Pain under the left shoulder blade is a frequent complaint with various sources. While often a minor muscle strain, it can also signal more serious underlying conditions, especially given its left-sided location. This article explores common causes, from localized muscular problems to pain referred from internal organs.
Common Local Causes
Pain directly beneath the left shoulder blade often stems from musculoskeletal issues or localized nerve irritation. A frequent cause is muscle strain or spasm, particularly involving the rhomboid or trapezius muscles. These strains commonly result from overuse, poor posture, or awkward movements, leading to a dull ache or sharp pain that may worsen with movement or breathing.
Myofascial pain syndrome, characterized by sensitive trigger points within muscle tissue, can cause pain in the shoulder blade area. Abnormal shoulder blade movement, known as scapular dyskinesis, also contributes to pain. This condition involves altered scapula positioning or motion, often due to muscle weakness or imbalance, leading to pain and sometimes a snapping or popping sensation with shoulder movement.
Nerve impingement, such as cervical radiculopathy, can manifest as pain under the shoulder blade. This occurs when a neck nerve is compressed or irritated, causing pain that radiates along its pathway. About half of individuals with cervical radiculopathy report burning or aching pain in the shoulder blades. Dysfunction or irritation of the ribs connected to the spine in that region can also cause sharp pain under the shoulder blade, sometimes feeling like a knife.
Pain Originating Elsewhere
Pain under the left shoulder blade can be referred from internal organs or other distant body parts, meaning it originates elsewhere but is perceived in this area due to shared nerve pathways. This is particularly relevant for left-sided pain, as it can indicate conditions affecting the heart, lungs, or digestive system.
Cardiac issues are a concern for left shoulder blade pain. Conditions like angina (chest pain from reduced blood flow to the heart) or a heart attack (where blood flow is blocked) can cause pain that radiates to the left shoulder, arm, jaw, or back. This pain may be sudden and severe, accompanied by symptoms like chest pressure or shortness of breath.
Pulmonary conditions can refer pain to the shoulder blade. Pleurisy, pneumonia, or lung cancer affecting the pleura (lining of the lungs) or diaphragm can cause discomfort in this area. Certain lung tumors, like Pancoast tumors, may cause shoulder pain as an initial symptom.
Digestive system problems, such as gastritis (inflammation of the stomach lining) or peptic ulcers, can lead to referred pain under the shoulder blade, commonly on the left side. Pancreatitis, an inflammation of the pancreas, can also cause left-sided referred shoulder pain. Diaphragm irritation, often associated with gastrointestinal issues or gas after abdominal surgery, can also manifest as pain in the left shoulder blade due to shared nerve connections.
When to Seek Professional Medical Advice
While pain under the left shoulder blade is often benign, certain symptoms warrant prompt medical evaluation to rule out serious conditions. Seek professional medical advice if the pain is accompanied by “red flag” symptoms such as chest pain, shortness of breath, dizziness, excessive sweating, or pain radiating to the arm or jaw, as these may suggest a cardiac event.
Neurological symptoms like numbness, tingling, or weakness in the arm or hand indicate a need for medical attention. Systemic symptoms such as fever, unexplained weight loss, night sweats, or persistent fatigue alongside shoulder blade pain should be investigated by a healthcare professional.
Any pain occurring after trauma or injury to the upper back, or pain that is severe, worsening, or persistent despite self-care measures, should be assessed. If the pain disrupts sleep or significantly interferes with daily activities, consult a doctor for an accurate diagnosis and appropriate treatment plan.