Why does it hurt under the blade of the left shoulder from behind?

Pain in the left under the scapula makes a suspicious person immediately think of a heart attack. Of course, do not forget about this life-threatening condition, but more often back and left back pain occurs for less dangerous reasons. It is worth knowing why it hurts under the blade of the left shoulder from back to back, in order to know which doctor to seek help and in which cases to call an ambulance.

1. Intercostal neuralgia

The disease is associated with inflammation of nerve processes.


Provokes nervous irritation:

  • hypothermia;
  • herpes infections;
  • rib or spine injuries;
  • nerve root injury with thoracic osteochondrosis;
  • diseases associated with chest deformity (spondylosis);
  • benign pleural neoplasms;
  • allergic reactions;
  • osteochondrosis.

Under the scapula on the left side, the pain of neuralgia suddenly appears and frightens a person, making him suspect the worst.


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

Typical symptoms that indicate inflammation or irritation of nerve processes are:

  • Relation to movement and respiration. The pain under the shoulder starts to hurt more when you move your left hand, cough, breathe hard or laugh.
  • Impact of heat. After reheating, the pain decreases or disappears altogether.
  • Palpation. When pressed, it hurts more.

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

In addition to pain, a person may experience:

  • tachycardia;
  • skin numbness;
  • increased sweating.

It is not always possible to determine if the pain under the left shoulder is caused by intercostal neuralgia or by cardiac pathologies. If the pain syndrome has appeared for the first time and there is no certainty that it hurts due to irritation of nervous processes, then you should immediately seek medical help.

visit a doctor for pain under the left shoulder


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

Patients are prescribed:

  • antiviral medicines and ointments (for herpes);
  • pain relievers;
  • non-steroidal anti-inflammatory drugs;
  • ointment with heating effect.

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

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

  • physiotherapy procedures;
  • massage;
  • acupuncture.

Treatment aims not only to relieve back pain under the left scapula, but also to treat a provocative disease (osteochondrosis, herpes). If this is not done, then the pathology becomes chronic, exacerbated by hypothermia or physical exertion.

Who to contact

If it hurts in the blade area of the left shoulder and there is no suspicion of cardiac pathology, then you should visit a neurologist.

2. Diseases of the broncho-pulmonary system

May ache in the left shoulder from behind due to a disease of the lower respiratory tract (bronchi, lungs, pleura).


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

  • bronchitis;
  • pneumonia;
  • pleurit.

Also, left back pain can occur due to the appearance of neoplasms in the bronchi or lungs.


A person has a persistent pulling pain or pain under the left scapula. When you cough and take deep breaths, the pain intensifies. In addition to painful sensations in the left back, patients may experience the following complaints:

  • fever, sometimes reaching high figures;
  • dry cough or with a flow of viscous saliva (there may be blood streaks or a mixture of pus in the mucous flow);
  • weakness and apathy;
  • difficulty breathing.

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


If back pain and signs of inflammation are provoked by the inflammatory process, then patients are prescribed:

  • antibiotics or antivirals;
  • medicines to liquefy and stimulate saliva discharge;
  • antipyretic drugs;
  • painkillers (if it starts to hurt badly).

For neoplasms, treatment depends on the nature and size of the tumor. Patients are removed from tumor formation or conservative therapy.

Who heals

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. Vegetative-vascular crises

The patient complains of a tingling pain in the left side under the scapula and a feeling of fear, but during the initial examination, diseases that provoke pain discomfort can not be detected.


Crises can pass on their own, and due to the lack of signs of organic pathology, such people are considered hysterical and unrestrained. But in reality, crises cause:

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

Vegetative crises are often the first sign of neurological disorders. Signs of deteriorating well-being and painful discomfort under the left scapula begin to appear after strong experiences or strokes. Most often, children and women under 30 suffer from the disease.

back pain under the left shoulder


With a vegetative-vascular crisis, not only pain occurs on the left under the scapula, in addition, the patient may experience:

  • a feeling of suffocation;
  • cardiopalmus;
  • tremors in arms and legs;
  • anxiety without cause;
  • hot or cold sensation;
  • sweating;
  • headache;
  • loss of consciousness.

It is characteristic that patients can not tell exactly where it hurts. Not only does the pain appear under the scapula, but also under the ribs, there is often radiation to the left shoulder, arm or abdomen.

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

An additional risk is the fear of an attack. A person is afraid of unpleasant sensations, tries to observe all kinds of rituals in order to avoid pain under the scapula and other unpleasant symptoms. Without treatment, the condition turns into a phobia.


