be no recurrence in any surgery. Therefore, complex treatments must be performed, which can last for several years.
Intercostal neuralgia
Intercostal neuralgia (chest pain) is characterized by severe symptoms. The most common manifestation is acute tingling in the front and back of the ribs. It may interfere intermittently or continuously. Pain syndrome is pain, burning, or dull pain, but it is always unbearable.
A characteristic of neuralgia is a sharp increase in pain when inhaling, changing body posture, or sneezing. Usually, during the onset of pain, the muscles twitch, sweating increases, and the skin turns red or, conversely, it turns pale. Numbness occurs in areas where nerve endings are damaged.
The direct cause of the pathology is the compression of nerve roots, which is promoted by various factors and diseases:
- Osteochondrosis;
- Spondylitis;
- Ankylosing spondylitis;
- Primary and metastatic tumors;
- Destruction of the stomach (gastritis);
- Age-related vascular changes;
- Metabolic disease
- Chest trauma;
- Influenza, SARS;
- Hypothermia and drafts;
- Chronic or severe nervousness;
- High physical activity
- Unsuccessful body turning, staying in a static position for a long time.
refer to:Intercostal neuralgia is characterized by pain lasting from a few seconds to three minutes. During this period, the patient tries not to breathe or move, so as not to aggravate the pain.
The main direction of treatment is to relieve pain syndrome, for which anti-inflammatory non-steroidal drugs (NSAIDs) are prescribed. For severe pain, anesthetics and steroids are used to treat the obstruction. To increase the excitability threshold of the central nervous system, sedatives are used.
The specific treatment depends on the origin of neuralgia and may include antivirals, antihistamines, and muscle relaxants.
Tumor
Bone tumors in the scapula are very rare and can be benign or malignant. The former includes osteoma and chondroma, and the latter includes chondrosarcoma and Ewing's sarcoma. Osteoma is characterized by slow growth and a good course of disease. It mainly affects children and adolescents between 5 and 20 years old.
Osteoma can grow asymptomatic and only appear when the surrounding structures-nerve roots and blood vessels-are compressed. The treatment is only surgery, and there is almost no recurrence.
Chondroma is a benign tumor that originates from cartilage tissue. It should be noted that when chondroma is located in the scapula, the tumor tends to degenerate into malignant. Due to the high risk of malignant tumors, such formations are completely removed.
Chondrosarcoma, like chondroma, is formed by 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 children, but the largest proportion is in middle age-from 40 to 60 years old. Most are men. The main method of treatment is to remove the tumor; if surgery is not possible, chemotherapy and radiotherapy are performed.
Ewing's sarcoma is one of the most aggressive malignant tumors that is most prone to early metastasis. It affects children and young people and manifests as severe symptoms-pain, swelling and redness.
Because tumors are highly aggressive, surgery and therapeutic treatment are required. Chemotherapy and radiotherapy were performed before and after the operation, and high-dose and multiple drugs were used. The prognosis of this disease is unfavorable.
Pain under the right shoulder blade may be a completely harmless symptom, or it may be a serious disease. In order to get rid of pain and prevent possible complications, you need to receive expert consultation and examination. Based on the results, the doctor will prescribe a treatment plan and give the necessary recommendations. healthy!