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Pain between shoulder blades

Pain Between Shoulder Blades

Interscapular pain, also known as the pain between shoulder blades, is characterized by sore, aching, dull, and shooting pain. Pain between shoulder blades makes it difficult to use the affected arm and interferes with daily activities. The pain can cause mild discomfort to a burning or sharp pain between the shoulder blade and spine or a tender pain across the upper back or shoulder [1].

In most cases, pain between the shoulder blades occurs as a result of poor posture, standing or sitting for a long time, and muscle strain. However, muscle, joint, or bone injuries do not always cause shoulder blade pain. Sometimes, interscapular pain can be a symptom of something more serious, such as arthritis, gallbladder disease, heart attack, or even shingles.

A lady with pain between shoulder blades

What’s the Anatomy of Back Pain Region?

The shoulder blade or scapula is a large triangular bone lying in the upper back and forming the back of the shoulder. Sometimes, there are one or more structures between the shoulders that cause pain between shoulder blades.

The shoulder blades contain the following structures:

  • The middle and lower trapezius muscles and the rhomboids. Both these muscles keep the shoulder blades back and down [2].
  • The thoracic spine and the thoracic aorta
  • Part of the heart
  • Part of the oesophagus
  • A portion of the lungs

What Are the Possible Causes of Back Pain Between Shoulder Blades?

Problem to any of the structures of the shoulder blades can cause pain between shoulder blades. Some possible causes of this pain include:

1. Muscle Strain:

A muscle strain is the most common cause of interscapular pain. Muscle strains often feel like a pulled muscle. A muscle strain can be the result of the following:

  • Lifting heavy objects
  • Sleeping on an unsupportive mattress or pillow
  • Sports injuries
  • Muscle overuse
  • Standing or sitting in an uncomfortable position for prolonged periods.
  • Poor posture [3].

Injuries of the rotator cuff muscles (rotator cuff tears) may also cause shoulder blade pain, resulting in difficulty moving the shoulder or arm.

2. Trauma:

Muscle trauma of the interscapular region occurs as a result of a blunt or direct force, such as vehicular accidents, falling or contact sports. Trauma results in bruising, inflammation, and pain in the affected area. Severe injuries, including spine fractures and joint separation, exert pressure on the muscles of the shoulder blades. This leads to tension build-up and severe tissue damage, resulting in intense pain between shoulder blades.

3. Herniated Disc:

The intervertebral discs are the cartilage cushioning of the spine and are made up of a tough exterior and a soft interior. An injury or trauma to the spine can cause the disc bulging, also referred to as herniated, bulging, or slipped disc, leading to intense pain, numbness, compressed nerves, inflammation, and tingling in the arms and shoulders.

Moreover, degenerative disc disease in the cervical or thoracic spine region can also manifest as back pain between the shoulders due to pinched nerves. This happens because of pressure or nerve-spine irritation and can cause severe pain.

4. Scoliosis:

In scoliosis, the spine has an unnaturally sideways curve that causes the hips and shoulders to look uneven. A curved spine causes muscle spasms, deformities, and pain between shoulder pain.

Other causes of pain between shoulder blades include:

  • Nerve compression
  • Shingles
  • Acid reflux
  • Arthritis
  • Osteoarthritis
  • Myofascial pain syndrome
  • Gallbladder disease
  • Pulmonary embolism
  • Heart attack
  • Fibromyalgia
  • Spine stenosis [4].

5. Pulmonary embolism:

Pulmonary embolism is also a potential respiratory condition that can lead to severe upper back pain between shoulder blades. It is a life-threatening condition. Some patients experience abrupt, sharp pain between shoulder blades. This happens when the blood clots present in the legs break off and gets mobilized and reaches the lungs. Characteristic symptoms of such conditions include shortness of breath – a hallmark of pulmonary embolism. It is crucial to seek immediate medical attention from healthcare professionals as pulmonary embolism can be a life-threatening medical emergency if ignored.

6. Heart Attack

Heart attacks don’t always start with chest pain. In a clinical study, it was found that 3% of people with heart attacks had pain limited to the region between the shoulder blades. The pain is often accompanied by shortness of breath, chest pain, and, lightheadedness. Numerous heart conditions can present with pain between the shoulder blades, such as aortic dissection. In aortic dissection, your body has a rupture or tear in the large blood vessel that branches off your heart.

7. Others

Moreover, if your pancreas is inflamed, you may also cause this type of pain. This happens because of the irritation of the underside of your diaphragm.

How Is Back Pain Between Shoulder Blades Diagnosed?

