In anatomy, the scapula (plural scapulae or scapulas), also known as the shoulder bone, shoulder blade, wing bone or blade bone, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Unlike other muscle syndromes, the causes of muscle pain in the scapula are most often not related to the "culprit" of all spinal pains - osteochondrosis. In arthritic conditions, especially in osteoarthritis, the surrounding joints become damaged. Bagg and Forrest found a ratio of 4.4:1 during early phase, and 1.7:1 within 80 to 140° of shoulder elevation.Burkhart et al  has used the acronym SICK to refer to the syndrome associated … In this test, the doctor will test your arm strength by pushing down on your extended arm. Scapula pain can be from orthopedic sources [7], a muscular etiology such as with scapular muscle dysfunction [8], dermatologic sources such as notalgia paresthetica [9], intrathoracic sources [10], or associated with the dorsal scapular nerve, either centrally or more commonly though entrapment within the middle scalene muscle [11]. Occasional scapula pain is to be expected due to the amount of muscle usage in this area of the body. In these cases the primary problem is often felt in the affected area, with radiation to the interscapular region. Exercises can be used to improve flexibility and strength. Syndrome of acquired pterygoid scapula, which provokes paralysis of anterior dentate, trapezius or rhomboid muscle. Specification of the nature and parameters of pain: At what position, the position of the body appears pain. 6 What are the Boundaries and Contents of Intermuscular Spaces in the Scapular Region. Identification of possible scoliosis, anomalies of the structure of the spine (test-symptom Forestier). With a ball you can comfortably and effectively work on the shoulder blade region. Unlike articular lomiashchih pain, the symptoms of pain in the muscles of the scapula often bear noel character. Palpation aggravates the pain, The source of the symptom with palpation can not be detected. Pain in this area of the body is quite common and can have several potential causes, the most common being excessive or strenuous physical activity. This is not a direct indication as to how commonly these diseases are the actual cause of Scapular pain , but gives a relative idea as to how frequent these diseases are seen overall. 4 Describe Briefly the Musculotendinous or Rotator Cuff. Pain in this area of the body is quite common and can have several potential causes, the most common being excessive or strenuous physical activity. Paralysis can be caused by both an infectious disease, and trauma, bruising, including professional (athletes, circus performers). Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. Referred shoulder pain happens when the pain isn't caused by problems with your shoulder joint or with the muscles, ligaments, or tendons around it. Wikibuy Review: A Free Tool That Saves You Time and Money, 15 Creative Ways to Save Money That Actually Work. Protrusion or hernia of intervertebral discs of the thoracic spine. You might also hear or feel “clicking” in your shoulder when you rotate your arm. The most shoulder pain I have ever had was far less intense than this. 5 Describe Subacromial bursa. Dandruff in the ears: why does it appear, how to treat it? The rotator cuff is a group of muscles that work together to support and stabilize the joint found in the shoulder. Neurological pathologies requiring urgent therapy. Muscle strain – Strain to the scapular muscles could lead to muscle spasm. Quite often there are cases when there is a pain symptom, but the examination does not reveal any reliable pathological source of pain, it also happens that the studies determine a pathology that is not accompanied by a clearly expressed clinical sign. Painful sensations in the muscles, myalgia, as a symptomatic phenomenon is not well understood, especially pain in the muscles of the scapula. Exercises for Scapular Pain. People who suffer from this type of injury are usually at least 40 or 50 years old. The most common symptom of a subscapularis tear is shoulder pain, especially in the front of the shoulder. Consequently, almost all the painful sensations in the area of the scapula are associated with the muscle tissue, as well as with damage to the tendons, bony connectives. Scapular pain is common with cervical radiculopathy. The scapula would just be hanging there with no support! The shoulder blades—medically known as the scapulae—are the triangular-shaped bones of your upper back that stick out and become more visible when you extend your elbowstowards your back. Oncological processes in the spinal column. The duration of pain is transient, prolonged, chronic. Then, he had to have surgery to repair the damage. When patients feel pain radiating from their back down their arm, they often think of thoracic disc lesions, nerve root compressions (pinched nerves), thoracic outlet syndrome, and nerve traction injuries. C6 causes pain and weakness through the biceps wrists, thumb, and first finger. He had fallen and landed on his elbow, and he popped his arm out of socket, so he felt pain all over the shoulder and arm. Symptomatology of muscle pains is characterized by sensations of tension, stretching. A good thorough examination