Why does the back hurt under the left shoulder blade?

Pain in the left side under the scapula makes a suspect immediately think about a heart attack. Of course, do not forget about this life-threatening condition, but more often back and left pain is caused by less dangerous causes. It is worth learning why the back hurts under the left shoulder blade to know which doctor to go to and in which cases to call an ambulance.

1. Intercostal neuralgia

The disease is accompanied by inflammation of nerve processes.


Causes nervous irritation:

  • hypothermia;
  • herpes infections;
  • damage to the ribs or spine;
  • nerve root disorder with thoracic osteochondrosis;
  • diseases accompanied by chest deformity (spondylosis);
  • benign pleural neoplasms;
  • allergic reactions;
  • osteochondrosis.

Neuralgic pain under the scapula on the left side suddenly appears and frightens a person, making him suspect the worst.


With intercostal neuralgia, the pain will be painful and the intensity will depend on the severity of the pathology. The pain may be severe, almost unbearable, or the disease will present itself as a mild painful discomfort.

Typical symptoms of inflammation or irritation of nervous processes are:

  • Contact with movement and breathing. Pain under the scapula begins to hurt more when you move your left hand, cough, breathe sharply, or laugh.
  • The effect of heat. After reheating, the pain decreases or disappears completely.
  • Palpation. It hurts more when pressed.

If the cause is a herpes infection, the patient develops characteristic rashes along the nerves.

In addition to pain, a person may have:

  • tachycardia;
  • skin tingling;
  • increased sweating.

It is not always possible to determine whether the pain under the left scapula is caused by intercostal neuralgia or cardiac pathology. If the pain syndrome occurs for the first time and you are not sure that it will cause pain due to irritation of nervous processes, you should see a doctor immediately.

Consult a doctor for pain under the left shoulder blade


Therapy for intercostal neuralgia depends on the cause of the disease.

Patients are prescribed:

  • antiviral drugs and ointments (for herpes);
  • painkillers;
  • non-steroidal anti-inflammatory drugs;
  • ointments with a warming effect.

If the disease is accompanied by severe pain under the left shoulder blade, which can not be stopped by taking analgesics, then patients are given novocaine blockade to alleviate the condition.

In the subacute phase, the following is used to improve tissue trophism and reduce the recovery period:

  • physiotherapy procedures;
  • massage;
  • acupuncture.

Treatment is aimed not only at relieving back pain under the left scapula, but also at the treatment of a provocative disease (osteochondrosis, herpes). When this is not done, the pathology becomes chronic, aggravated by hypothermia or physical exertion.

Who to contact

If you have pain in the area of the left shoulder blade and there is no suspicion of heart pathology, you should consult a neurologist.

2. Diseases of the broncho-pulmonary system

Diseases of the lower respiratory tract (bronchi, lungs, pleura) can cause back pain in the left shoulder blade.


The main causes of pain in pathologies of the respiratory system are diseases caused by pathogenic bacteria and viruses:

  • bronchitis;
  • pneumonia;
  • pleurisy.

Left back pain can also be caused by the appearance of neoplasms in the bronchi or lungs.


A person has constant pulling or aching pain under the scapula on the left side. The pain intensifies when coughing and breathing deeply. In addition to pain in the left back, patients may present with the following complaints:

  • shooting, sometimes reaching high numbers;
  • with a dry cough or discharge of viscous sputum (there may be streaks of blood or pus in the mucous discharge);
  • weakness and apathy;
  • difficulty breathing.

If back pain under the scapula causes swelling, then there will be no hyperthermia, and coughing and breathing problems will become additional symptoms.


If back pain and inflammatory symptoms are provoked by the inflammatory process, patients are prescribed:

  • antibiotics or antiviral drugs;
  • drugs to dilute and stimulate sputum secretion;
  • antipyretic drugs;
  • painkillers (if bad pains start).

Treatment for neoplasms depends on the nature and size of the tumor. Patients are excluded from tumor formation or conservative therapy.

Who is healed

Inflammatory processes in the bronchi or lungs will be treated by a pulmonologist, and in case of neoplasms you should visit an oncologist or surgeon.

3. Vegetovascular crises

The patient complains of pain and fear in the left side under the scapula, but the initial examination does not reveal any diseases that cause pain.


Crises can go away on their own, and such people are considered hysterical and restrained due to the lack of signs of organic pathology. But in fact, crises cause:

  • hormonal imbalance;
  • neurological pathologies;
  • stress;
  • psycho-emotional overload;
  • endocrine diseases;
  • long-term use of antidepressants or psychotropic drugs.

Vegetative crises are often the first sign of neurological disorders. Signs of deteriorating health and painful discomfort under the left scapula begin to appear after intense experiences or shocks. Children and women under the age of 30 often suffer from the disease.

back pain under the left shoulder blade


With vegetative-vascular crisis not only pain on the left under the scapula, but also may be sick:

  • feeling of suffocation;
  • cardiopalmus;
  • tremors in arms and legs;
  • unreasonable anxiety;
  • feeling hot or cold;
  • sweating;
  • Headache;
  • loss of consciousness.

It is characteristic that patients are unable to show exactly where they are in pain. Pain appears not only under the scapula, but also under the ribs, often there is radiation to the left shoulder, arm or abdomen.

