Left shoulder blade pain when breathing can be a concerning symptom, signaling a range of underlying issues. While often linked to common muscular problems, this discomfort can sometimes point to more significant health conditions. Understanding the potential origins of this pain, from less severe to those requiring prompt medical attention, is important for identifying when to seek professional help. This article explores various causes of left shoulder blade pain that intensifies with breathing.
Common Musculoskeletal Causes
Musculoskeletal issues frequently cause left shoulder blade pain exacerbated by breathing. Muscle strains are a common culprit, particularly affecting the rhomboid muscles (between the shoulder blades and spine) or the trapezius muscles (from the neck across shoulders and upper back). These muscles support the rib cage and enable arm and shoulder movements. Overuse, poor posture, or sudden movements can strain them, leading to pain that sharpens with deep breaths, coughing, or sneezing.
Poor posture, such as prolonged slouching, places additional stress on shoulder and upper back muscles, contributing to tension and pain that can worsen with breathing. Repetitive stress injuries, often from activities involving overhead movements or heavy lifting, can also lead to muscle fatigue and inflammation around the shoulder blade, causing discomfort when the chest expands.
Rib dysfunction, including costochondritis or rib subluxation, can also manifest as pain near the shoulder blade that intensifies with breathing. Costochondritis involves inflammation of the cartilage connecting the ribs to the breastbone, causing sharp or aching pain on the left side of the chest that can radiate to the shoulder and worsen with deep breaths. A rib subluxation, a slight misalignment, can cause sharp pain in the upper back, often feeling like a “knot” under the shoulder blade, noticeable during breathing as the rib cage expands and contracts.
Internal Organ-Related Pain
Pain originating from internal organs can sometimes be felt in the left shoulder blade area, a phenomenon known as referred pain. This occurs because nerves supplying certain internal organs share pathways with nerves that supply areas like the shoulder blade, causing the brain to misinterpret the pain’s origin.
Conditions affecting the heart, such as angina or a heart attack, can cause pain that radiates to the left arm, jaw, or between the shoulder blades, sometimes worsened by deep breathing. Lung-related issues are another source of referred pain; conditions like pleurisy (inflammation of the lung lining), pneumonia, or a pulmonary embolism (a blood clot in the lung) can lead to sharp pain in the upper back or shoulder blade, often with shortness of breath and intensified by breathing.
Upper gastrointestinal problems, including gastroesophageal reflux disease (GERD), pancreatitis, or ulcers, can also cause referred pain in the left shoulder blade region. Acid reflux can irritate nerves that connect to the shoulder area, leading to perceived pain there. Diaphragm issues, the muscle responsible for breathing, can also result in pain felt in the shoulder, especially with breathing movements.
Neurological Considerations
Nerve irritation or impingement can also lead to left shoulder blade pain affected by breathing. Cervical radiculopathy, a pinched nerve in the neck, can cause radiating pain, numbness, or tingling sensations that extend from the neck into the shoulder blade and down the arm. Movements of the neck or changes in posture, which can occur during breathing, might aggravate the nerve and intensify the pain.
Thoracic outlet syndrome involves the compression of nerves or blood vessels in the space between the collarbone and the first rib. This compression can lead to pain, numbness, or tingling in the shoulder, arm, and hand; certain breathing mechanics that alter the position of the ribs or collarbone may worsen these symptoms. Conditions like shingles, caused by the varicella-zoster virus, can affect nerve pathways, resulting in a sharp, burning, or stabbing pain along the affected nerve distribution, which can include the area around the shoulder blade. This nerve pain might be triggered or exacerbated by the expansion and contraction of the chest during breathing.
When to Seek Medical Attention
Understanding when to seek medical attention for left shoulder blade pain with breathing is important. Immediate medical evaluation is necessary if the pain is accompanied by concerning symptoms. These include chest pain, shortness of breath, dizziness, or excessive sweating, as these can indicate serious conditions like a heart attack or pulmonary embolism.
Additional red flag symptoms that warrant prompt medical consultation include pain that radiates down an arm (especially the left), or involves numbness, tingling, or weakness. Sudden onset of severe pain, pain not improving with rest, or pain accompanied by fever, chills, or coughing up blood also require urgent medical assessment. Do not self-diagnose potentially serious conditions; medical professionals can conduct necessary tests, such as imaging or cardiac evaluations, to determine the underlying cause.
Initial Steps for Managing Discomfort
For discomfort not accompanied by immediate warning signs, several initial steps can help manage the pain. Rest is often beneficial, as it can reduce strain on affected muscles and tissues. Applying heat or ice to the painful area can help alleviate discomfort and reduce inflammation; ice is typically recommended immediately after an injury to reduce swelling, while heat can help relax tense muscles.
Gentle stretching exercises can improve flexibility and reduce muscle tightness around the shoulder blade and upper back. Improving posture, particularly for individuals who spend long hours sitting, can reduce stress on the back and shoulder muscles. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can also help manage pain and inflammation. These measures offer temporary relief and are not a substitute for professional medical diagnosis if concerning symptoms are present or if the pain persists or worsens.