Understanding Pain Between the Shoulder Blades

Experiencing a deep, sharp or burning sensation between the shoulder blades is common. This type of pain, interscapular pain, may leave you wondering about its origins. Such discomfort in the shoulder blade area often arises from muscle strains or overextensions, mainly due to poor posture or prolonged periods in uncomfortable positions.

Shoulder strain can lead to pain and tension in the surrounding areas, affecting the upper back. For instance, hours hunched over a computer can lead to neck or upper back pain, sometimes manifesting as a sharp sting under either the right or left shoulder blade.

While muscle strain and posture issues are common culprits, it’s important to note that the cause of shoulder blade pain isn’t always musculoskeletal. Given its location, the pain could indicate more severe conditions, like a heart attack or gallbladder disease, which necessitate urgent medical care.

Keep reading to discover the prevalent causes of upper back pain, explore potential home remedies to alleviate discomfort, and highlight when it might be a good idea to consult a physician for expert medical help.

The Muscle Behind the Pain: The Rhomboids

The rhomboid muscles adduct (move toward the midline), elevate the scapula, and stabilize it in the retracted position. They are active in both forward and backward arm swings when walking, and if the rhomboids have trigger points, you will experience shoulder blade pain.
The rhomboids are less likely to develop trigger points than other shoulder girdle muscles, such as the levator scapula, supraspinatus, and trapezius.
ALT=pain under your shoulder blade could be caused by the rhomboid muscle

Symptoms of Rhomboid Trigger Points

If you do have rhomboid trigger points, symptoms include superficial aching shoulder pain at rest that doesn’t seem to get worse with any movement. The rhomboid muscle causes referred pain underneath the shoulder blade. You won’t feel too much pain in the actual shoulder joint. You will likely have pain between the shoulder blade and spine, sometimes even severe shoulder blade pain.
If you are feeling pain in your upper arm bone area, this is likely caused by a different muscle. It is not uncommon for multiple muscles to have trigger points at once.

What Are The Possible Causes of Pain Under the Shoulder Blades?

Many things can cause pain under the shoulder blade. You can get trigger points in the rhomboids by being in a sustained stretch position, the round-shouldered posture caused by tight pectoralis muscles.  Repetitive activities, like lifting weights, vacuuming, or scrubbing the bathtub, also cause pain near your shoulder blade.
If you hear snapping and crunching noises during the movement of the scapula, it may be because of trigger points in the interscapular area. [If you think its frozen shoulder, read this]
man grabbing his shoulder from pain

How to Alleviate Upper Back & Shoulder Pain – Treatment Options

It is imperative to fix a round-shouldered posture to avoid severe shoulder pain. You must elongate the pectoralis muscles and strengthen the rhomboids and trapezius to fix your poor posture.
A lumbar pillow can help correct round-shouldered posture and prevent shoulder and lower back pain. Avoid any chair that pushes the shoulders forward. Also, set a timer so that you get up from your chair every 20-30 minutes to get the blood pumping back into the muscles.
You can use a tennis or lacrosse ball placed on the floor to relieve rhomboid pain. (shown in the video below). The pressure is centered on a tender spot until the tenderness dissipates, which could be up to a minute. When you get up, you should notice your upper back pain has lessened. [7 Tips for Shoulder Blade Pain]
I am including a video of rhomboid stretching exercises in this post. This should only be used when your rhomboids hurt from being in a shortened position, such as lying on one side too long.

5 Ways Chiropractors Relieve Their Own Back Pain

Alternative Causes of Pain Under Your Shoulder Blade

Here is a list of possible reasons you could have upper back or shoulder pain:

Bulging or Disc Herniation

Disc herniation occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior casing. This can irritate nearby nerves, leading to pain radiating to other body parts, including the area between the shoulder blades. Disc herniation in the thoracic or cervical spine is more likely to cause upper back problems.

Spinal Misalignment

Another possible reason for pain in this area is misalignment of the spine. This condition may arise due to several factors, such as:

  • Sustaining an injury from incidents like falls or vehicular collisions
  • Maintaining poor posture
  • Sleeping in a position that doesn’t support the spine properly
  • Performing repetitive movements

This type of misalignment can lead to pain in the area between the shoulder blades or in the neck.


Arthritis refers to the swelling and tenderness of one or more of your joints. Intrascapular pain usually refers to osteoarthritis of the thoracic spine. As the cartilage wears down, bones can rub against each other, causing pain and stiffness in the back.