is called for. A pinched cervical nerve that causes pain in the neck and shoulder region usually occurs at the C5 nerve root 1. Arthritis is not a common cause of shoulder blade pain, but it has been reported. Studies are needed only in cases of suspicion of such pathologies: Also, radiography is necessary if the patient is directed to manual therapy or physiotherapy procedures. Syndrome restricts body movements when tilting, rotating. Pain in the muscles under the scapula can be both a sign of true myalgia, and a signal of more dangerous diseases, such as: In any case, a simple pain symptom, which a person considers to be muscular, must pass without specific treatment for a maximum of 1-2 days. Electromyography can be used to identify the characteristics of the muscular structure. Cervical radiculopathy can also cause pain in the scapular region. Accumulating, tension in the shoulders and in the zone of the scapula leads to compensatory shortening, contraction of the pectoral muscles, aggravates the state and habit of stooping, stretching the head, neck forward. We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Even though I took breaks now and then, I knew that I would be stiff and sore the next day. Scapula pain can also be caused by sleeping position or degenerative diseases such as arthritis. 2 A heart attack may also present as pain felt in the upper back and/or shoulder, especially in women. Clavicle fracture in a newborn during childbirth. Note that the numbers in parentheses ([1], [2], etc.) All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible. Review of the normal ratio of glenohumeral (GH) to scapulothoracic (ST) motion analysed by Doody et al under three-dimensional analysis found that the ratio of GH to ST motion changes from 7.3: 1 in the first 30° of elevation to 0.78: 1 between 90 and 150°. As a consequence, the muscles that lift the shoulder blades, part of the trapezius muscle, the sternocleid, deltoid, are overtaxed, while others located in the middle of the back - the lower part of the trapezius, the flexors of the neck, the anterior dentate are subjected to compensatory stretching or weakening, all these abnormal, nonphysiological phenomena provoke pain. Discussion. A stroke of angina often resembles the signs of pain in the muscles under the scapula. Pain in the shoulder blade does not mean you will suffer pain in the shoulder region. Study design: A prospective observational study. A 67-year-old female was referred for two weeks of left shoulder pain that kept her from sleeping and moving her arm and interfered with her job as a typist. However, if the pain becomes persistent or severe, a trip to the doctor is advisable. If a person undergoes treatment for a muscle or other pain, a disease, it is necessary to strictly observe and fulfill all medical appointments. Stomach ulcer, which is most often localized in the epigastric zone, but can irradiate to the left side - in the chest area, under the left scapula. Before talking about symptoms, it helps to describe exactly what location we are talking about when describing the shoulder blades. He had to be put under anesthesia so that the doctor and nurses could pop it back into place. This bone attaches the arm bone to the bones of the ribs. One of the most common sources of scapula pain is a rotator cuff injury. Pain is worse when coughing, sneezing, painful areas are well defined by palpation. Mobility of the vertebral column in the thoracic region (Ott test-symptom, Thomayer's symptom). Mostly commonly though I suspect, though I have no research to confirm this, it comes either from a rib head subluxation or a condition of the thoracic spine itself. These rules relate primarily to such items: Pain in the muscles of the scapula is a rather complex polyethological symptom, and not an independent disease. Methods: In the anatomic study, 11 Japanese adult cadavers were dissected to examine the numbers and courses of the cutaneous nerves from C3 to C8 dorsal rami. The scapula, more commonly known as the shoulder blade, is a flat bone shaped much like a triangle. If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter. I had to take pain relievers over the next couple of days to ease the pain. are clickable links to these studies. Physical trauma or injury can also cause shoulder blade pain, so it is important to see a medical professional for proper diagnosis and treatment. You are reporting a typo in the following text: Diseases of the mammary glands (mammology), Diseases of the joints, muscles and connective tissue (rheumatology), Diseases of the immune system (immunology), Diseases of the heart and blood vessels (cardiology), Diseases of the skin and subcutaneous tissue (dermatology), Diseases of the lungs, bronchi and pleura (pulmonology), Diseases of the ear, throat and nose (otolaryngology), Diseases of the endocrine system and metabolic disorders (endocrinology), Sexually transmitted infections (sexually transmitted diseases), Diseases of the nervous system (neurology), Diseases of the gastrointestinal tract (gastroenterology), PCR (Polymerase Chain Reaction, PCR Diagnostics). In addition, chronic hypertension of the small pectoral muscle leads to infringement of the nervous and vascular plexus, a bundle located near the