Pain between the shoulder blades is common. Doctors refer to this discomfort as interscapular pain.
People with shoulder blade pain typically have aching, dull, sore, or shooting pain in the upper part of their back between their shoulder blades.
Most of the time, shoulder blade pain isn’t anything to worry about. But in some cases, it can be a sign of a more serious condition.
Keep reading to learn more about this common problem and how it can be treated or prevented.
There are many possible causes for pain between your shoulder blades. An injury to a muscle or a tendon around the shoulder blades is a common reason for this type of pain. More serious causes are also possible.
Read on to learn about the possible causes of shoulder pain.
Muscle strains can result from:
- poor posture
- heavy lifting
- working at a computer for extended periods of time
- other activities, even during sleep
Injuries to other parts of your body can also lead to pain between your shoulder blades. These injuries might include:
- rotator cuff tears
- spine fractures
- shoulder dislocation
- other injuries that cause trauma
Other causes of shoulder blade pain might include:
- degenerative disc disease, or a herniated or bulging disc in the spine
- osteoarthritis in the joints around your neck, spine, or ribs
- spinal stenosis, or a narrowing of your spinal cord
- acid reflux
- myofascial pain syndrome
- certain cancers, such as lung cancer, lymphomas, liver cancer, esophageal cancer, mesothelioma, and cancers that spread to bones
- nerve compression
Some sudden events that cause shoulder pain require emergency care. These can often cause severe pain, but not always. Such conditions include:
- Heart attack. Shoulder blade pain is sometimes a symptom of heart attack, especially among women. Other signs, such as chest pain and shortness of breath, may also be present. Seek emergency medical treatment if you experience these symptoms.
- Aortic tear. Thoracic aorta rupture, or aortic dissection, occurs when you have a tear or rupture in the inner layer of the aorta, which is a large blood vessel that branches off from your heart. This can cause a sharp, severe pain in your upper middle back. If this happens, call your local emergency services right away. An aortic tear is considered a medical emergency.
- Pulmonary embolism. People who are experiencing a pulmonary embolism report a sudden, sharp pain in their shoulder blades, often accompanied by shortness of breath. This can be the result of blood clots in their legs breaking off and traveling to their lungs. Get emergency medical help immediately if you think you have a pulmonary embolism.
The scapula, commonly called the shoulder blade, is a large flat, triangular bone midway up your back. You have two of them, one on each side of your back.
Around the scapula, and attached to it, is a network of muscles that support and maintain the scapula’s position. These muscles make it possible for you to move your arms.
When an injury or condition weakens or otherwise damages these muscles, the position of the scapula may change. This change in the position or motion of the scapula is called dyskinesis. It’s a common cause of shoulder blade pain.
There may be more serious causes of shoulder blade pain, such as heart attack, cancer, or blood clot. It’s important to see a medical professional for a diagnosis, especially if your pain is sudden or severe.
Symptoms of shoulder blade pain may include:
- pain, which may be either a dull ache or sharp, around the scapula
- weakness in the affected arm, especially when attempting overhead movements
- a limited range of motion that makes it difficult to raise your arm above your shoulder
- a snapping sound when you move your shoulder
- a visible projection of the scapula, called “winging”
- a tilted posture on your affected side
When you should see a doctor
You should see a doctor if your pain is severe, unusual, or doesn’t go away. Pain is a sign that something could be wrong. Your condition might not be serious, but it could be. If it’s bothersome in any way, you will want to get it checked out.
If your shoulder blade pain is accompanied by certain symptoms, it could mean you have a life threatening condition that requires prompt medical attention. Seek help right away if you have pain between your shoulder blades along with the following:
- shortness of breath
- chest pain
- excessive sweating
- pain, swelling, or redness in your legs
- coughing up blood
- rapid or irregular heart rate
- sudden difficulty speaking
- loss of vision
- paralysis on one side of your body
- loss of consciousness
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TreatmentTreatment for your shoulder blade pain will depend on the cause and severity of your condition. Recovery time will vary from person to person.
Home remediesSome people find relief from shoulder blade pain with therapies performed at home.
Exercise can help strengthen areas in your back, which may help lessen your shoulder pain.
A 2020 research review found that exercise therapy was as effective as a corticosteroid injection or shoulder decompression surgery in reducing shoulder pain.
It’s best to work with a physical therapist to reduce your shoulder pain through exercise. They will design a regimen of exercises specific to your particular condition. That way, you’ll know you are helping and not hurting your shoulder with the exercises you do. Your primary doctor may be able to refer you to a physical therapist.
Good exercises to strengthen muscles in your back and abdomen include:
Here are several basic exercises you can try to help strengthen your shoulder and back muscles. These exercises are recommended by the American Association of Retired Persons (AARP).
Shoulder blade squeeze
This exercise will help improve your posture.
- Stand up straight.