The duration of the crisis varies from a few minutes to an hour and a half. In severe cases, a person has seizures.

An additional danger is the fear of attack. A person is afraid of unpleasant feelings, tries to observe all kinds of rituals to avoid pain under the scapula and other unpleasant symptoms. When left untreated, the condition can develop into a phobia.


The presence of seizures will be an indication for immediate hospitalization, and milder forms of vegetative vascular crises are treated at home. Used as therapy:

  • sedatives for severe fear;
  • herbal remedies to help calm down;
  • antidepressants to reduce increased nervousness and anxiety.

If the crises are caused by neurological or endocrine diseases, additional therapy is chosen to eliminate the resulting disorders.

When the onset of an attack is related to a stress factor, patients are additionally trained to respond appropriately to stressful situations and are advised to avoid overwork.

Which doctor to consult

You should contact a vegetarian when panic attacks appear, but not all cities have these specialists. If it is not possible to get advice from a vegetarian, then you should consult a neurologist or therapist. In addition, you should consult an endocrinologist.

4. Myocardial infarction

A life-threatening condition resulting from acute ischemia and necrosis of the heart muscle. In this case, the pain will be strong under the backbone and behind the sternum.

Motivating factors

The cause of such pain under the scapula on the left side of the back is a complete cessation of coronary blood flow to a certain part of the myocardium due to blockage of blood vessels. The following pathologies can cause a heart attack:

  • atherosclerosis;
  • thrombosis.

The resulting blood clot or plaque breaks and blood flow to the heart. In small-diameter coronary arteries, they once close the vascular lumen and stop blood flow to the tissues. Lack of oxygen causes the death of myocardial cells.


The pain is sharp and throbbing, localized to the left behind the sternum. Radiates:

  • in the left hand;
  • under the shoulder blade;
  • in the lower jaw.

Radiation is possible with an atypical heart attack:

  • in the epigastric region;
  • right behind;
  • in the lower abdomen.

With a heart attack, the pain behind the scapula is not relieved by taking analgesics, and is somewhat reduced after taking nitroglycerin.

pain under the left shoulder blade in the back


Therapy aims to eliminate obstacles to blood flow, reduce the focus of myocardial necrosis and relieve pain. To do this, apply:

  • blood-soluble agents;
  • drugs that have a blood-thinning effect;
  • narcotic analgesics;
  • drugs to improve vascular tone.

Other drugs are selected taking into account the disorders that occur - these include cholesterol-lowering drugs, antihypertensive drugs with high blood pressure, etc.

In the first hours, operative angioplasty may be performed to reduce the focus of necrosis. Surgery allows you to quickly restore impaired blood flow and reduce postinfarction wounds.

Which doctor is treating

In case of a heart attack, emergency hospitalization is provided in the cardiology department, where resuscitators and cardiologists will choose effective therapy. If you suspect a heart attack, you should call an ambulance immediately.

5 more reasons that can cause pain under the back of the back

Think about why you may have pain in the back under the left scapula:

  1. Angina pectoris. Short-term coronary spasm caused by stress or physical exertion. Acute pain appears in the left back under the spine and behind the sternum, and disappears after taking medication with nitroglycerin.
  2. Osteochondrosis or hernia of the thoracic region. If the nerve root is compressed, there will be diffuse pain in the left back under the spine, intensified by movement.
  3. Peptic ulcer disease. The pain is visible not only behind the scapula, but also in the epigastric region. It starts to hurt more after a meal or after a long period of hunger. In addition, there is heartburn, unpleasant belching, nausea. After vomiting, the pain is slightly reduced.
  4. Pancreatic or spleen disease. With these pathologies, there is pain in the left side of the scapula and ribs. In acute pancreatitis, he will not only have pain in the back, but also pain in the girdle, which covers the left and right hypochondria.
  5. Injuries. Injuries to the left back in the scapular region can irritate nerve processes, and the pain syndrome may reappear a few weeks after the injury with increased physical exertion or hypothermia.

If the back hurts under the left shoulder blade, you should not ignore this situation, even if the pain is a little expressed. Painful anxiety can lead to a life-threatening situation.

What to do if there is pain in the left back under the scapula

When the pain syndrome appears under the scapula on the left back, there is no need to panic, but you should not ignore the situation. Before deciding which doctor to go to, you should try to find out exactly what hurts from the left side under the scapula. To do this, you need to determine the additional features of pain:

  • Localization. If there is pain in the back under the left shoulder blade and the painful discomfort increases after eating or fasting for a long time, the chances of heart disease are minimal.
  • Intensity. Moderate pain syndrome is often accompanied by chronic diseases, but severe pain indicates a severe pathological process.
  • Character. Acute pain requires immediate medical attention and you should go to the clinic with a pull or aching pain.
  • Contact with movement and breathing. If it hurts more when coughing, bending forward, or trying to move the left arm, it indicates spinal or intercostal neuralgia.

Back pain under the left scapula is caused by various reasons and they are not always safe for life and health. Newly onset pain syndrome in the left under the scapula requires special attention - it can be a sign of neuralgia, angina pectoris or even a heart attack. If you have any doubts about the origin of the pain syndrome, then you should call an ambulance. Seeing a doctor early can help protect your health and sometimes save your life.