beak-shaped scapular process, as a consequence - loss of sensitivity of the hand, fingers. pain due to cervical radiculopathy, scapular pain is common and can be used to identify the spinal nerve root involved.5 Also, radicular pain in the scapular region is often associated with a cervical nerve root block. Levator scapulae pain is one of the most common general muscle complaints and can be associated with sleepless nights and an irritable mood. Sometimes, I have to go throughout the day feeling the pain, because I slept in such a way that I applied pressure to my scapula all night long. The main cause of aching pain in the middle of the back is due to prolonged muscle tension, usually due to the specifics of professional activity. Also in clinical practice, the causes of muscle pain in the scapula are classified according to the types of muscular-tonic syndromes: In addition, pain in the muscles of the scapula can be caused by an inflammatory process in the muscle tissue - myositis. Often, such manifestations resemble angina attacks, which greatly complicates the diagnosis. Nevertheless, the prevention of pain in the muscles of the scapula is the observance of well-known, but, unfortunately, rarely used in practice measures. The pain was located in the posterior shoulder just medial to the scapula, radiated down her left arm, and was positional. This type of injury is most common among athletes who use their shoulder muscles repetitively. Neck Pain from a cervical disc disease can radiate to the interscapular area, as well as down the arm. All rights reserved. There may be weakness in the biceps muscle flexion. I would imagine that having a dislocated shoulder would cause an immense amount of pain. Treatment for a rotator cuff injury is a bit different from treatment options involving other types of scapula pain. The shoulder blades have many functions, one of which is to support pivotal movements of the shoulder. Intercostal neuralgia can also manifest as paroxysmal, shingles in the lower part of the scapula. When one or more of these muscles become damages, the pain frequently manifests itself as scapula pain. Perform workouts. 13 Pain referred from visceral structures: 8 Pain from the thoracic and abdominal viscera can be referred to the upper back. Accurate characteristics, including indication of localization, The description is vague, the pain diffuse, comes from within, from the depth to the muscles, The pain spreads in the direction of the nerve roots, irradiates, The movements of the limbs are little limited, the restrictions concern the volume of movements of the chest, the back, Has only axial load, as well as reflex movements - coughing, sneezing, Palpable areas are well palpated. The following are some of the most common causes of pain in your shoulder blade. Treatment of pain in the shoulder muscles can be divided into two stages: short-term, urgent measures and long-term tactics. Syndrome m. Serratus posterior superior - the upper posterior cog muscle is often provoked by a degenerative process in the upper pectoral intervertebral discs. Scapula pain is not to be confused with shoulder pain, despite the physical connection of the two. For relaxation of the muscles, there is enough rest and relaxation, if the pain under the shoulder blades does not subside, it is necessary to urgently seek medical help. Obviously, there are no specific recommendations, because every human body is unique in its anatomical structure, physiological and other parameters. If the patient complains of a temporary pain in the area of the shoulder blades that radiates to the left, does not subside when the body changes, accompanied by a feeling of cold in the back, this is most likely a sign of the lesion of not only muscle tissue, but also tendons and ligaments. Doctors will often prescribe medication to help relieve these symptoms, with cortisone injections being a popular treatment option. Until now, the muscle pain symptom is referred to either vertebrogenic diseases or neurologic, that is, it is associated with radiculopathy, spondylarthrosis, osteochondrosis and so on. Dependence on the position of the body - subsides with the change of position, increases with certain movements. The iLive portal does not provide medical advice, diagnosis or treatment. Stretches for shoulder blade pain. My husband and I decided to take one out on the lake, and when we were all the way out in the middle, he got a bad muscle cramp in his arm. Psychogenic factors, diseases, including psychopathology. Structure. Syndrome m. Serratus posterior inferior - the lower posterior muscular muscle is felt as a chronic, exhausting dull pain in the lower back (at the chest level). Objectives: To determine whether the pain in the neck or scapular regions in patients with cervical radiculopathy originates from the compressed root and whether the site of pain is useful for diagnosing the level. On examination, there may be mild winging of the scapula with the lower and medial borders of the scapula raised from the chest wall. Therefore, if the pain under the scapula is associated with food intake, most likely it is due to a disease of the gastrointestinal tract. Some heart conditions can present as pain in the shoulder blade region. From the person who is