- Bring your elbows back and inward, pulling your shoulder blades down and back.
- Return to starting position.
- Work up to doing 3 sets of 10.
This is a shoulder stretch that will loosen muscles and help you become more limber.
- Stand upright with your arms feet shoulder-width apart and your arms straight down your sides.
- Move your arms around in big circles going forward. Be sure to keep your arms straight.
- After several reps, switch direction so you move your arms in a circle going backward.
- Work up to doing 15 to 20 reps in both directions.
This exercise is designed to strengthen your shoulders, back, and core muscles. The plank is a very common exercise recommended for many conditions, and it is sometimes done using the hands.
Try doing it on your elbows instead to help reduce shoulder strain.
- Lie on the floor facing down, with your elbows bent.
- Tighten your abdominal muscles as you lift your hips and knees off the floor.
- Hold for 30 seconds, then resume your starting position.
- Rest 30 seconds, then repeat the exercise.
- Gradually work up to 5 repetitions a day.
Yoga and other stretching techniques can improve circulation to your muscles and joints, which may offer better mobility and pain relief.
This shoulder stretch sometimes helps:
- Extend one arm out in front of you.
- With your other arm, pull the elbow of your outstretched arm toward your chest.
- Hold this stretch for about 10 seconds.
Certain foods can contribute to inflammation in your body that may worsen your symptoms. Avoid processed foods, and eat plenty of fruits and vegetables. Choosing foods high in omega-3 fatty acids, such as salmon, may also help.
RestSometimes, you just need rest to recover from your shoulder blade pain, especially if it’s the result of an injury.
Hot or cold therapy
Applying hot and cold compresses between your shoulder blades may relieve discomfort. Typically, it’s best to use them for 15 minutes at a time, every few hours.
TherapyMassage or physical therapy may provide relief in many cases, especially if the pain is caused by overuse of your muscles or joints, or an injury.
Massage therapyA massage therapist can work on areas between your shoulder blades to relax muscle tissue. You can also purchase handheld massage devices to use at home.
Physical or occupational therapyIf you have an injury or a compressed nerve, your doctor might recommend physical or occupational therapy. A therapist will help you perform certain exercises that may improve symptoms.
Certain medications can help relieve pain and discomfort between your shoulder blades. These may include various anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB).
Sometimes, steroids are given as a pill or injection to help with pain and inflammation. These are corticosteroids, which are different from anabolic steroids used to strengthen muscles.
Muscle relaxers and certain antidepressants are also sometimes prescribed for pain management of conditions involving the shoulder blades.
Surgery is only rarely required to resolve shoulder problems.
According to the American Academy of Orthopaedic Surgeons (AAOS), the large majority of people with shoulder blade pain respond to nonsurgical options, such as a change of activities, rest, exercise, and medications.
Surgery is usually reserved for cases involving:
- severe shoulder blade pain
- non-responsiveness to more conservative treatment
- severe arthritis
- shoulder blade fracture
- injuries treatable by surgery
If your doctor does recommend surgery, it may involve removing scar tissue or repairing tendons in your shoulder or upper back area. Shoulder replacement surgery may also be considered.
Diagnosis will begin with your doctor discussing your medical history and symptoms with you. They’ll then do a physical examination in which they examine your shoulder and scapula to find areas of weakness, tenderness, or tightness.
Your doctor may also perform tests of your muscle and resistance strength to pinpoint the source of your shoulder blade disorder.
They may also prescribe imaging tests such as:
- CT scan
- MRI scan
Your doctor may refer you to a specialist such as a neurologist or an orthopedist for a further diagnosis and specialized treatment.
Tips for prevention
The following measures may help prevent shoulder pain injuries and pain.
- Maintain good posture. Good posture is one of the best preventive measures for shoulder issues. Stand tall, sit erect, and avoid slouching. You might invest in ergonomic workplace items such as chairs and pillows to assist you.
- Sit only for short periods. Stretch frequently and get up for frequent breaks when you’re working at a computer or desk. This will help keep your muscles limber. A standing desk is a good option.
- Be careful when you lift. Lifting heavy items can sometimes cause injuries. When you do lift an item, bend your knees first and do not strain when you lift. Avoid lifting overly heavy items.
- Warm up first. Always do light stretching as a warmup before a workout or exercise period. This will prime your muscles for activity and help avoid injury.
- Maintain a healthy lifestyle. Eat a nutritious diet, get sufficient sleep, and exercise regularly. Find ways to manage stress and keep a positive attitude. These practices will help you feel rested and better able to keep physically and mentally fit.
The outlook of your condition will depend on what’s causing your shoulder blade pain and the severity of your condition.
Most of the time, pain between the shoulder blades is a temporary ailment that will go away with rest and proper treatment.
Although discomfort can linger for some people, your doctor and physical therapist will help you find ways to manage pain and treat your condition.