Discover everything you need to know about pain between the shoulder blades (interscapular pain), its common causes, and the most effective treatments, including an advanced therapy called Prolotherapy.
Interscapular pain refers to discomfort between your shoulder blades. This pain may range from a dull ache to sharp or burning sensations. It can make arm movement difficult and interfere with daily activities. Often, it may also be associated with neck pain due to muscle strain.
Common causes include poor posture, heavy lifting, prolonged sitting or standing, pinched nerves, muscle strain, or sports injuries affecting the back muscles. However, not all shoulder blade pain is due to muscle, joint, or bone injuries.
Anatomy of the Shoulder Blade and Upper Back
The shoulder blade (scapula) is a triangular bone in the upper back forming the back of the shoulder. Several structures around the scapula can cause pain, including:
- Middle and lower trapezius muscles and rhomboids, which stabilize the shoulder blades
- The thoracic spine and thoracic aorta
- Parts of the heart, oesophagus, and lungs
Common Causes of Pain Between Shoulder Blades
Pain in this area can stem from injuries or conditions affecting muscles, bones, nerves, or internal organs. Key causes include:
1. Muscle Strain
The most common cause of interscapular pain. Muscle strain may result from:
- Lifting heavy objects
- Poor posture or sitting for long periods
- Sports injuries or overuse
- Sleeping on unsupportive mattresses or pillows
Rotator cuff injuries can also cause shoulder blade pain, restricting arm movement.
2. Trauma
Direct injuries from falls, accidents, or contact sports can damage muscles, joints, or spine, leading to pain and inflammation.
3. Herniated or Degenerative Discs
Damage to the intervertebral discs can compress nerves, causing pain, tingling, or numbness in the shoulders and arms.
4. Scoliosis
An abnormal sideways curve of the spine can create muscle spasms and uneven stress, causing shoulder blade pain.
5. Pulmonary Embolism
A life-threatening condition where blood clots travel to the lungs, causing sudden sharp pain between the shoulder blades and shortness of breath.
6. Heart Problems
Sometimes, heart conditions like heart attacks manifest as pain between the shoulder blades, often accompanied by chest discomfort, shortness of breath, or lightheadedness.
7. Other Causes
- Shingles
- Acid reflux
- Arthritis or osteoarthritis
- Myofascial pain syndrome
- Gallbladder disease
- Fibromyalgia
- Thoracic aorta rupture
Diagnosis of Shoulder Blade Pain
Healthcare providers assess pain through a physical exam and patient history. Important questions include:
- When did the pain start, and how severe is it?
- What aggravates or relieves the pain?
- Have you experienced injury or trauma?
- Do you have a family history of heart disease or lifestyle risk factors?
Seek immediate medical attention if shoulder blade pain is accompanied by:
- Shortness of breath, chest tightness, or irregular heartbeat
- Dizziness, lightheadedness, or loss of consciousness
- Redness or swelling of legs/feet
- Coughing up blood or fever
Treatment Options
1. Stretching
Gentle stretching and yoga improve circulation and relieve tension. Example: Cross one arm over your body and gently pull the elbow toward the chest for 5–10 seconds.
2. Exercise
Strengthening back muscles reduces pain. Effective exercises include push-ups, pull-ups, and targeted back exercises.
3. Hot or Cold Compresses
Apply for 15 minutes every four hours to reduce inflammation and discomfort.
4. Diet
An anti-inflammatory diet rich in leafy greens, omega-3s, fruits, and legumes can help manage chronic shoulder blade pain.
5. Massage Therapy
Physical therapy or massage by licensed therapists relaxes muscles, improves mobility, and supports healing, especially for overuse injuries.
6. Medications
NSAIDs (like ibuprofen), muscle relaxants, or steroids may be prescribed after a thorough medical assessment.
7. Prolotherapy
This advanced treatment injects regenerative solutions into tissues with poor blood supply, stimulating collagen production and healing the root cause of pain. It is considered a long-term solution for chronic shoulder blade pain.
Prevention Tips
- Exercise regularly, sleep 7–8 hours, and eat a balanced diet
- Avoid prolonged sitting and heavy lifting
- Maintain proper posture
- Consider Prolotherapy for chronic upper back pain
Conclusion
Upper back pain between the shoulder blades is often temporary and treatable with proper care. If pain persists or comes with red-flag symptoms, consult a healthcare provider. Practicing good posture, exercising, stretching, and maintaining a healthy diet can reduce recurrence.
Frequently Asked Questions
What does it mean when you have pain between your shoulder blades?
Most commonly, it’s a muscle strain caused by poor posture, sports injuries, lifting, or sudden trauma. Other possibilities include shingles or spinal compression.
How do I relieve pain between my shoulder blades?
- Rest the upper back for 2–3 days
- Apply heat or ice
- Take anti-inflammatory medication if needed
- Massage the area
- Seek medical attention if pain persists
Can heart problems cause pain between shoulder blades?
Yes. Interscapular pain can be a sign of heart issues like a heart attack. Seek emergency care if accompanied by chest pain or shortness of breath.
When should I worry about shoulder blade pain?
Seek medical advice if pain worsens over a week, interferes with daily life, or comes with red-flag symptoms like weakness, swelling, dizziness, or chest discomfort.
What organs are behind the right shoulder blade?
The liver and gallbladder lie below the right shoulder blade, with the gallbladder storing bile essential for digestion.
References
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- DeVon HA, Noureddine S. J Cardiovasc Nurs 2014;29(5):384–385. https://doi.org/10.1097/JCN.0000000000000129
- Brandt M, et al. Pain Res Treat 2014;2014:352735. https://doi.org/10.1155/2014/352735
- Lollino N, et al. Musculoskelet Surg 2012;96:63–8. https://doi.org/10.1007/s12306-012-0192-5
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