Pain Between Shoulder Blades: Causes and Treatments

A dull ache between the shoulder blades, often referred to as interscapular pain, is fairly common. In most cases, this pain is a result of muscle strain brought on by poor posture or by sitting and standing in an uncomfortable position for a long period of time. For example, a day spent hunched over the computer can often result in pain in this area.

However, shoulder blade pain may not always be related to tendon, joint, muscle, or bone injuries. In some cases, interscapular pain can be caused by something more serious, such as a heart attack or gallbladder disease.

In our post, we outline some possible causes of pain in the upper back. Plus, we discuss possible treatments you can do at home to find relief, and when you should contact your doctor.

Causes

Muscle Strains

The most common cause of shoulder blade pain is straining the muscles or tendons in the upper back or in the cervical spine area. This strain can be the result of one of the following:

• Poor posture
• Sitting or standing in the same position for a prolonged period of time
• Lifting heavy objects
• Exercise or sports injuries (especially those that involve twisting)
• Sleeping on an unsupportive mattress

Trauma

A severe injury such as joint separation, rotator cuff tears, and spine fractures can put pressure on the muscles between the shoulder blades, leading to tension build-up. This trauma could be caused by a sports injury, car accident, or from excessive lifting.

Herniated or Bulging Disc

A herniated disc in the cervical or thoracic spine, also referred to as degenerative disc disease, can lead to intense back pain. Those with disc disease tend to experience pain that radiates down the arm and hands. However, pain can also start between the shoulder blades and at the base of the neck, especially when turning the head or bending the neck forward or backwards.

Other symptoms of a herniated or bulging disc include tingling, numbness, and weakness in the arms and hands.

SEE ALSO: Best Mattresses for Herniated Disc

Arthritis

Arthritis in the neck, ribs, or spine can lead to interscapular pain. In some cases, arthritis in the neck may manifest in the upper back first.

SEE ALSO: Best Mattresses for Arthritis

Fibromyalgia

Fibromyalgia causes chronic pain throughout the body. Typically fibromyalgia pain starts at the bottom of the neck and radiates down between the shoulder blades. If this pain is persistent and accompanied by fatigue, migraine, and nausea, you may want to talk to your doctor about fibromyalgia treatments.

Shingles

Shingles pain can manifest anywhere in the body depending on which nerves are affected. A rash will often appear near the source of the pain. If you experience sharp pains between the shoulder blades and notice a rash on the upper part of the back, it may be a sign of shingles.

Acid Reflux

Acid reflux, or Gastroesophageal disease (GERD), occurs when the muscles at the base of the esophagus relax and allow stomach acid to enter the esophagus. This leads to an uncomfortable, burning sensation in the chest. Frequent heartburn can cause interscapular pain, as well as hoarseness and difficulty swallowing.

Untreated GERD can make it difficult to sleep at night. Plus, it may be a sign of esophageal cancer. If you frequently experience symptoms of GERD, it is best to talk to your doctor. A medical professional will be able to prescribe something to relieve heartburn and, in turn, ease pain in the upper back.

SEE ALSO: Best Mattresses for Acid Reflux

Cancer

Lung cancer can also be a potential cause of persistent pain between the shoulder blades. This is especially true if Pancoast tumors develop. These tumors sit near the top of the lungs and typically spread to tissue near the ribs and vertebrae. If tumors grow, they can press on the nerves in the lungs and cause shortness of breath and sharp pains in the upper back.

Esophageal cancer, mesothelioma, lymphomas, liver cancer, and cancers that spread to the bones could also be a cause of pain in this region.

Nerve Compression

Nerve compression, also known as a pinched nerve, is another common cause of interscapular pain. Thoracic radiculopathy occurs when a nerve in the upper portion of the back becomes pinched. This can lead to sharp pains between the shoulder blades, as well as chest pain.

A compressed nerve in the neck is called cervical radiculopathy and often leads to weakness and loss of feeling in the arms and hands. This pain can also radiate down between the shoulder blades.