A disorder characterized by widespread musculoskeletal pain, fibromyalgia can lead to tenderness and pain in the upper back area. Its exact cause remains unknown, but it’s believed to involve various genetic and environmental factors.


Caused by the same virus responsible for chickenpox, shingles can lead to a painful rash that often appears as a single stripe wrapping around the body’s left or right side. The pain can sometimes be felt between the shoulder blades.

Acid Reflux

Acid reflux, or gastroesophageal reflux disease (GERD), occurs when stomach acid frequently flows back into the esophagus. This can lead to a burning sensation in the chest and, occasionally, pain near the shoulder blades.

Nerve Compression

Compression or a pinched nerve, often due to herniated spinal discs or bone spurs, can cause pain in the upper back.

Gall Bladder Infection

Gallstones or inflammation of the gall bladder can sometimes cause pain that is felt between the shoulder blades or under the right shoulder.

Heart Attack

While chest pain is the most common symptom of a heart attack, some people may experience pain in the back shoulder blade area, especially women.

Thoracic Aorta Rupture

This heart condition refers to a tear or rupture in the aorta, the main vessel supplying blood to the body. It can lead to severe internal bleeding and is often caused by traumatic injuries.

Pulmonary Embolism

A blockage in one of the pulmonary arteries in the lungs, usually due to blood clots, can result in chest pain that may also be felt between the shoulder blades.

Shoulder Joint Bone Spurs

Bone spurs are bony projections that develop along bone edges, often in joints. If they form in or around the shoulder joint, they can cause pain in the shoulder region, which might radiate toward the scapula.

Aortic Dissection

A serious condition where the large blood vessel branching off the heart tears. This can cause sharp or burning pain down into the shoulder and requires immediate medical attention.

Compression Fractures

A fracture of the scapula may cause pain in the shoulder blade region

When To See A Doctor

As we see from our list above, some causes of shoulder pain may be serious, even deadly. If severe pain persists and interferes with mobility or regular activities, see a doctor for relief.

If you experience any of the following symptoms and a burning sensation between shoulder blades, you should visit a doctor immediately.

  • 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
  • Trouble speaking

Shoulder pain can be a debilitating and frustrating experience, ranging from sharp and acute pain behind the left shoulder blade to tightness between the shoulder blades to chronic pain. The cause of the pain can be linked to both the thoracic and cervical spine and can include poor posture, muscle tension, structural changes, and strain.

Shoulder pain treatment can include physical therapy, massage, chiropractic adjustments, and lifestyle changes. If the pain is persistent or severe, it is important to seek medical attention, as the cause may need to be evaluated and diagnosed.

repetitive strain can put undue pressure on the shoulder blade muscles

Prevention and Maintenance For Shoulder Blade Pain

Understanding the causes and treatments of shoulder blade pain is essential, but preventing the pain or its recurrence is equally crucial. Here are some preventive measures and daily habits you can adopt:

  1. Ergonomics at Work: Ensure your workspace is ergonomic. Your computer screen should be at eye level, and your keyboard and mouse should be positioned so your elbows are at a 90-degree angle. This can prevent strain on your upper back and provide some pain relief.
  2. Regular Exercise: Engage in exercises that target and strengthen the upper back, shoulders, and core. This includes activities like rowing, swimming, and specific weight-training exercises.
  3. Posture Awareness: Be conscious of your posture throughout the day. Consider practicing yoga or Pilates, which emphasize alignment and balance.
  4. Stretching Routine: Incorporate daily stretching into your routine. Upper back stretches can relax tight muscles and improve flexibility, reducing the risk of strain.
  5. Healthy Weight: Maintaining a healthy weight reduces the strain on your muscles and spine, decreasing the risk of pain around the shoulder blades.
  6. Stay Hydrated: Muscles need water to function optimally. Ensure you drink enough water throughout the day to keep muscle cramps and stiffness at bay.
  7. Wear Supportive Footwear: Believe it or not, your shoes can impact your upper back and shoulder. Supportive footwear can promote proper alignment and may help relieve strain.
  8. Regular Check-ups: Schedule regular check-ups with a physical therapist or chiropractor, especially if you’ve had previous episodes of left or right shoulder blade pain. They can provide guidance on preventive exercises and pain management.

By implementing these strategies, you can not only tackle the pain you’re currently experiencing but also reduce the chances of future episodes.

Your physician is instrumental in pinpointing the cause of your shoulder blade discomfort and guiding you toward the best treatment options. Before consulting a physical therapist, we recommend scheduling a massage therapy session with our seasoned massage therapists at Body Ache Escape Massage Center. At times, a single massage session can make the interscapular pain vanish. For scheduling, you can either book online or call us at 614-604-6358.