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

  • sedatives for strong fears;
  • herbal medicines to help soothe;
  • antidepressants to reduce the increase of nervousness and anxiety.

If seizures are caused by neurological or endocrine diseases, then additional therapy is chosen to eliminate the disorders that have emerged.

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

Which doctor to contact

When panic attacks occur, you should contact a vegetarian, but not all cities have these specialists. If it is not possible to get advice from a vegetarian, then you should visit a neurologist or therapist. Furthermore, you may need to consult an endocrinologist.

4. Myocardial infarction

A life-threatening condition caused by acute ischemia and heart muscle necrosis. In this case, the pain under the scapula and behind the sternum will be strong.

Provocative factors

The reasons for such pain under the scapula on the left back are the complete cessation of coronary blood flow to a certain part of the myocardium, caused by a blockage of the vessel. The following pathologies can provoke a heart attack:

  • atherosclerosis;
  • thrombosis.

The resulting blood clot or plaque breaks off and blood flow goes to the heart. Once they enter the small-diameter coronary arteries, they close the vascular lumen and stop blood flow to the tissues. Lack of oxygen leads to death of myocardial cells.


The pain is acute and throbbing, localized to the left behind the sternum. Radiation:

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

With an atypical course of a heart attack, radiation is possible:

  • in the epigastric region;
  • on the back right;
  • in the lower abdomen.

With a heart attack, the pain behind the shoulder is not relieved by taking analgesic and is reduced after taking nitroglycerin.

pain under the blade of the left shoulder in the back from the back


Therapy aims to eliminate obstructions in the bloodstream, reduce the focus of myocardial necrosis, and eliminate pain. To do this, apply:

  • blood-distributing agents;
  • blood-thinning drugs;
  • analgesic narcotics;
  • medicines to improve the tone of blood vessels.

Other medications are chosen based on the violations that have occurred - these can be cholesterol-lowering drugs, antihypertensive drugs for high blood pressure, etc.

In the first hours to reduce the focus of necrosis operative angioplasty can be performed. Surgical intervention allows you to quickly restore damaged blood flow and reduce scarring after a heart attack.

Which doctor treats

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

5 other reasons why your back can hurt under your back shoulder

Consider why you may have a back injury below your left shoulder:

  1. Angina pectoris. Short-term coronary spasm caused by stress or physical exertion. Acute pains appear on the left side behind under the scapula and behind the sternum, which disappear after taking nitroglycerin medication.
  2. Osteochondrosis or hernia of the chest region. If the nerve root is caught, there will be a diffuse pain in the left back below the shoulder, which will intensify with movement.
  3. Peptic ulcer disease. The pain appears not only behind the scapula, but also in the epigastric region. It starts to hurt more after eating or with prolonged hunger. In addition, there is heartburn, uncomfortable belching, vomiting. Pain discomfort decreases slightly after vomiting.
  4. Diseases of the pancreas or spleen. With these pathologies, the left side aches in the scapular and rib area. In acute pancreatitis, not only will there be pain in the back, but there will be generational pain covering the left and right hypochondria.
  5. Injuries. Injuries to the left back in the scapular area can provoke irritation of nerve processes and pain syndrome may recur several weeks after injury with increased physical exertion or hypothermia.

If it hurts from behind from behind under the blade of the left shoulder, then you should not ignore this condition, even if the pain is a little pronounced. Painful discomfort can be caused by a life threatening condition.

What to do if you have back pain on the left under the scapula

When a pain syndrome appears from behind under the scapula on the left, you do not need to panic, but you should not ignore the condition that has arisen. Before deciding which doctor to go to, you should try to find out what exactly hurts from the back to the left under the scapula. To do this, you will need to define additional pain characteristics:

  • Localization. If you have back pain below the blade of your left shoulder and painful discomfort increases after eating or with prolonged fasting, then the chances of heart disease are minimal.
  • Intensity. Moderate pain syndrome often accompanies chronic diseases, but severe pain indicates a severe pathological process.
  • Character. Acute pain requires immediate medical attention, and with withdrawal or excruciating pain, you should visit the clinic.
  • Relation to movement and respiration. When it hurts the most when you cough, bend forward, or try to move your left hand, it indicates a spinal disease or intercostal neuralgia.

Back pain under the left shoulder is caused by various reasons and is not always safe for life and health. Pain syndrome with new onset on the left under the scapula requires special attention - it could be a sign of neuralgia, angina pectoris, or even a heart attack. If there is any doubt about the origin of the pain syndrome, then you should call an ambulance. Seeking early medical care can help maintain health and sometimes save lives.