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Left Shoulder Blade Pain

SYMPTOMS, CAUSES AND TREATMENT

Left Shoulder Blade Pain-Causes, Symptoms and Treatments

Learn to know the symptoms and causes of shoulder blade pain as well as the diagnostic tests to run for it and its treatment options. Shoulder blade pain can be a common, annoying, hard to diagnose problem. There are many different causes of shoulder blade pain and the exact cause of the shoulder blade pain will determine what type of treatments would be recommended.

Why Does My Left Shoulder Blade Hurt?

The shoulder blade is the scapula bone. It sits behind the rib cage and attaches the upper arm to the shoulder via the glenohumeral joint.

Muscle Strains

Shoulder dislocation is serious and if left untreated can result in the following:

Muscle strains can occur from chronic poor posture, improper lifting technique or specific injuries. Injuries could be those involving twisting or rotation of the upper back or thoracic region, heavy lifting with pushing or pulling activities or overhead lifting. There also can be direct trauma to the area or a direct fall on the shoulder blade causing a bone bruise, fracture or broken bone. Muscles that can get injured related to the shoulder blade can be the rhomboid minor or major, the levator scapula, the serratus anterior, the teres minor, teres major, infraspinatus, trap muscle or intercostal muscles that do not attach to the shoulder blade but can be strained deep to the shoulder blade.

Scapula Disorders and Snapping Scapula - Dr. Groh

What Does Pain In The Shoulder Blade Feel Like?

  • It can be a dull, achy type pain.
  • It can be a sharp or stabbing type pain.
  • It can be a shooting or radiating pain that starts in the shoulder blade and travels or starts elsewhere and travels to the shoulder blade. There can be weakness in the arm, especially with motion. There can be stiffness, lack of range of motion or movement in the shoulder blade or arms.

Possible Medical Conditions Causing Pain In The Shoulder Blade Area

  • Musculoskeletal conditions. These would be things such as muscle strain, myofascial pain syndrome with trigger points, direct tears of tendons or muscles.
  • Neck related problems. Cervical disk injury or facet injury can radiate pain into the shoulder blade area.
  • Cervical nerve injury can refer pain to the shoulder blade area as well.
  • There can be some ligamentous injury causing instability that leads to more muscle-related pain.
  • There can be a direct bony injury to fractured rib, fractured shoulder blade.
  • There can be some rib or thoracic joint pain or instability.

Heart Conditions

  • Heart attack, aortic dissection, pericarditis can refer pain to the left shoulder blade.

Abdominal Conditions

  • Heartburn or acid reflux disease problems, gallstones, liver disease, upset stomach could potentially radiate pain to the left shoulder blade area.
  • Lung related conditions, pulmonary embolism/blood clot, pneumothorax.

Cancers

  • Lymphoma, esophageal cancer, stomach cancer, liver cancer, pancreatic cancer or lung cancer could potentially cause pain in these areas.

AC Joint Impingement

AC joint Impingement is a painful condition that occurs when the space beneath the acromion bone is narrowed.   This narrowing can result in irritation of the rotator cuff tendons and bursa.  A bursa is a fluid-filled sac that reduces the friction on tendons and muscles as they cross bony surfaces.  A tendon is thick collagen tissue that connects muscles to bones.  The rotator cuff tendons provide important support and enable movement in the shoulder.   If severe,  impingement can cause tears in the rotator cuff tendons.  Patients with AC joint impingement typically have pain with elevation of the arm and or while lying on the shoulder.

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Avascular Necrosis of the Shoulder

Avascular Necrosis is essentially a lack of blood flow, eventually resulting in necrosis, or dying of the bone. This happens in multiple joints. And today we’re talking specifically about the shoulder. So talking about AVN in the shoulder, patients typically come up with two main questions. Number one, can this heal on its own? And if not, how long or how fast will this progress? Now we classify AVN in multiple different stages: Number one: we have stage one, where it’s very normal X-ray  — usually, typically, someone just has pain with activity. Is the bone itself continues to deteriorate, then we start getting some changes on your X-ray..

Read More About Avascular Necrosis of the Shoulder

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a painful loss of shoulder movement and range in motion.  The incidence of frozen shoulder is 3-5% in the general population and up to 20% in those with diabetes.  The peak incidence is between 40-60 years of age.  The exact mechanism is poorly understood.  In general, the capsule becomes inflamed, thickened, and contracted with pain and significant restriction in range of motion. causes are poorly understood but risk factors include trauma, prolonged immobility, systematic diseases such as diabetes, stroke, connective tissue disease, and heart disease.  Other causes include post-surgery, chronic inflammation causing stimulation of myofibroblasts

Read More About Frozen Shoulder

Rotator Cuff Tear

Are you plagued by shoulder pain that has now transitioned from intermittent to constant and keeps you up at night? Are daily shoulder movements, such as dressing and reaching for objects in the kitchen cabinets, painful? Is your range of motion decreasing as your pain is increasing? You may have a full- or partial-thickness rotator cuff tear. Has conservative therapy in the form of heat, ice, stretching, rest, and acupuncture failed to provide significant relief? Has an MRI demonstrated a full-thickness or partial-thickness tear of the rotator cuff? What to do? If left untreated, full-thickness and 26% of partial-thickness tears will progress.

