Understanding Referred Pain and the Scapula
Referred pain is when pain is felt in a location different from the source of the pain [1]. This occurs because nerves from internal organs and certain skin and muscle areas share pathways [1]. While muscle strains are common causes of scapula pain, referred pain from internal organs is a possibility to consider when investigating what organ causes scapula pain?
Cardiac-Related Scapula Pain
The heart can cause referred pain to the scapula, often the left one [1, 4]. This can be a sign of a medical emergency [1]. Nerve pathways from the heart can cause pain to radiate from the chest to the upper back and shoulder area [1].
Signs of Cardiac Pain
- Location: May be felt under the left scapula and radiate to the left arm, jaw, or neck [1, 4].
- Accompanying Symptoms: Chest pain or pressure, shortness of breath, sweating, nausea, and lightheadedness can occur [1].
- Triggers: Pain might worsen with physical activity and improve with rest [1].
- Note: Scapula pain can be a more prominent symptom in women experiencing atypical heart attack symptoms [1].
Gallbladder and Liver Conditions
Problems with the gallbladder and liver can cause referred pain under the right scapula [1, 4, 5]. The phrenic nerve, which supplies the diaphragm, is involved in this referral pattern [1, 4]. Irritation of the diaphragm by these organs can lead to pain felt in the right shoulder and scapula [1, 4].
Signs of Gallbladder/Liver Pain
- Location: Typically experienced under the right scapula and shoulder [1, 4, 5].
- Accompanying Symptoms: Abdominal pain (especially after eating fatty foods), nausea, vomiting, and jaundice may be present [1].
- Triggers: The pain can be constant or come in waves, sometimes after consuming fatty meals [1].
Pancreatic Issues and the Scapula
The pancreas, located in the abdomen, can cause referred pain to the left scapula [1, 4]. This is due to its location and nerve connections [1, 4]. Pancreatitis, an inflammation of the pancreas, can cause severe back pain that may include the scapula area [1, 4].
Signs of Pancreatic Pain
- Location: Pain often spreads from the upper abdomen to the back, potentially under the left scapula [1, 4].
- Accompanying Symptoms: Severe upper abdominal pain that might worsen when lying flat, nausea, vomiting, and fever are possible symptoms [1].
- Note: Severe pancreatic pain requires immediate medical evaluation [1].
Lung and Chest Cavity Disorders
Conditions affecting the lungs and chest lining, such as pneumonia, pulmonary embolism, or lung cancer, can cause referred pain to the scapula [1, 4, 5]. Irritation of the pleura, the lining of the lungs, can result in sharp pain that might be felt in the upper back or shoulder blade [1, 4, 5].
Signs of Lung-Related Pain
- Location: Pain can occur in either the right or left scapula area, depending on which lung is affected [1, 4, 5].
- Accompanying Symptoms: Shortness of breath, coughing, fever, and chest pain that worsens with deep breaths are potential signs [1, 4, 5].
Comparison of Organ-Related Scapula Pain
| Organ System | Location of Referred Pain | Common Accompanying Symptoms | Urgency Level |
|---|---|---|---|
| Heart | Left scapula, arm, neck, jaw | Chest pain, shortness of breath, sweating | Emergency |
| Gallbladder | Right scapula, right shoulder | Abdominal pain (post-fatty meal), nausea | High |
| Lungs | Either side, upper back | Shortness of breath, cough, fever | High |
| Pancreas | Left scapula, upper abdomen | Severe abdominal pain, nausea | High |
| Musculoskeletal | Localized to affected muscle/nerve | Soreness, stiffness, limited movement | Non-Emergency (typically) |
When to Seek Medical Attention
While musculoskeletal issues are the most frequent cause of scapula pain, it is important to recognize signs that might indicate a more serious condition [1, 2, 3]. If you experience sudden, severe, unexplained scapula pain, especially with symptoms like chest pain, shortness of breath, dizziness, or abdominal pain, seek immediate medical attention [1]. Prompt evaluation is crucial to rule out serious conditions such as a heart attack or pulmonary embolism [1].
In summary, referred pain to the scapula can originate from several organs, including the heart, gallbladder, lungs, and pancreas [1, 4, 5]. The location and accompanying symptoms are crucial for diagnosis [1, 4]. A medical evaluation is necessary to distinguish between common musculoskeletal issues and referred pain from internal organs [1, 2, 3]. Always consult a healthcare professional for diagnosis and treatment [1, 2, 3]. For more information on referred pain, consult the {Link: National Institutes of Health https://www.nih.gov/}.
