Scapular Pain

As we all know, our body has two shoulders, and each shoulder has a flat triangular bone referred to as the scapula. Also known as the shoulder blade, the scapula is found at the back of the shoulder and attaches the arm bone with the ribs. Pain in the scapula or the shoulder blade is quite common and often the result of excessive physical activity. Scapular pain can restrict shoulder movement considerably, and lifting objects like a bucket of water is likely to trigger sharp shooting pain in the shoulder. Radiating pain from the back area of the shoulder while moving the shoulder joints are some of the most common scapular pain symptoms.

Causes

Experiencing occasional scapular pain in the day-to-day routine is understandable. However, persistent pain in the shoulder blade is something related to an underlying condition or improper sleeping positions. It is explained below:

Inappropriate Sleeping Position: Shoulder hurts while moving after waking up. Well this is a common complaint and occurs as a consequence of improper sleeping positions. Sleeping on one side for prolonged periods of time, without a pillow, can put excessive strain on the shoulder blades, resulting in pain. A proper pillow is essential as it provides support to the neck and the head, in turn allowing the shoulder to relax comfortably with minimal stress. However, doctors firmly believe that by far, the best sleeping position is to lie on the back.

Overuse: Any activity that causes repetitive movement of shoulders can lead to scapular pain. Outdoor games like tennis, badminton and golf involves excessive use of shoulder muscles. This can leave the muscles connected to the scapular bone tense and strained. Eventually, the muscular pain radiates to the scapular bone.

Fracture: Broken scapular bone from trauma (accident or a sports injury) can cause excruciating pain, especially during movement of arms. Apart from intense pain, the affected area may appear swollen and show discolored skin.

Osteoporosis: This is an age related disorder that is typically marked by gradual decline of bone density, eventually making the bones brittle and susceptible to fractures. Initially, one may not feel osteoporosis pain but over the course of time, there is substantial loss of bone mass, which can lead to moderate to severe pain. Men who have crossed 70 and women above 50 are in the risk zone of shoulder osteoporosis

Osteoarthritis: Diagnosed in older people, arthritis is a painful condition that brings inflammation in joints. With age, the joints and bones in the body, become considerably weak, making them vulnerable to conditions like osteoarthritis. As we all know, the place where two bones meet is referred to as a joint. The cartilage is a tissue that covers the end points of bones and prevents them from rubbing against each other. The movement of the joints in our day-to-day routine leads to substantial wear and tear, which leads to destruction of cartilage. Shoulder arthritis, although relatively uncommon, can bring scapular pain.

Nerve Impingement: Scapular pain that is not restricted to the shoulder and runs down the arm is an indication of pinched nerve in the neck. In simple terms, a pinched nerve means a part of the nerve has compressed and is causing sharp shooting pain. Pinched nerve in the neck are symptoms of cervical spondylosis. The cervical (neck) spine primarily consists of seven bones. Between two adjacent bones lies a 'disc' (a tough fibrous tissue) that prevent friction and gives flexibility to the neck. Also, various muscles and ligaments are connected to the neck bones that provide support and allow free movement of the neck.

Now, the spinal cord that runs through the neck and ends at the base of the skull, contains nerves that carry brain signals. Some of these nerves branch out of the neck and pass through the shoulder area. Now, over time (after the age of 50), these 'discs' may becomes brittle as well as the joints between neck bones may wear away. In some cases, the discs move out of their normal position and compress the nerve roots, above it. This excessive pressure on any of nerve roots can trigger pain which may travel down to the shoulder blade. People with a pinched nerve in the neck often experience pain in the scapula. In most cases, scapular nerve pain does not remain confined to the neck and the shoulder area but often spreads to the arms. People suffering from scapular nerve pain often experience numbness or an unusual burning sensation in the hand and fingers. Scapular pain resulting from nerve impingement does not go away within a few days. It is likely to continue for weeks and sometimes may even last for months.

Rotator Cuff Injury: The rotator cuff is a term that refers to the 4 muscles, located in the shoulder area. They provide support and stability to the shoulder joints. As tendons do the job of connecting muscles to bones, rotator cuff injuries can also affect the shoulder bones. Any injury to the rotator cuff muscles can manifest in the form of scapula pain.

Maintaining proper posture while sitting or taking rest is very important to stop the pain from worsening. Simply by correcting the posture, one can get tremendous relief from shoulder pain. Exercises that stretch the neck and the shoulder area too can contribute to overcome the pain. In case of tendon or muscle injury, one should opt for exercises that help to make these weakened shoulder tissues stronger. Scapular retraction exercises are often recommended as they benefit to strengthen and heal the painful shoulder area.

Massaging the scapular area is an easy way to relieve the strain and tightness of the muscles. You need to consult a physical therapist to know the exact massaging technique that provides pain relief. Many patients have also found relief after attending multiple chiropractic sessions.

After diagnosing the underlying condition, the doctor may decide appropriate scapular pain treatment plan. However, the doctor may advice to take rest and avoid physical activities that cause shoulder blade pain. In case of a pinched nerve, muscle relaxants, non-steroidal anti-inflammatory medications or cortisone injections are generally prescribed to relieve the pain. If the discomfort does not decrease, the doctor may perform a surgery to reduce the pressure on the nerve roots. Physical therapy that involves doing some exercises may help to improve cervical spondylosis and shoulder arthritis.