symptoms

Scapula pain Pain on the scapula

Scapula pain Pain on the scapula / symptoms
Scapular pain may occur on or under the scapula, but also between the shoulder blades. The symptoms can become noticeable depending on the movement or at rest. For example, some patients complain of being awakened by pain at night. Pain on the scapula is often due to one-sided stress or overload, irritation and inflammation of the tendons and bursae as well as muscle tension. In addition, accidental injuries in the shoulder area can lead to severe discomfort and restricted mobility.


contents

  • definition
  • clinical picture
  • Functional causes
  • The rotator cuff syndrome
  • The impingement syndrome
  • Shoulder blade pain from injuries
  • risk factors
  • diagnosis
  • treatment options
  • Prevent scapula pain

definition

Scapular pain is a painful condition that occurs around the scapula. The pain can be felt on one or both sides. Often, complaints on the scapula are associated with a restriction of movement.

Pain in the area of ​​the scapula is often associated with functional impairments of the shoulder. (Image: olly / fotolia.com)

clinical picture

Mostly scapula pain is due to one-sided stress or overload. The symptoms then disappear after a period of sparing alone. However, if there are persistent, recurring or acute pain after an accident, a medical examination should be made to rule out serious illness of the shoulder.

The anatomy shoulder consists of three main structures:

  • the shoulder girdle (clavicles and shoulder blades),
  • the shoulder joint (scapula and humerus),
  • the shoulder roof (acromion) and the raven beak extension (coracoid), which belong as bony prominences to the scapula.

Unlike many other joints in the human body, the ligaments of the shoulder joint are relatively weak. Muscles and tendons provide stability to the shoulder, collectively called rotator cuffs. Roof-like cover

  • the upper bony muscle (Musculus supraspinatus),
  • the lower bones muscle (Musculus infraspinatus),
  • the small round arm muscle (Musculus teres minor)
  • and the sub-scapular muscle (Subscapularis muscle)

as part of the rotator cuff the shoulder joint. They run from the scapula to the humerus where their tendons attach.

Those affected often locate shoulder-blade pain centrally between the scapula and spine. The complaints can also occur on or under the scapula. Some patients also complain of neck pain or neck tension. Often the pain becomes noticeable when lifting or lifting the arm.

The structure of the shoulder blades is held together by muscles and tendons. (Image: bilderzwerg / fotolia.com)

Functional causes

Between the shoulder blades are the so-called Musculi rhomboid (Rhomboid muscle minor and Rhomboid muscle major). Due to tension, these muscles can lead to discomfort and have so-called trigger points, noticeable indurations, which are softer and less painful by the pressure during the treatment. The Musculi rhomboid be from the trapezius muscle (Musculus trapezius), which runs outward to the shoulders and to the back of the head and may also have tension and trigger points. Those affected usually complain of pain when contracting the scapula towards the spine, some of which can radiate to the arm and fingers.

At the upper middle "tip" of the shoulder blade the shoulder blade lifter (Musculus levator scapulae), which also have tension and can "stick together" with the trapezius muscle so that the muscles and their connective tissue sheaths (fascia) no longer slide properly together and cause discomfort. Afflicted complain mostly about punctual pain at the base of the scapula when lifting the shoulder or turn the head obliquely backwards.

Muscle tension is one of the most common causes of scapular pain and can affect any muscle that runs around the shoulder.

The rotator cuff syndrome

The term "rotator cuff syndrome" (PHS, Periarthropathia humeroscapularis) are summarized various complaints, which are accompanied by wear-related damage and can lead among other things to pain in the area of ​​the scapula. The signs of wear range from small cracks (ruptures) in the tendon fibers to complete tendon tear. This affects above all:

  • the rotator cuff (rotator cuff syndrome),
  • the tendon plate of the shoulder rotators,
  • the biceps tendon (biceps tendon syndrome).

This usually pain and restricted mobility occur. In addition, the tendons and / or bursae may catch fire. Lime deposits, which mainly affect the supraspinatus tendon or adhesions in the joint can lead to stiffening of the shoulder. Some sufferers also report clicking sounds in the shoulder (shoulder cracking).