Some other articles about shoulder and back pain.

Sharp Pain in Your Shoulder Muscles

Shoulders Hurt When Typing

Back of Your Shoulders Hurt

Stabbing Mid Back Pain

Burning Upper Back Pain

How To Fix  Muscular Chest Pain

Fix Pain In The Shoulder Joint

Trapezius Pain

Bicep Pain

Pain between the shoulder blades, known medically as interscapular pain, can arise from various causes and conditions, each with its own treatment approach. Here are the common causes and typically recommended treatment plans:

Common Causes:

  1. Muscle Spasms: Sudden, involuntary contractions of the muscles between the shoulder blades, often due to strain, overuse, or poor posture.
  2. Myofascial Pain Syndrome: Chronic pain involving tissue that surrounds muscle fibers, leading to tender trigger points and radiating pain in the shoulder area.
  3. Trapezius Muscle Strain: Overuse or injury to the trapezius, the large muscle spanning the back, neck, and shoulder blades can result in pain and stiffness.
  4. Rotator Cuff Issues: Tears or inflammation in the rotator cuff muscles can cause pain to radiate to the shoulder blades.
  5. Degenerative Disc Disease: Aging and wear on the spinal discs can lead to pain that emanates from the spine to the shoulder blades.
  6. Compression Fractures: Small breaks in the bones of the spine can cause severe pain across the shoulders or upper back.
  7. Poor Posture: Long periods spent in poor positions, especially while using computers or mobile devices, can strain the upper back muscles and ligaments.

Treatment Plans:

  1. Physical Therapy: Tailored exercises to strengthen muscles, improve posture, and increase the range of motion. Therapy may focus on the rotator cuff muscles, trapezius muscle, and other key areas in the upper back.
  2. Cold Therapy and Heat Therapy: Cold packs can reduce inflammation and numb the affected area, while heat therapy can relax tight muscles and improve blood circulation.
  3. Medication: Over-the-counter pain relievers and anti-inflammatory drugs can help manage pain and inflammation. In some cases, muscle relaxants or prescription pain medications may be recommended.
  4. Massage Therapy: A licensed massage therapist can target soft tissues, trapezius muscle, and other areas to relieve tension and pain. Myofascial release techniques are particularly useful for myofascial pain syndrome.
  5. Posture Correction: Education on proper posture and ergonomic adjustments at work or home to prevent long-term strain on the upper back muscles.
  6. Rest and Activity Modification: Taking frequent breaks from activities that exacerbate the pain, such as heavy lifting or prolonged sitting, and incorporating gentle stretches and movements.
  7. Foam Roller Exercises: Using a foam roller to perform self-myofascial release can help alleviate tension and improve mobility in the affected area.

In severe cases or when the pain is often due to more serious conditions like spinal stenosis, a healthcare professional may recommend advanced imaging tests to get an accurate diagnosis. Treatment might then include more specialized interventions such as corticosteroid injections, chiropractic care, or even surgery for severe structural problems. Always consult with a healthcare provider or a medical professional to get a tailored treatment plan that addresses the root cause of your pain and follows a safe approach to recovery.

Maintaining good posture and being mindful of daily activities are crucial in preventing and managing pain between the shoulder blades. Good posture aligns the spine, reduces strain on soft tissues and muscles, including the main muscles of the back and shoulder, and decreases the risk of developing conditions such as rotator cuff tears or exacerbating existing medical conditions. Adopting ergonomic starting positions, like adjusting your chair and computer screen to the correct height, taking regular breaks from long periods of sitting, and engaging in exercises that strengthen the shoulder muscles, can significantly reduce the occurrence of a dull ache or mild discomfort in the shoulder area. Consultation with a health care provider is recommended to tailor these strategies to individual needs, ensuring long-term shoulder and back health.

Differentiating between a heart condition and muscle pain, especially when experiencing stabbing pain under or near the left shoulder blade, is crucial for appropriate management and treatment. Here are some key points to consider:

Nature of Pain:

Muscle Pain: Typically, muscle pain (musculoskeletal pain) is localized, and its intensity can change with movement, posture, or physical activity. It might feel sore, achy, or tight and often worsens when you move, stretch, or press on the affected area.
Heart Condition: Pain related to a heart condition, such as angina or a heart attack, is often described as pressure, fullness, squeezing, or pain in the center of the chest that can spread to other areas of the body, like the arms, jaw, or back. This pain usually isn’t affected by movement and might not be localized to one specific area.

