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

Pain on the left under the scapula immediately makes a suspicious person think of a heart attack. Of course, do not forget about this potentially fatal disease, but more often back pain and left pain occurs for less dangerous reasons. It is worth getting acquainted with the reasons for which it hurts under the left shoulder blade from behind from the back, in order to know which doctor to ask for help and in what cases to call an ambulance.

1. Intercostal neuralgia

The disease is accompanied by inflammation of the nervous processes.


Causes nerve irritation:

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

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


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

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

  • Connection with movement and breathing. The pain under the scapula starts to hurt more when you move your left hand, cough, inhale heavily, or laugh.
  • The influence of heat. After warming, the pain decreases or disappears completely.
  • Palpation. When you press on it, it hurts more.

If the cause is a herpes infection, 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 heart conditions. If the pain syndrome appeared for the first time, and there is no certainty that it is painful due to irritation of nervous processes, you should immediately consult a doctor.

see a doctor for pain under the left shoulder blade


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

Patients are prescribed:

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

If the disease is accompanied by severe pain under the left scapula, which cannot be stopped by taking pain relievers, patients are given novocaine blockade to relieve the disease.

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

  • physiotherapy procedures;
  • massage;
  • acupuncture.

Treatment is aimed not only at relieving back pain under the left scapula, but also at treating a provocative disease (osteochondrosis, herpes). If this is not done, the pathology becomes chronic, exacerbated by hypothermia or physical exertion.

Who to contact

If it hurts in the region of the left scapula and there is no suspicion of cardiac pathology, you need to consult a neurologist.

2. Diseases of the bronchopulmonary system

It can hurt the left scapula from behind due to 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 may occur due to the appearance of neoplasms in the bronchi or lungs.


A person has constant or aching pain under the left shoulder blade. When you cough and breathe deeply, the pain intensifies. In addition to painful sensations in the back on the left, patients may have the following complaints:

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

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


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

  • antibiotics or antivirals;
  • drugs to liquefy and stimulate the flow of sputum;
  • antipyretic drugs;
  • pain relievers (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 need to consult an oncologist or surgeon.

3. Vegetovascular crises

The patient complains of a pulling pain on the left side under the scapula and a feeling of fear, but during the initial examination, diseases causing painful discomfort cannot be detected.


Seizures 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 overwork;
  • endocrine diseases;
  • prolonged 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 shocks. Most often, children and women under the age of 30 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 feel:

  • a feeling of suffocation;
  • heart disease;
  • tremors in the arms and legs;
  • anxiety without cause;
  • feeling hot or cold;
  • sweat;
  • headache;
  • loss of consciousness.

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

The duration of a seizure 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 disease 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. In therapy they are used:

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

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

When the onset of a seizure is associated with a stressor, patients are further trained to respond correctly to stressful situations, and overwork is recommended to be avoided.

Which doctor to contact

When panic attacks appear, you need to contact a vegetarian, but not all cities have such specialists. If it is not possible to get advice from a vegetarian, you should consult a neurologist or therapist. Additionally, you may need to see an endocrinologist.

4. Myocardial infarction

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

Provoking factors

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

  • atherosclerosis;
  • thrombosis.

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


The pain is sharp and stabbing, localized to the left behind the breastbone. Irradiates:

  • in the left hand;
  • under the scapula;
  • in the lower jaw.

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

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

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

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


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

  • blood dissolving agents;
  • drugs with an anticoagulant effect;
  • narcotic pain relievers;
  • drugs to improve vascular tone.

Other drugs are selected taking into account the violations that have arisen - these can be drugs for lowering cholesterol, antihypertensive drugs for high blood pressure, etc.

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

Which doctor treats

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

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

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

  1. Angina pectoris. Short-term spasm of the coronary vessels caused by stress or physical exertion. Sharp pains appear on the left under the scapula and behind the breastbone, which disappear after taking drugs containing 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. 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, unpleasant belching, nausea. The pain discomfort is slightly reduced after vomiting.
  4. Disease of the pancreas or spleen. With these pathologies, the left side hurts at the level of the scapula and the ribs. In acute pancreatitis, not only will it hurt your back, but there will be girdle pain covering the left and right hypochondria.
  5. Injuries. Injuries to the back on the left in the area of the scapula can cause irritation of nervous processes, and the pain syndrome may reappear several weeks after the injury with increased physical exertion or hypothermia.

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

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

When pain syndrome appears from behind under the left scapula, you do not need to panic, but you should not ignore the condition that has occurred. Before deciding which doctor to refer to, you should try to find out exactly what hurts your back on the left under the scapula. To do this, you will need to determine additional features of the pain:

  • Location. If it hurts in the back under the left shoulder blade and the painful discomfort increases after eating or with prolonged fasting, then the risk of heart disease is minimal.
  • Intensity. Mild pain syndrome often accompanies chronic diseases, but severe pain indicates a serious pathological process.
  • Personage. Acute pain requires immediate medical attention, and if there is a tightening or aching pain, you should go to the clinic.
  • Connection with movement and breathing. When it hurts more when coughing, leaning forward, or trying to move the left hand, it indicates spinal disease or intercostal neuralgia.

Back pain under the left shoulder blade is caused by various reasons and is not always safe for life and health. Recently onset pain syndrome on the left under the scapula requires special attention - it could be a sign of neuralgia, angina, or even a heart attack. If in doubt about the origin of the pain syndrome, you should call an ambulance. Seeing a doctor early can help maintain health and sometimes save lives.