Why does it hurt under the left shoulder blade?

The pain on the left 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 occurs for less dangerous reasons. It is worthwhile to get acquainted with why it hurts under the left shoulder blade from behind to know which doctor to seek help and in which cases to call an ambulance.

1. Intercostal neuralgia

The disease is accompanied by inflammation of the nervous processes.


Provokes nervous irritation:

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

Under the shoulder blade on the left side, the pain of neuralgia appears suddenly and scares a person, which makes him suspect 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 painful discomfort.

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

  • Relationship 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.
  • The influence of heat. After warming up, the pain decreases or disappears completely.
  • Palpation. It hurts more when pressed.

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

In addition to the pain, one may experience:

  • tachycardia;
  • skin tingling;
  • increased sweating.

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

go to the 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;
  • non-steroidal anti-inflammatory drugs;
  • ointments with a warming effect.

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

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

  • physiotherapy procedures;
  • massage;
  • acupuncture.

The treatment is aimed not only at relieving back pain under the left shoulder blade, but also at treating a provocative disease (osteochondrosis, herpes). If this is not done, then the pathology becomes chronic, exacerbated by hypothermia or exercise.

Who to contact

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

2. Diseases of the broncho-pulmonary system

May have pain in the left shoulder blade due to disease 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, left back pain can occur due to the appearance of neoplasms in the bronchi or lungs.


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

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

If back pain to the 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 provoked by the inflammatory process, then patients are prescribed:

  • antibiotics or antivirals;
  • drugs for liquefaction and stimulation of sputum production;
  • antipyretic drugs;
  • painkillers (if it starts to hurt badly).

In 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 the case of neoplasms it is necessary to visit an oncologist or surgeon.

3. Vegetative 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 can be found that cause pain discomfort.


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.

Autonomic crises are often the first sign of neurological disorders. After strong experiences or concussions, signs of deteriorating well-being and painful discomfort under the left shoulder blade begin to appear. The disease most often affects children and women under 30 years of age.

back pain under the left shoulder blade


In a vegetative-vascular crisis, not only does pain occur on the left side of the shoulder blade, but the patient may also experience:

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

Characteristically, patients cannot pinpoint exactly where it hurts. There is not only pain under the shoulder blade, but also under the ribs, there is often irradiation in the shoulder, arm or abdomen on the left.

The duration of the 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 attack. One is afraid of unpleasant sensations, tries to observe all sorts of rituals to avoid pain under the shoulder blade and other unpleasant symptoms. Without treatment, the condition becomes phobic.


The presence of seizures will be an indication for immediate hospitalization, and milder forms of autonomic 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, then additional therapy is chosen to eliminate the disorders.

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

Which doctor to go to

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. You may also 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 severe.

Provoking factors

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

  • atherosclerosis;
  • thrombosis.

The resulting blood clot or plaque breaks down and the blood flow goes to the heart. Once in the small diameter coronary arteries, 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 sharp and throbbing, localized to the left behind the sternum. irradiates:

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

In the atypical course of a heart attack, radiation is possible:

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

In the case of 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


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

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

Other drugs are chosen taking into account the disorders that have occurred - these may be drugs to lower cholesterol levels, antihypertensive drugs with high blood pressure and others.

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

Which doctor treats

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

5 more reasons why the back can hurt under the shoulder blade in the back

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

  1. Angina pectoris. Short-term coronary vasospasm caused by stress or exercise. Acute pain appears on the left back under the shoulder blade and behind the sternum, which disappears after taking drugs with nitroglycerin.
  2. Osteochondrosis or thoracic hernia. When pinching the nerve root, there will be diffuse pain in the back to the left below the shoulder blade, which will intensify when moving.
  3. Peptic ulcer disease. The pain occurs not only behind the shoulder blade, but also in the epigastric region. It starts to hurt more after eating or with prolonged starvation. In addition, there are heartburn, unpleasant belching, nausea. The discomfort of the pain 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. In acute pancreatitis, not only will there be back pain, but there will also be lumbar pain covering the left and right hypochondria.
  5. Injuries. Injuries to the left back in the area of the shoulder blade can provoke irritation of nervous processes and the pain syndrome may reappear a few weeks after the injury during increased physical activity or hypothermia.

If there is pain in the back and back 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 you have back pain on the left under the shoulder blade

When there is a pain syndrome behind the shoulder blade on the left, you do not need to panic, but you should not ignore the condition. Before deciding which doctor to go to, you should try to understand exactly what hurts from the back to the left under the shoulder blade. To do this, you will need to determine additional characteristics of the pain:

  • Localization. If back pain under the left shoulder blade and painful discomfort increases after eating or prolonged fasting, then the likelihood of heart disease is minimal.
  • Intensity. The syndrome of moderate pain often accompanies chronic diseases, but severe pain indicates a severe pathological process.
  • character. Acute pain requires immediate medical attention and in case of pulling or aching pain you should visit the clinic.
  • Relationship with movement and breathing. When it hurts more when coughing, leaning forward, or trying to move the left arm, 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. The newly developed pain syndrome on the left side of the shoulder blade 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 should call an ambulance. Seeking medical help early can help maintain health and sometimes save lives.