Why does it hurt under the left shoulder blade from the back?

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

1. Intercostal neuralgia

The disease is accompanied by inflammation of the nerve processes.


Provokes nerve irritation:

  • hypothermia;
  • herpes infections;
  • injuries to the ribs or spine;
  • infringement of the nerve root with thoracic osteochondrosis;
  • diseases accompanied by deformation of the chest (spondylosis);
  • benign neoplasms of the pleura;
  • allergic reactions;
  • osteochondrosis.

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


With intercostal neuralgia, the pain will be aching, and the intensity will depend on the severity of the pathology. The pain can be severe, almost unbearable, or the disease will manifest itself as slight painful discomfort.

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

  • Connection with movement and breathing. The pain under the scapula begins to hurt more when you move your left hand, cough, inhale sharply or laugh.
  • The influence of heat. After rewarming, the pain decreases or disappears altogether.
  • Palpation. When pressed, it hurts more.

If the cause is a herpes infection, then the patient develops characteristic rashes 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 the pain under the left scapula is caused by intercostal neuralgia or cardiac pathologies. If the pain syndrome has arisen for the first time, and there is no certainty that it hurts due to irritation of the nerve processes, then you should immediately seek medical help.

see 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);
  • pain relievers;
  • non-steroidal anti-inflammatory drugs;
  • ointments 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 stage, 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 scapula on the left, but also at treating 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 area of the left shoulder blade, and there is no suspicion of cardiac pathology, then you need to visit a neurologist.

2. Diseases of the broncho-pulmonary system

It can hurt in the left shoulder blade 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;
  • pleurisy.

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


A person has a constant pulling or aching pain under the scapula on the left. When you cough and take a deep breath, the pain intensifies. In addition to painful sensations in the back on the left, patients may present with the following complaints:

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

If the 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 the patients are prescribed:

  • antibiotics or antivirals;
  • medicines to liquefy and stimulate sputum 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 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 need to visit an oncologist or surgeon.

3. Vegetovascular crises

The patient complains of a pulling pain in the left side under the scapula and a feeling of fear, but during the initial examination, diseases provoking pain discomfort cannot 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 overstrain;
  • endocrine diseases;
  • long-term use of antidepressants or psychotropic drugs.

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

back pain under the left shoulder blade


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

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

It is characteristic that patients cannot indicate exactly where it hurts. Not only pain appears under the scapula, but also under the ribs, often there is irradiation to the shoulder, arm or abdomen on the left.

The duration of a 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 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 becomes a phobia.


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

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

If crises are caused by neurological or endocrine diseases, then additional therapy is selected to eliminate the disorders that have arisen.

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

Which doctor to contact

When panic attacks appear, you need to 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. Additionally, 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 scapula and behind the sternum will be strong.

Provoking factors

The reasons for such pain under the scapula on the left from the back are in 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 the blood flow goes to the heart. Once in the coronary arteries with a 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 throbbing, localized to the left behind the sternum. Irradiates:

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

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

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

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

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


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

  • agents that dissolve blood;
  • medicines with a blood thinning effect;
  • narcotic analgesics;
  • medicines to improve vascular tone.

Other drugs are selected taking into account the violations that have arisen - these can be drugs to lower cholesterol levels, antihypertensive drugs with 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 impaired blood flow and reduce postinfarction scar.

Which doctor treats

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

5 more reasons why the back may hurt under the scapula behind

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

  1. Angina pectoris. Short-term spasm of the coronary vessels caused by stress or physical exertion. Sharp pains appear on the left behind under the scapula and behind the sternum, which disappear after taking drugs with nitroglycerin.
  2. Osteochondrosis or hernia of the thoracic region. If the nerve root is pinched, there will be a diffuse pain in the back on the left under the scapula, 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. Additionally, there is heartburn, unpleasant belching, nausea. Painful discomfort is slightly reduced after vomiting.
  4. Disease of the pancreas or spleen. With these pathologies, the left side hurts in the area of the scapula and ribs. In acute pancreatitis, it will not only hurt from the back, but there will be girdle pains covering the left and right hypochondria.
  5. Injuries. Back injuries to the left in the area of the scapula can provoke irritation of the nerve processes and pain syndrome can reappear several weeks after the injury with increased physical exertion or with hypothermia.

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

What to do if you have pain in the back 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 on the left under the scapula. To do this, you will need to determine additional characteristics of pain:

  • Localization. If it hurts in the back below the left shoulder blade and the painful discomfort increases after eating or with prolonged fasting, then the likelihood of heart disease is 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 pulling or aching soreness, you need to visit the clinic.
  • Connection with movement and breathing. When it hurts more when coughing, bending forward or when trying to move the left hand, this indicates a disease of the spine or intercostal neuralgia.

Back pain under the scapula on the left is caused by various reasons and they are not always safe for life and health. The new-onset pain syndrome on the left under the scapula requires special attention - this may 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 need to call an ambulance. Seeking medical attention early can help maintain health and sometimes save lives.