There are several possible causes of pain below the left scapula: first, myofasciitis, patients with myofasciitis can experience pain on the inside of the scapula, often due to exertion or cold, then it is necessary to conduct relevant physical examination and related tests to exclude other diseases for early diagnosis and treatment; second, herpes zoster, in the early stages of herpes zoster can also occur pain on the inside of the scapula. Herpes can appear after 1-2 weeks of incubation period and should be diagnosed and treated in the dermatology department; third, rib diseases, when there is a tumor or metastasis in the ribs, pain can appear in the lower part of the scapula, which should be diagnosed by CT or ECT examination of the ribs; fourth, spinal diseases, when there is osteoporosis, compression fracture, or tumor or tuberculosis in the spine. Fourth, spinal diseases, when the spine has osteoporosis, compression fracture, or tumor, tuberculosis, can also appear below the scapula pain in the spine, then the spine X-ray, nuclear magnetic examination for diagnosis and treatment.