Pain below the right shoulder blade has many potential causes, and some are more serious than others. Attempts at self-diagnosis are risky, and you should see a doctor for pain that does not go away, gets worse or comes and goes. Causes range from muscle strain to infections, fractures and tumors.
Muscle and Bone Pain
The most common sources of pain near the shoulder blade are the muscles and bones that lie under and around it. Muscle pain is most often due to straining during exercise or sports, although any sudden movement -- such as a cough -- may bring on the pain. These pains are usually made worse by repetition of the causative action. Fractures in the spinal column or in a rib can cause pain below the shoulder blade, and they are usually the result of a fall or significant impact. Rare tumors of muscle and bone begin in this region, and cancer may spread from other organs, such as the skin, breast and lung.
The right kidney lies directly in front of the tip of the shoulder blade. Right kidney pain may be due to a kidney stone, severe infection or tumor. Kidney stone pain is typically colicky in nature and may be severe enough to cause fainting. Movement does not make stone pain worse. Pain from infection is constant and made worse when the doctor taps lightly with a fist. Tumor pain is continuous and usually increases with time.
Pain From Abdominal Sources
The brain perceives pain from the gallbladder or liver as coming from the right shoulder blade, because the nerves for sensation in these organs enter the spinal cord at the same level. Gallbladder disease is usually accompanied by intolerance of certain foods and nausea with or without vomiting. Tumors and abscesses of the liver may cause similar pain, but it will not be associated with food or nausea. Aneurysms are weaknesses in the wall of blood vessels, and aneurysms in kidney or pancreas vessels will cause pain near the right shoulder blade when they leak or rupture.
Pneumonia and blood clots in the right lung may cause pain below the shoulder blade, usually made worse by deep breaths. An unusual complication of pneumonia is lung abscess, which causes constant pain associated with spiking fevers. Lung cancer may also cause pain below the shoulder blade that is not affected by movement and may be worse at rest than in motion.
If you have had chickenpox, you are at risk for getting shingles. The virus that causes chickenpox lives in your nerves and can be reactivated, causing a moderate to severe pain that ordinarily precedes the development of a rash. Shingles can occur virtually anywhere in the body, including below and around the shoulder blade. A vaccine (Zostavax) reduces your chance of getting shingles.