When the pinched nerve is the sciatic nerve in the lower body, this results in sciatica. Usually, sciatica affects only half of the body, so you might feel pain in one shoulder and similar pain in the arm and leg on the same side.

SEE ALSO: Best Mattresses for Sciatica

Gallbladder Disease

Nausea, vomiting, and sharp pains in the upper right portion of the abdomen are often a sign of gallstones or that the gallbladder is not functioning correctly. However, gallbladder disease can cause stabbing pains between the shoulder blades.

Heart Attack

Shoulder blade pain can be a sign of a heart attack, this is especially true for women. Studies show that women often experience cardiac pain differently than men. Instead of chest pain, women typically feel an achy, persistent pain between the shoulder blades. This pain may also be accompanied by shortness of breath, chest pain, dizziness, and lightheadedness.

Thoracic Aorta Rupture

A sudden, sharp pain in the upper back may also be a sign of aortic dissection or thoracic rupture. This happens when a tear or rupture occurs in the inner lining of the large blood vessel that connects to the heart. If you experience severe pain in the upper back, along with shortness of breath and abdominal pain, you should seek immediate medical attention.

Pulmonary Embolism

Blood clots in the legs that travel up to the lungs can cause a sudden and debilitating pain between the shoulder blades. This is called a pulmonary embolism and is often accompanied by shortness of breath, dizziness, lightheadedness, sweating, fever, swelling in the legs and feet, and clammy skin. If you suspect you have a pulmonary embolism you should seek emergency medical care.

When to See a Doctor

As you can see from our list above, some causes of shoulder pain may be serious, even life-threatening in some cases. If pain is persistent and causes disruption to your mobility or daily activities, it is a good idea to discuss your symptoms with your doctor.

If severe interscapular pain is accompanied by any of the following symptoms, it is important to seek medical attention right away.

• Dizziness and lightheadedness
• Shortness of breath
• Sweating
• Fever
• Swelling or redness of the legs and feet
• Coughing
• Rapid heartbeat
• Impaired vision
• Paralysis
• Loss of consciousness
• Difficulty speaking

Your doctor can help you determine the cause of shoulder blade pain and help you find the best treatment options. In some cases, physical therapy, surgery, or medication may be prescribed. See also our guide for sleeping after shoulder surgery.

Treatments

If your doctor determines that the source of your pain is not serious and requires a mild treatment plan, there are steps you can take at home to find pain relief. Below, we outline some simple ways to alleviate your interscapular pain.

Light Stretching

Gentle stretching techniques can help ease tension in the back muscles, improve circulation, and help relieve shoulder pain. These stretches also improve muscle function and joint mobility.

One easy stretch is to bring your right arm over your head and gently bend your neck to the right. You should feel a stretch on the left side of your neck. Hold the stretch for about 1 minute. Repeat the same stretch with your left arm.

Exercise

“Many people avoid exercise when dealing with shoulder pain, however, strengthening the muscles in the back and abdomen can facilitate a faster recovery,” says Dr. Bhavik Sheth, Physical Therapist. “Resistance band pull-aparts, and rowing are low impact exercises that can gradually improve strength without causing further strain to the area.”

Just be careful not to overdo it, as pushing too hard can negate the benefits of exercise.

Massage

Massage therapy can ease tension in the back muscles, allowing them to fully relax so healing can take place. If your massage therapist is aware of chronic or persistent pain in your shoulder blades, they can pay special attention to this area.

Rest on a Supportive Mattress

As we mentioned above, resting on an unsupportive mattress can cause the muscles between the shoulder blades to strain. If body weight is not evenly distributed throughout the night, you may end up in uncomfortable sleep positions that tense up the back muscles. Over time, this can lead to chronic upper back pain.

The best mattress for back pain is one that keeps the spine resting in a safe, neutral position so back muscles can fully relax and recover. When the spine is kept in alignment with the hips and shoulders and the joints are cushioned, you will experience deeper, more restorative sleep and wake with less pain.

