Female left shoulder back pain

There are many causes of left shoulder and back pain in women. Please note that this is because women have heart diseases, such as myocardial infarction and angina pectoris. Heart disease will pull the nerves in the back, causing back pain in patients. When women have left shoulder and back pain, they will experience difficulty breathing and insufficient blood supply. Therefore, it is best for women to undergo an electrocardiogram when they have left shoulder and back pain.

Once pain occurs in the left shoulder, especially when accompanied by pain in the shoulder and back, all doctors should consider the possibility of heart problems, such as acute myocardial infarction or angina pectoris, because these two problems will involve the nerves in the shoulder and back, causing the patient to experience shoulder and back pain. When Dr. Xie just graduated, my superior doctor, who is also my master, told me this: "When on night shift, if a patient complains of shoulder and back pain, as well as stomach pain, no matter how late it is or whether the patient has slept, you must ask a cardiologist to draw an electrocardiogram to rule out the possibility of myocardial infarction. If the patient is too sleepy, there may be big problems!"

Therefore, if you frequently experience left shoulder pain, please remember to get an electrocardiogram to rule out heart problems. It is also best to go to the hospital to make an appointment with the cardiology department and communicate with the cardiologist to find out whether there is any hidden danger.

Next, let’s talk about left shoulder pain caused by other problems such as cervical spine or rotator cuff.

Cervical disc herniation compressing the nerve roots can cause shoulder pain

When there is a herniated bone or bone hyperplasia in the cervical spine, which leads to bone marrow formation and compresses the nerve roots, shoulder pain will occur. This pain has a characteristic. Most of the time, it is like a tingling pain like an electric shock, and it is generally not correlated with shoulder movement. In other words, this pain exists no matter what angle the shoulder moves. On the contrary, this pain may be related to the movement of the cervical spine. For example, excessive backward tilt of the cervical spine or lowering of the head forward may stimulate the nerve roots and cause the pain to worsen.

Simply put, the pain is in the shoulders, but the problem is in the cervical spine!

If you suspect that the cervical spine is causing the shoulder pain, you need to undergo a cervical spine MRI to determine whether there is a cervical disc herniation or an abnormality in the bone structure that is causing nerve compression. If it is accompanied by shoulder or upper limb weakness, you may even need an electromyography test to determine whether the nerves are damaged. For treatment, you can choose acupuncture and appropriate traction. If the pain is severe, you can take oral analgesics and anti-inflammatory drugs. Since most of this pain causes edema of the nerve roots, you can take some anti-edema drugs orally. You can also undergo some physical therapies such as transcutaneous electrical nerve stimulation. Generally, there will be relief after systematic treatment. The acute phase may last for 1-2 weeks, and then gradually ease, which may take about three months. Therefore, patients must be mentally prepared and not be anxious. This kind of problem needs to be dealt with slowly.

Shoulder pain due to shoulder impingement

The general explanation of shoulder impingement syndrome is that due to problems with the bony structure of the shoulder joint, there is collision between bones during shoulder movement. Between the two bones are the rotator cuff and some soft tissues. These soft tissues are stimulated, causing aseptic inflammation, resulting in obvious pain. We call this situation shoulder impingement syndrome.

The characteristic of shoulder pain caused by hip impingement syndrome is that the pain is related to the movement of the shoulder joint (which can be distinguished from shoulder pain caused by the cervical spine), especially doing certain upper limb raising movements or abduction movements will cause pain. Some patients will hear a crackling sound in the shoulder when the pain is induced. In this case, it is often possible to determine whether there is a problem through an X-ray or MRI of the shoulder joint (as you can see in the picture below, the white arrow represents the bone hyperplasia of the acromion caused by impact, and the black arrow represents the bone hyperplasia of the greater tuberosity of the humerus that collides with the acromion).

Shoulder impingement syndrome can be treated by rest, intra-articular steroid injection, oral or topical medications, and strengthening shoulder rehabilitation exercises and muscles around the shoulder joint. If conservative treatment is ineffective and the factors causing shoulder impingement cannot be removed, shoulder arthroscopy may be required to remove the proliferating osteophytes.

Shoulder pain due to rotator cuff injury

The shoulder pain caused by rotator cuff injury is similar to shoulder impingement syndrome, and if shoulder impingement syndrome is too severe, it can also lead to rotator cuff tear.

Many people may not know what the rotator cuff is? After all, the rotator cuff is actually four relatively important tendons wrapped around the humeral head of the shoulder joint. These four tendons together make up the rotator cuff, also called the rotator cuff, which is of great significance for the movement of the shoulder joint (the picture below shows the four tendons that make up the rotator cuff).

Many factors such as trauma, overuse of the shoulder joint and shoulder impingement syndrome can induce rotator cuff tears, causing patients to experience obvious shoulder pain and limited range of motion.

The diagnosis of rotator cuff tear often requires an MRI examination of the shoulder joint. The picture below shows the MRI imaging manifestation of obvious rotator cuff tear and retraction.

For shoulder pain caused by this situation, conservative treatment often does not have a particularly good effect, and what is needed is rotator cuff tear suture surgery under shoulder arthroscopy.

The acromioclavicular joint is also a part of the shoulder joint and plays a very important role in the movement of the shoulder joint. However, it causes the cartilage of the acromioclavicular joint to degenerate, leading to the formation of secondary bone spurs and osteoarthritis, which causes pain in the patient's shoulder during upper limb movement.

This joint also plays an important role in the stability of the shoulder joint, so we generally adopt conservative treatment, such as oral or topical medications, or intra-articular steroid injections and shock wave therapy, which have good therapeutic effects.

Other factors

The above is a brief introduction to the diagnosis and treatment of left shoulder pain that excludes myocardial infarction or angina pectoris. If you have other questions, you can leave a message below and we can discuss it together. However, we also need to consider some uncommon situations. For example, the cause of left shoulder pain may be lung cancer on the left side. This situation is more common in a relatively rare cancer, which we call superior pulmonary sulcus cancer (accounting for 5% of lung cancer). When the cancer grows silently, it does not induce special symptoms, nor does it cause the patient to cough or sputum. When the tumor breaks through the surface of the lung and stimulates the chest wall, it will cause shoulder pain and back pain in the patient. Data show that nearly 16% of patients with superior pulmonary sulcus cancer have shoulder pain as the first symptom.

Never take shoulder pain lightly. You must go to the hospital for relevant examinations. As a doctor, you should also think more and consider more, try to rule out some serious problems that may induce shoulder pain, and do your best to avoid misdiagnosis that affects the patient's treatment. Personally, I think it’s not excessive for doctors to think more. Even if the consideration is excessive, it is better than misdiagnosis!