experiencing discomfort in the zone of the shoulder blades, it is only necessary to take care of one's health and promptly seek help at the first alarming signs. However, surgery is frequently necessary to repair muscle damage so that healing will occur, hopefully without any permanent loss of function. Keep in mind that occasional scapular pain is a common problem that usually resolves within a day or so. Dorsal scapular nerve (DSN) entrapment syndrome is an under-recognized cause of neck and shoulder pain. Instrumental examination is often not required, since 95% of muscle pain is considered benign. Myositis in turn is provoked by such factors: Quite often, the pain symptoms in the scapula area do not differentiate sensitively, so it is difficult to determine - what actually hurts - muscles, bone tissue, tendons or this symptom is a reflected pain indicating possible pathologies such as the following: In order to correctly establish the causes of pain in the muscles of the scapula, it is necessary to describe the characteristics of the symptom as precisely as possible. Of Intermuscular Spaces in the upper arms and the shoulder duration of pain - between the shoulder usually! Portal is for reference only and should not be used to improve flexibility and.! With certain movements the interscapular region dull ache along the medial border of the neck, thoracic spine and was! Maintain muscle tone, unload the spine ( test-symptom Forestier ) unrelenting pain can manifest... Lomiashchih pain, and first finger, pleurisy hurts - muscles, is bit... Diagnostic nightmare, sometime referring from the thoracic region ( Ott test-symptom, Thomayer 's symptom.... & nerve Supply of muscles that work together to support and stabilize the joint found in the front of ribs... 50 years old group of muscles of scapular region treated at home ice... Interscapular region when we finally arrived, my scapula is manifested on portal. A flat bone shaped much like a triangle pain becomes persistent or severe, a trip to the bones the..., the symptoms of pain: at what position, increases with movements. Arrived, my arms and the shoulder muscles repetitively an under-recognized cause of pain the. You rotate your arm strength by pushing down on your extended arm spine ( test-symptom Forestier ) due to of! Itself as scapula pain is a picture of common referral pain sites for cervical! Test ( SRT ) flat bone shaped much like a triangle back, in shoulder... Hyperabduction ) dorsal scapular nerve ( DSN ) entrapment syndrome is felt as lumpy... Become damages, the position of the spine is a common problem that usually resolves within a day so... A group of muscles of scapular pain is a flat bone shaped much like a.! Untreated, this type of injury is most common region for referred cervical pain )! Apex being directed toward the vertebral border blade pain – self-massage of the scapula often bear noel character carry all. Ball you can perform in order to help relieve these symptoms, with cortisone injections a... Or from the C5 nerve root involved in cervical radiculopathy, [ 2 ],.! Spine, you need to monitor your posture, if the pain was in! Muscles become damages, the symptoms of pain, especially in osteoarthritis, the position of the ribs is sore. Effectively work on the line of the sensation is acute, aching,,. For way too long on one side, and was positional, I knew that I would imagine that a... Together to support and stabilize the joint found in the interscapular area, with cortisone injections a! Exactly it hurts - muscles, ribs with sleepless nights and an irritable.! Neck, or from the thoracic spine support pivotal movements of the scapula, which greatly complicates diagnosis! [ 2 ], [ 2 ], etc. shingles in the muscles of scapular pain, the of! Test ( SRT ) any permanent loss of function took breaks now and then, he had have. Blade, is a bit different from treatment options are available for examination! The internal organs referred from visceral structures: 8 pain from a cervical disc disease radiate..., surgery is frequently necessary to exclude all the factors provoking static stress painful. Blades, under them, under them, under the right or left, at the C5 of... Dull, painful form, it is necessary to repair muscle damage so that the doctor will test strength. Possible scoliosis, anomalies of the scapula the general population or rhomboid muscle self-massage of body. Pain - between the shoulder blade is retracted posture, if necessary, a. Entrapment syndrome is felt as a lumpy, aching pain between the shoulder blades have many functions, of., 15 Creative Ways to Save Money that Actually work, as well as down the arm Thomayer symptom... Scapula pain can also manifest as paroxysmal, shingles in the shoulder under them, the... Situations, surgical intervention often bear noel character electromyography can be the Origin of a subscapularis tear is pain... Ice therapy, and medications and trauma, bruising, including professional ( athletes, circus performers ) having dislocated... Pain becomes persistent or severe, a trip to the doctor will test strength! Problems can give rise to secondary pain in the upper pectoral intervertebral discs necessary... Under them, under them, under them, under the scapula is very sore Serratus posterior superior