Symptoms and Clinical Manifestations of Scapular Pain

The most common symptom associated with various diseases is pain. If unexplained pain is experienced in the right scapula, it may be due to muscle damage or strain caused by external forces, or it could indicate issues with the bones or cellular tissues. If the pain in the right scapula does not show significant improvement in a short period of time, it is advisable to consult an orthopedic doctor to avoid conditions such as arthritis, fasciitis, and other related diseases.

Pain beneath the right scapula may be related to poor posture, exposure to cold, muscle strain in the scapular area, frozen shoulder, and cervical spondylosis. Therefore, when experiencing pain, it is essential to rest and maintain good posture in daily life while taking measures to keep warm and avoid cold exposure. Severe pain can be managed with non-steroidal anti-inflammatory and analgesic drugs, combined with heat therapy and physical therapy. Localized pain can also be treated with local injection therapy, which can effectively alleviate the pain. It is recommended to visit a hospital for a physical examination and radiological imaging to identify the cause of the pain and initiate targeted treatment.

Clinical Manifestations of Scapular Pain

1. Shoulder pain initially presents as episodic pain, often chronic, which gradually intensifies into dull or knife-like pain and becomes persistent. Changes in climate or exertion often exacerbate the pain, which may radiate to the neck and upper limbs (especially the elbows). Accidental collisions or stretching of the shoulder can cause tearing-like severe pain. A characteristic feature of this condition is that the pain is usually more severe during the night, often waking patients up in the middle of the night and preventing them from sleeping, especially when lying on the affected side. This condition is particularly evident in patients with blood deficiency. Those who experience pain due to cold exposure are particularly sensitive to changes in climate.

2. Limited range of motion: The shoulder joint may have limited range of motion in all directions, with outward rotation, upward lifting, internal and external rotation being particularly affected. As the condition progresses, long-term disuse can lead to adhesions in the joint capsule and surrounding soft tissues, resulting in gradual decline in muscle strength. Factors such as the fixation of the coracohumeral ligament in a shortened internally rotated position can further restrict both active and passive motion in all directions of the shoulder joint. This can make it difficult to perform activities such as combing hair, dressing, washing one's face, and placing hands on the hips. In severe cases, elbow function may also be affected, with the inability to touch the contralateral shoulder when bending the elbow, especially when extending the arm backwards.

3. Cold sensitivity: The affected shoulder is sensitive to cold, and many patients use padded shoulder wraps year-round, even during hot weather, as they dare not expose their shoulders to drafts.

4. Tenderness: Most patients can feel tender points around the shoulder joint, often located in the long head of the biceps tendon groove, the subacromial bursa, the coracoid process, and the attachment points of the supraspinatus muscle.

5. Spasm and atrophy: Early on, muscles around the shoulder, such as the deltoid and supraspinatus, may experience spasms. In the later stages, disuse atrophy may occur, resulting in prominent scapular spines, difficulty in lifting the arm, and limited backward bending. At this point, pain symptoms may actually decrease. There may be mild atrophy of the deltoid muscle and spasms of the trapezius muscle. Tenderness can be felt in the supraspinatus tendon, the long and short heads of the biceps tendon, and the anterior and posterior borders of the deltoid muscle. The most significant limitations in range of motion are usually observed in outward rotation, external rotation, and backward extension of the shoulder joint.