Read More About Rotator Cuff Tear

Shoulder Impingement Syndrome

Pain is the most common symptom.  It typically occurs with the elevation of the arm, forced movement overhead, and when lying on the shoulder.  Impingement can also cause shoulder pain when reaching across the body. Narrowing of the subacromial space is the most common cause of shoulder impingement syndrome (6).  The subacromial space is the area between the top of the arm bone (humerus) and the AC joint.   This narrowing compresses or pinches the rotator cuff tendons and bursa.  If left untreated the rotator cuff tendons can become inflamed, damaged, and or torn.Bursa and tendons can not be seen on x-ray.  An x-ray may demonstrate…

Read More About Shoulder Impingement Syndrome

Shoulder Labral Tears

The labrum is a cartilaginous cup that circles the shallow shoulder socket (the glenoid) to make the socket deeper. The labrum supports and stabilizes the shoulder joint. Causes of Shoulder Labral Tears Injury to the labrum typically occurs from repetitive trauma in overhead throwers, such as in baseball. It can also occur from a traction injury to the arm, such as lifting a heavy object off the ground or getting your arm jerked. Symptoms of Shoulder Labral Tears. Typical symptoms include pain in the front of the shoulder or deep inside the joint. Treatment options initially include physical therapy which is designed to restore range of motion and strength to the shoulder.

Read More About Shoulder Labral Tears

Prevention

  • Prevention of musculoskeletal causes of shoulder blade pain would be working on good ergonomics and posture when sitting or using computers, always using proper lifting technique when working out or lifting heavy objects.
  • Doing exercises for mobility, strength training and flexibility of the upper back, thoracic area, neck and lumbar spine as well as core activating and strengthening program.
  • Eating well can help improve overall health, wellness and decrease many chronic diseases and aid healing when you have musculoskeletal injuries. See my nutrition book: Nutrition 2.0 (Download Your Copy of Nutrition 2.0! – Centeno-Schultz Clinic (centenoschultz.com)).

Examination And Diagnosis

If you are having shoulder blade pain especially that is not going away after a few days to a few weeks, you should also see your doctor. The doctor will take a history, do a physical exam and if needed may run some laboratory tests or obtain some imaging.

Questions Your Physician May Ask You

  • How long as the shoulder blade been hurting?
  • Did the pain come on suddenly or gradually?
  • Did you recently modify your activity level or fitness routine?
  • What type of movements, positions or activities increase the shoulder blade pain. Any activities, movements or positions decrease your shoulder blade pain?
  • Do you have any associated pain elsewhere such as in the neck, chest, stomach or down the arm?
  • On exam they may palpate or touch areas around and on the shoulder blade, neck, arm, chest to identify sources of pain and take you through
  • specific exam maneuvers to see if that elicits pain or improves the pain.
  • If a medical condition is suspected, they may run some diagnostic laboratory tests such as a complete blood count, basic metabolic panel, potentially an EKG or stress test, potentially an endoscopy to test for any esophageal or stomach abnormalities.
  • Might receive some imaging tests such as a diagnostic ultrasound, MRI or CAT scan if any suspicion for cardiac, pulmonary or abdominal medical problems.

Common Treatment Options For Pain In The Shoulder Blade

RICE Treatment

  • Initial early treatment, if a musculoskeletal injury is suspected, can include RICE, which stands for rest, ice, compression and elevation meaning limiting aggravating activities, using ice a few times a day, a compression garment and elevating the shoulder blade when in a resting position if possible.

Hot Compressions

  • Heat and hot compresses could also potentially help.

Physical Therapy

  • Physical therapy is a great place to start to work on posture, alignment, core stabilization, therapeutic stretching, exercising, etc.

Anti-Inflammatory Medications

  • Over-the-counter medications such as Tylenol or anti-inflammatory medicines or anti-inflammatory supplements.

Bone-Modifying Drugs

  • More revolutionary healing type procedures could include regenerative injections such as prolotherapy, PRP, bone marrow concentrate containing stem cells for musculoskeletal injuries.

Additional Treatment

  • If there is a particular medical diagnosis made, then depending on that medical problem will dictate what treatment is recommended.

Possible Prognosis

  • Many times musculoskeletal related shoulder blade pain will resolve on its own with minimal intervention. Occasionally, more serious musculoskeletal problems such as muscle or tendon tear or cervical problem may be diagnosed requiring physical therapy plus or minus injection-based intervention medications, prolotherapy, PRP or bone marrow concentrate containing stem cells.
  • Prognosis for any medical condition will depend on the medical condition and the severity of that problem.
  • It is never too late to get yourself checked.

Conclusion:  It’s Never Too Late To Get Yourself Checked

  • Shoulder problem is a common, often annoying problem. Many times it will self-resolve, but sometimes can linger on and require medical evaluation and possible treatment.
  • It also can be a sign of an underlying more serious medical problem that needs evaluation and treatment.
  • Here at the Centeno-Schultz Clinic, we specialize in treating musculoskeletal and orthopedic problems with a focus on regenerative techniques to get the body to heal itself. If you need help identifying the root cause of the pain in her shoulder blade, we can help.

Need help identifying the root cause of the pain in your left shoulder blade? We can help, book your appointment with us today!

Doctors that Can Help Treat Left Shoulder Blade Pain

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

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