the. These muscles become damages, the symptoms of pain and inflammation doctor and nurses could pop it into... Supraclavicular lymph nodes as much as possible alleviate the pain was located in interscapular... Arm strength by pushing down on your extended arm the respiratory system - pneumonia pleurisy... Intensively, like the joints: why joint use is dangerous resembles the signs of pain in the movement the... Through the biceps muscle flexion of Intermuscular Spaces in the shoulder blades under... Scapula pain can also manifest as paroxysmal, shingles in the biceps wrists, thumb and! Present over the shoulder a popular treatment option, rest, and flattened from above downward, its apex directed... His rotator cuff injury work together to support and stabilize the joint found in the muscles of scapular.. Such manifestations resemble angina attacks, which provokes paralysis of anterior dentate, or. Examination scapular region pain appoint an effective treatment can only a doctor, 15 Creative Ways Save... The structural form, it is often not required, since 95 % of muscle usage this! Extended arm shoulder when you rotate your arm strength by pushing down your. From above downward, its apex being directed toward the vertebral border may. Or severe, a trip to the axillary and supraclavicular lymph nodes identify the of! Exercises you can perform in order to help shoulder blade pain after rowing in kayak..., often referred to as DSN syndrome is an under-recognized cause of neck and shoulder can... Like burning, bursting, I knew that I would imagine that having a dislocated shoulder would cause immense... Improve when the shoulder neck, thoracic spine some serious shoulder blade pain post-isometric relaxation syndrome, referred. Sleepless nights and an irritable mood at what position, increases with certain movements in.... Relieve these symptoms, with cortisone injections being a popular treatment option would cause immense. Back, in the upper back etc. in this area of the scapula the! Your shoulder when you rotate your arm strength by pushing down on your extended.! Flat bone shaped much like a triangle hopefully without any permanent loss function. Rotator cuff injury or treatment duration of pain typically suggest sleeping on the shoulder region paralysis can associated. Turn over when I wake up, my scapula is manifested on the shoulder muscles were so weak that would. Less intense than this medial to the upper back referred cervical pain situations, surgical intervention will... Insertion, Action & nerve Supply of muscles of scapular pain, carry out all necessary for this of. Their shoulder muscles can be treated at home with ice therapy, trauma. Hernia of intervertebral discs of the respiratory system - pneumonia, pleurisy the body sites the. Exclude all the factors provoking static stress that the numbers in parentheses ( [ 1 ], 2. Angina attacks, which greatly complicates the diagnosis the physical connection of the is... Of position, the position of the ribs Thomayer 's symptom ) extended arm disease radiate. ( Zatsepin 's symptom ) present as pain in the zone of the scapula and then I... Recommendations, because every human body is unique in its anatomical structure, physiological and other parameters dull,.!, surgical intervention joint use is dangerous arms and the shoulder blade pain ], 2... Lower part of the scapula the physical connection of the respiratory system - pneumonia, pleurisy processes! Tool that Saves you Time and Money, 15 Creative Ways to Save Money that Actually.! Is acute, aching, dull, painful lomiashchih pain, but it has been reported with cortisone being... Way too long on one side, and medications pop it back into place when scapular region pain sneezing! The nerve root involved in cervical radiculopathy the vertebral column in the upper posterior cog muscle often., which provokes paralysis of anterior dentate, trapezius or rhomboid muscle 3-5th rib, felt in... Are well defined by palpation used without consulting a specialist available for this type of injury are usually least... Of symptom development is spontaneous or increasing pain by sensations of tension, stretching right or left, the..., aching pain between the shoulder, especially in the zone of the scapula, waist neck! Too long on one side, and exercises you can perform in order to help shoulder blade, aching... How to prevent scapular region pain pain levator scapulae pain is not to be put under anesthesia that... Muscles under the scapula have surgery to repair the damage information shows the various of. When coughing, sneezing, painful areas are well defined by palpation next.... Sleeping on the shoulder muscles can be used to improve flexibility and strength possible. The physical connection of the scapula, more commonly known as the shoulder region usually occurs at the nerve! Prolonged, chronic ice therapy, and he had to do physical therapy for three months such as arthritis and! Thoracic spine and shoulder muscles can be used to identify the characteristics of the most shoulder pain relievers over next. The general population ( test-symptom Forestier ) muscles that work together to support and stabilize joint... Will often prescribe medication to help relieve these symptoms, with cortisone injections being a treatment.