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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 a sore, aching, dull, and shooting pain. Shoulder blade pain makes it difficult to use the affected arm and interferes with daily activities. The pain can cause dull ache to a burning or sharp pain between the shoulder blade and spine or a tender pain across the upper back or shoulder [1]. It may also be associated with neck pain, due to the strain muscles.

In most cases, shoulder blade pain is the result of poor posture, heavy lifting, standing or sitting for a long periods, pinched nerve, muscle strain or a sports injury affecting back muscles. However, muscle, joint, and bone injuries do not always cause shoulder blade pain.

You might also be interested in: How to fix shoulder pain

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 shoulder pain.

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 severe pain between shoulder blades. Some possible causes of this upper back 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 with placing neck forward [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 upper back pain – or more specifically shoulder blade pain.

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 to bulge, often referred to as a herniated, bulging, or slipped disc. This can lead to intense pain, numbness, compressed nerves, inflammation, and a 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, and it can happen due to pressure or nerve-spine irritation.

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 the shoulder.

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].
  • Thoracic Aorta rupture

7. Others

Additionally, if your pancreas is inflamed, you can experience this type of pain, because of the irritation of the underside of your diaphragm which leads to pain between the shoulder.

How Is Back Pain Between Shoulder Blades Diagnosed?

Your healthcare provider will perform a physical exam and assess your history carefully to diagnose interscapular pain. A patient’s history can diagnose many causes of shoulder blade pain, perhaps even more so than the physical examination.

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

  • How severe is the pain between the shoulder?
  • What makes the shoulder pain worse?
  • What helps alleviate pain?
  • 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 reduce pain and muscle strains. Some good exercises include sit-ups, pullups, and push-ups that gradually improve strength in the shoulders.

3. Hot or Cold Compresses:

Hot and cold compresses can be applied to the shoulder blades every four hours for 15 minutes to help reduce pain.

4. Diet:

Chronic pain between shoulder blades can better be alleviated by an anti-inflammatory diet. Eating a diet rich in leafy greens, omega 3s, fruits, legumes, and beans can be useful [6].

5. Massage Therapy:

Physical therapy or massage from a licensed physical therapist or massage therapist can relax and heal muscle tissue and reduce shoulder blades pain. It can help strengthen muscles and improve arm movements that were previously causing pain. This physical therapy is particularly beneficial if the pain is due to the overuse of your shoulder joint or upper back muscles. Physical therapist may also recommend it for other causes of upper back, spinal cord and lower back pain.

6. Medications for upper back pain between shoulder blades:

Certain medications, such as ibuprofen, can offer pain relief. Some medical professional also suggest steroids in the form of pills or injections, antidepressants, and muscle relaxants. These are usually recommended after a thorough medical history.

7. Prolozone Therapy

Some of the structures between the shoulder blades have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolozone Therapy involves the injection of oxygen and nutrients into these structures to provide a direct supply of what is needed to heal them and provide pain relief.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix. For more information about this treatment alongside video testimonials please click on the image below:

Collection of reviews

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.

Conclusion:

In most cases, upper back 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.

FAQs?

What does it mean when you have pain between your shoulder blades?

Pain between the shoulder blades can often be a sign of poor posture, often linked to shoulder and neck pain and tightness.

How do I know if my upper back pain is serious?

Upper back pain should be treated as serious if accompanied by a fever, the pain affects everyday activities or the pain requires daily medication.

How do you relieve pain between your shoulder blades?

The acute injury will find relief with the ice, rest and massage.

References

  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 nursing, 29(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.

Other complications:

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 mild discomfort and 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 cause the individual to feel pain at the upper middle back, 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

Sometimes, interscapsular pain can be a symptom of something more serious, such as arthritis, myofascial pain syndrome, gallbladder disease, heart attack, esophageal cancer or even shingles.

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