The impingement syndrome

The Impingement Syndrome (constriction syndrome) refers to a narrowing of the gliding space of the tendons of the rotator cuffs as well as the bursa between the humeral head and the shoulder roof. As a result, movement restrictions of the shoulder joint occur, which are accompanied by pain. Often the permanent overload is the cause of the discomfort. In some cases, however, the trigger of the disease can not be detected.

In the impingement syndrome, wear-related changes in the saccaspinatus tendon occur due to narrowing in the area of ​​the rotator cuff and the superimposed bursae. The squeezing causes some suffering from severe pain, including the scapula.

When falling with a bicycle, the shoulder blade can be affected. (Image: RioPatuca Images / fotolia.com)

Shoulder blade pain from injuries

Accidental injuries in the shoulder area are relatively common. These may affect the shoulder joint and / or its surrounding structures such as muscles, tendons and ligaments as well as the shoulder bones. The dislocation of the shoulder joint (shoulder luxation) can lead, among other complaints, also to shoulder blade pain. The same is true for injuries to the other structures of the shoulder.

Under massive violence as in traffic accidents, the shoulder blade can break. Such a fracture is usually treated conservatively, as long as no other structures are affected. In addition, there are numerous other causes that can lead to shoulder blade pain such as

  • Inflammation around the shoulder,
  • arthrosis,
  • nerve damage,
  • rheumatism,
  • tumors
  • and vascular diseases.

risk factors

Among the risk factors for scapular pain include chronic overuse, for example, due to certain sports such as tennis and muscle tension, which are not treated in time. Frequently a massage is sufficient to prevent strong tension in the shoulder area. Injury-related scapular pain often occurs as a result of traffic accidents or skiing and riding accidents.

diagnosis

If shoulder-blade pain occurs acutely as a result of an accident, persistent or recurrent, sufferers should seek medical attention. The medical examination initially asks questions about the medical history and possible causes of the complaints. This is followed by an in-depth examination of the shoulder, examining possible movement restrictions and visible changes such as redness and swelling. Frequently, scapular pain occurs during certain movements that may provide important clues at the time of diagnosis. A palpation examination can give, among other things, evidence of trigger points.

To diagnose a muscular or neurological problem, an electromyogram (EMG) can be performed, measuring the activity of the muscles at rest and in motion, to determine which area (muscle or nerve) is in disorder. In addition, the nerve conduction velocity can be determined. Further investigations may also be necessary, including

  • X-ray,
  • Ultrasonic,
  • Magnetic Resonance Imaging (MRI),
  • Computed tomography (CT)
  • or blood tests.

treatment options

The treatment of scapular pain depends on the cause. In inflammatory processes, anti-inflammatory analgesics are usually administered. In addition, the protection of the shoulder can be useful. In other cases, exercise and targeted muscle growth can help. In the case of a fracture of the scapula, either the shoulder can be immobilized or, if necessary, a surgical procedure be performed.

Rolfing can release tension in the musculature of the scapula and thereby free you from the pain. (Image: Adam Gregor / fotolia.com)

Since often no disease, but rather functional causes are the cause of the discomfort, osteopathic treatment and Rolfing can be promising. Both treatment concepts incorporate the overall statics of the body and examine which structures lead to tensions on the shoulder. Often, trigger points trigger pain. With various treatment methods, including those from manual therapy or physiotherapy, the trigger points are deliberately softer and less sensitive to pain.

Prevent scapula pain

To prevent muscular tension - especially when you work a lot sitting, doing monotonous work that puts a lot of strain on the muscles in the shoulder blade area, and are exposed to high levels of stress - relaxation and movement exercises can be used for prevention, such as:

  • yoga,
  • Thai chi,
  • Autogenic training
  • or progressive muscle relaxation according to Edmund Jacobsen,
  • or easy swimming.

In addition, there are many loosening exercises to stretch the shoulder area, which can be incorporated into your daily routine.
(ag, fp, ok, updated on 13.12.2018)