Typically, your healthcare provider does a physical exam and takes a careful history to diagnose interscapular pain. A patient’s history can diagnose many causes of shoulder blade pain. However, the physical exam alone cannot diagnose the cause of pain between shoulder blades.

The following are some questions that a healthcare provider may ask:

  • How severe is the pain?
  • What makes the pain worse or better?
  • Is the pain dull, aching, or burning?
  • Have you experienced any injury or trauma?
  • Do you have any family history of heart disease?
  • Have you ever smoked?
  • How the pain starts gradually or suddenly?

You should see your doctor if you have shoulder blade pain accompanied by the following symptoms:

    • Shortness of breath
    • Impaired vision
    • Lightheadedness and dizziness
    • Chest tightness
    • Difficulty speaking
    • Irregular heartbeat
    • Excessive sweating
    • Loss of consciousness
    • Paralysis
    • Redness or swelling of the legs and feet
    • Coughing up blood
    • Fever

A lady with back pain and pain between shoulder blades

What Are The Treatment Options For Upper Back Pain Between Shoulder Blades?

The following are some simple treatment options for alleviating interscapular pain:

1. Stretching:

Gentle stretching and yoga can improve blood circulation, relieve shoulder pain, and ease tension in the shoulders, resulting in better mobility [5]. The following is one easy stretch:

  • Crossing one arm over the body
  • Pulling the elbow of the overstretched arm by using the other arm towards the chest
  • Holding the stretch for 5-10 seconds.

2. Exercise:

Exercise strengthens the areas of the back and shoulder blades to facilitate faster recovery from pain and muscle strains. Some good exercises include situps, pullups, and pushups that gradually improve strength in the shoulders.

3. Hot or Cold Compresses:

Another useful method to relieve the discomfort is applying hot and cold compresses to the shoulder blades. Hot and cold compresses can be used every four hours for 15 minutes.

4. Medications for upper back pain between shoulder blades:

Certain medications, such as ibuprofen, can offer pain relief but they aren’t a long-term fix.

5. Prolozone Therapy

If the above treatment options aren’t working, then Prolozone Therapy is the most effective long-term solution available. It involves the injection of a concentrated form of oxygen, alongside anti-inflammatory plant extracts. It has been shown in studies to stimulate collagen production. Collagen cells are the building blocks to all the structures that cause pain between the shoulder blades.

For more information. Please visit the Prolozone page of our website, you can find this on the home page.

Prevention of pain between shoulder blades:

The following are some tips to prevent common causes of pain in the upper back, neck, and between shoulder blades:

  • Adopting health habits, including exercising 4-5 times a week, sleeping for 7-8 hours, and eating a healthy diet.
  • Not sitting for long periods of time.
  • Avoid heavy lifting as it can sprain your ligaments.
  • Not lifting heavy objects (as it can lead to injuries).
  • Practising good posture.


In most cases, pain between the shoulder blades is temporary that goes away with proper treatment and rest. If you have interscapular pain along with other symptoms, you should consult your healthcare provider for professional medical advice. Practising good posture, exercising, stretching, and a balanced diet can further ease the pain.


  1. Haydar AA, Morgan-Hughes G, Roobottom C. Investigating severe interscapular pain. BMJ 2008;337:a688. https://doi.org/10.1136/bmj.a688.
  2. Fennell J, Phadke CP, Mochizuki G, Ismail F, Boulias C. Shoulder Retractor Strengthening Exercise to Minimize Rhomboid Muscle Activity and Subacromial Impingement. Physiother Canada 2016;68:24–8. https://doi.org/10.3138/ptc.2014-83.
  3. DeVon, H. A., & Noureddine, S. (2014). 20 things you didn’t know about women and heart disease. The Journal of cardiovascular nursing29(5), 384–385. https://doi.org/10.1097/JCN.0000000000000129
  4. Brandt M, Sundstrup E, Jakobsen MD, Jay K, Colado JC, Wang Y, et al. Association between Neck/Shoulder Pain and Trapezius Muscle Tenderness in Office Workers. Pain Res Treat 2014;2014:352735. https://doi.org/10.1155/2014/352735.
  5. Lollino N, Brunocilla PR, Poglio F, Vannini E, Lollino S, Lancia M. Non-orthopaedic causes of shoulder pain: what the shoulder expert must remember. Musculoskelet Surg 2012;96:63–8. https://doi.org/10.1007/s12306-012-0192-5.
  6. Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther 2012;7:109–19.
  7. Galland L. Diet and Inflammation. Nutr Clin Pract 2010;25:634–40. https://doi.org/https://doi.org/10.1177/0884533610385703.

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