If you’re a side sleeper, you may need to look at mattresses for shoulder pain, due to the unique stress side sleepers place on their shoulders and hips. Such mattresses typically have extra cushioning in these areas specifically tailored for side sleepers.

Diet

An anti-inflammatory diet can alleviate symptoms of chronic pain. A diet rich in fruits, vegetables, nuts, and legumes will be high in omega-3 fatty acids, which will naturally lower inflammation and pain in the body.

It is best to avoid foods with high fat and salt content, such as processed foods.

Heat and Cold Therapy

Applying hot or cold compresses to an injured area can relieve pain. However, what is the better treatment will depend on the exact injury.

If you have tense or tight muscles, applying a heated pad or standing in a warm shower can relieve achiness. If you have an injury, such as a rotator cuff injury, you will want to apply ice or a cold compress when the injury is fresh. After a few days, you can switch over to heating compresses. You will only want to use each for about 15 to 20 minutes every few hours.

Frequently Asked Questions

How should I sleep to relieve upper back pain?

Side and back sleeping are often the best positions to rest in if you are dealing with upper back pain.

When side sleeping, it is important that your mattress not be too firm, otherwise pressure points can form near the joints. A soft to medium firmness typically works best for side sleepers. When opting for a softer mattress, be sure the mattress does not cause excessive sinking. If the hips and shoulders too far into the bed, the spine may bow, leading to tension in the back.

When looking for a mattress for back sleepers, choose something with a medium to medium-firm comfort level tends to work best. This firmness will keep body weight evenly distributed, so no one area of the body sinks too far into the bed. This will keep the spine natural and alleviate tension in the back.

Does anxiety cause back pain?

Adults tend to carry stress in their shoulders. When we are anxious, these muscles tense and put pressure on the back, which can lead to pain. Feelings of emotional stress often lead to chronic pain in the shoulder blades. This is because emotional anxiety often affects the nerves and muscles that run through the neck and upper back.

“Anxiety or psychological stress has a profound impact on a person’s physical symptoms,” says Dr. Bhavik Sheth, Physical Therapist. “It is very common for neck and shoulder pain to be worse at times of high stress, and less symptomatic at times of leisure or pleasure.”

Is it okay to exercise with pain between the shoulder blades?

Yes! Exercising, stretching, and strengthening the muscles in the back can help to ease tension and pain. We recommend starting with light stretching and low impact exercises to build up endurance and reduce the risk of straining.

Can heartburn cause pain between the shoulder blades?

When stomach acid makes its way back into the esophagus, it can cause an intense burning in the chest. In some cases, a dull, aching pain can also radiate down from the neck and in between the shoulder blades. You can alleviate symptoms of acid reflux by avoiding spicy, fatty, or acidic foods, such as garlic, onions, tomatoes. Coffee and tea also have a high acid content that can trigger heartburn.

Sleeping on an incline can help reduce acid reflux at night so your sleep is not interrupted. You can do this by using a wedge pillow or an adjustable bed frame.

Is a heating pad good for upper back pain?

Yes! Hot and cold compresses can help to alleviate pain between the shoulder blades. You can use a heating pad for about 15 minutes and then switch to a cold compress for another 15 minutes. Doing this every 3 to 5 hours will keep swelling and inflammation down.

Usually, you will want to use cold compresses more when the injury is fresh, and use hot compresses as the injury has healed somewhat. However, if you’re unsure which is the better option, we suggest consulting your doctor.

Conclusion

In most cases, pain between the shoulder blades is a result of muscle tension and strain. Using our tips above, you can find relief and improve your mobility at home. Practicing good posture, changing your sitting and standing positions frequently, and avoiding heavy lifting can also help prevent upper back pain.

However, if you believe your shoulder pain is a result of something more serious, it is important to talk to your doctor or physical therapist right away.