Why does it hurt under the left shoulder blade?

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

1. Intercostal neuralgia

The disease is accompanied by inflammation of nervous processes.


Causes nerve irritation:

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

Under the shoulder blade on the left side, neuralgic pain appears suddenly and scares the person, which is why he suspects the worst.


In 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 manifest as mild excruciating discomfort.

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

  • Connection with movement and breathing. The pain under the shoulder blade starts to hurt more when you move your left arm, cough, inhale sharply, or laugh.
  • Influence of heat. After warming up, the pain decreases or disappears completely.
  • Palpation. When pressed, it hurts more.

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

In addition to pain, a person may experience:

  • tachycardia;
  • numbness of the skin;
  • increased sweating.

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

consult a doctor for pain under the left shoulder blade


The treatment of intercostal neuralgia depends on the cause of the disease.

Patients are prescribed:

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

If the disease is accompanied by severe pain under the left shoulder blade, which cannot be stopped by taking analgesics, then patients are given novocaine blockade to alleviate 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 is aimed not only at relieving back pain under the left shoulder blade, but also at treating provocative disease (osteochondrosis, herpes). If this is not done, then the pathology becomes chronic, exacerbated by hypothermia or physical exertion.

Who to contact

If there is pain in the left shoulder blade, and there is no doubt about cardiac pathology, it is necessary to visit a neurologist.

2. Diseases of the broncho-pulmonary system

It can hurt in the left shoulder blade due to diseases of the lower respiratory tract (bronchi, lungs, pleura).


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

  • bronchitis;
  • pneumonia;
  • pleurisy.

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


The person has constant pulling or aching pain under the shoulder blade on the left side. When you cough and take a deep breath, the pain intensifies. In addition to painful sensations in the back on the left side, patients may have the following ailments:

  • fever, which sometimes reaches high numbers;
  • dry cough or discharge of viscous sputum (there may be traces of blood or pus in the mucous discharge);
  • weakness and apathy;
  • difficulty breathing.

If back pain left below the shoulder blade causes tumors, then there will be no hyperthermia, coughing and breathing problems will become additional symptoms.


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

  • antibiotics or antivirals;
  • drugs for diluting and stimulating sputum secretion;
  • antipyretic drugs;
  • painkillers (if it starts to hurt a lot).

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

When it heals

Inflammatory processes in the bronchi or lungs will be treated by a pulmonologist, and in the case of neoplasms it is necessary to visit an oncologist or surgeon.

3. Vegetovascular crises

The patient complains of pulling pain in the left side under the shoulder blade and a feeling of fear, but at the initial examination no diseases that cause painful discomfort can 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;
  • psychoemotional overstrain;
  • 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 shoulder blade begin to appear after strong experiences or shocks. Most often, children and women under the age of 30 suffer from this disease.

back pain below the left shoulder blade


In vegetative-vascular crisis, not only does the pain under the left shoulder blade occur, in addition, the patient can feel:

  • feeling of suffocation;
  • cardiopalmus;
  • trembling in arms and legs;
  • causeless anxiety;
  • feeling hot or cold;
  • sweating;
  • headache;
  • loss of consciousness.

Characteristically, patients cannot pinpoint exactly where it hurts. Not only pain occurs under the shoulder blade, but also under the ribs, irradiation often occurs in the shoulder, arm or abdomen on the left side.

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

An additional danger is the fear of attack. The person is afraid of unpleasant sensations, trying to observe all sorts of rituals to avoid pain under the shoulder blade and other unpleasant symptoms. Without treatment, the condition becomes a phobia.


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

  • sedatives for severe fear;
  • herbal sedatives;
  • antidepressants to reduce increased nervousness and anxiety.

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

When the onset of an attack is related to a stress factor, patients are additionally trained to react properly to stressful situations, and it is recommended to avoid overload.

Which doctor to go to

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

4. Myocardial infarction

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

Provocative factors

The causes of such pain under the shoulder blade on the left side of the back are the complete cessation of coronary blood flow to a certain part of the myocardium due to blockage of a blood vessel. The following pathologies can cause heart attack:

  • atherosclerosis;
  • thrombosis.

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


The pain is acute and pulsating, localized to the left behind the sternum. radiate:

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

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

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

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

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


Therapy is aimed at removing obstacles to blood flow, reducing the focus of myocardial necrosis and eliminating pain. To do this, log in:

  • blood-dissolving agents;
  • medicines with blood thinning effect;
  • narcotic analgesics;
  • drugs to improve vascular tone.

Other drugs are selected taking into account the resulting injuries - these can be drugs to lower cholesterol, antihypertensive drugs with high blood pressure, etc.

In the first hours, surgical angioplasty may be reported to reduce the focus of necrosis. Surgery allows you to quickly restore impaired blood flow and reduce post-infarction scarring.

Which doctor is treating

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

5 more reasons why your back can hurt under the shoulder blade behind

Consider why it can hurt from the back under the shoulder blade on the left:

  1. Angina pectoris. Short-term coronary artery spasm caused by stress or physical exertion. There is sharp pain on the left side below the shoulder blade and behind the sternum, which disappears after taking nitroglycerin medication.
  2. Osteochondrosis or hernia of the thoracic region. If the nerve root is pinched, diffuse back pain will occur to the left below the scapula, which will intensify with movement.
  3. Peptic ulcer. Pain occurs not only behind the shoulder blade, but also in the epigastric region. It starts to hurt after eating or after prolonged starvation. Additionally, heartburn, unpleasant belching, nausea. Painful discomfort is slightly reduced after vomiting.
  4. Disease of the pancreas or spleen. In these pathologies, the left side hurts in the area of the shoulder blade and ribs. With acute pancreatitis, not only will the back hurt, but there will also be pain that covers the left and right hypochondria.
  5. Injuries. Left back injuries in the scapular region can cause irritation of nervous processes, and pain syndrome may recur several weeks after the injury with increased physical exertion or with hypothermia.

If there is pain in the back from under the left shoulder blade, then you should not ignore this condition, even if the pain is mild. Painful discomfort can be caused by a life-threatening condition.

What to do if your back hurts on the left side under the shoulder blade

When the pain syndrome occurs from behind under the shoulder blade on the left side, you should not panic, but you should not ignore the condition that has arisen. Before deciding which doctor to go to, try to find out exactly what back pain on the left side under the shoulder blade is. To do this, you will need to determine additional pain characteristics:

  • Localization. If the back hurts under the left shoulder blade and the painful discomfort intensifies after eating or prolonged starvation, then the probability of heart disease is minimal.
  • Intensity. Moderate pain syndrome often accompanies chronic diseases, but severe pain indicates a serious pathological process.
  • character. Acute pain requires urgent medical attention, and in case of withdrawal or excruciating pain, it is necessary to visit a clinic.
  • Connection with movement and breathing. When you have more pain when you cough, bend forward, or try to move your left arm, it indicates spinal disease or intercostal neuralgia.

Back pain under the shoulder blade on the left side occurs for various reasons and is not always safe for life and health. The syndrome of new pain left under the shoulder blade requires special attention - it can be a sign of neuralgia, angina pectoris or even a heart attack. If there is a suspicion of the origin of the pain syndrome, it is necessary to call an ambulance. Seeking medical help early can help maintain health and sometimes save lives.