Associated Symptoms:

Muscle Pain: May be accompanied by swelling, visible bruising, or a limited range of motion due to muscle strain.
Heart Condition: Can include symptoms like shortness of breath, nausea, sweating, dizziness, or a feeling of impending doom. Heart-related pain might occur during physical exertion or stress and can improve with rest or medication like nitroglycerin.

Onset and Duration:

Muscle Pain: Often occurs after a specific event or activity that strained the muscles, such as new or intense physical activity, and the pain can last from a few days to a few weeks.
Heart Condition: The pain or discomfort can occur unexpectedly, even at rest or during mild exertion, and the duration can vary. Angina pain typically lasts for a few minutes and improves with rest.

It’s essential to err on the side of caution when dealing with any type of chest or back pain, especially if it could be heart-related. If you’re unsure about the cause of your pain, if the pain is severe or accompanied by other symptoms of a heart attack, or if you have risk factors for heart disease, seek medical attention immediately. Only a healthcare professional can accurately diagnose the cause of your pain through physical examination, medical history, and possibly ordering tests such as an ECG, blood tests, or imaging studies.

Yes, massage therapy can be beneficial for a pulled muscle between the shoulder blades. It can help in several ways:

Pain Relief: Massage therapy can reduce pain in the affected area by increasing blood flow, which brings nutrients and oxygen to the muscle tissues. Improved circulation also helps in the removal of waste products and toxins that can accumulate in muscles after an injury.

Reducing Inflammation: Gentle massage techniques can help reduce inflammation and swelling around the injured muscle, promoting faster healing.

Improving Flexibility: Massage can help loosen tight muscles and increase range of motion by stretching and elongating muscle fibers. This is particularly beneficial for muscles that have become shortened or contracted due to a pull or strain.

Promoting Relaxation: Massage therapy can reduce stress and promote relaxation not only in the specific injured area but throughout the body. This can be particularly beneficial if muscle tension due to stress is contributing to the discomfort.

Enhancing Healing: By improving circulation, massage can enhance the delivery of oxygen and nutrients essential for healing to the injured tissues, potentially speeding up the recovery process.

Preventing Further Injury: By addressing muscle imbalances and tensions in the body, massage therapy can help prevent future injuries. It can also provide an opportunity for a professional to assess your posture and muscle health, offering advice on corrective exercises and movements to avoid further strain.

Yes, there are specific stretches that can help relieve scapular (shoulder blade) pain. These stretches aim to improve flexibility, reduce tension, and strengthen the muscles between the spine and shoulder blades, neck, and upper back. Here are some effective stretches and exercises:

Doorway Stretch:

Stand in a doorway and place your arms on the door frame at shoulder height, elbows bent at a 90-degree angle.
Gently step forward until you feel a stretch in the front of your shoulders and chest.
Hold for 15-30 seconds and repeat 2-3 times.

Neck Tilts:

Sit or stand with your back straight.
Gently tilt your head towards one shoulder until you feel a stretch on the opposite side of your neck.
Hold for 15-30 seconds, then repeat on the other side.
Perform 2-3 repetitions per side.

Thoracic Extension:

Sit on a chair and place a rolled towel or a foam roller horizontally behind you at the level of your mid to upper back.
Interlace your fingers behind your head and gently lean back over the towel or foam roller, extending your thoracic spine.
Hold for 15-30 seconds and return to the starting position.
Repeat 2-3 times, moving the towel or foam roller to different segments of your upper back.

Scapular Squeeze:

Sit or stand with your back straight.
Squeeze your shoulder blades together as if you’re trying to hold a pencil between them.
Hold for 5-10 seconds and release.
Repeat 10-15 times.

Child’s Pose Stretch:

Start on your hands and knees, then sit back on your heels, reaching your arms forward on the floor.
Lower your chest towards the ground, keeping your arms extended, to stretch your back and shoulders.
Hold for 20-30 seconds and return to the starting position.
Repeat 2-3 times.

Cross-Body Shoulder Stretch:

Bring one arm across your body at about chest height.
Use the other hand to press the arm closer to your chest until you feel a stretch in the shoulder and rear part of the shoulder blade.
Hold for 15-30 seconds and then switch arms.
Repeat 2-3 times on each side.

Before starting any stretching routine, it’s important to consult with a healthcare professional, especially if your pain is severe or persists. They can provide personalized advice based on your specific condition. Additionally, when performing these stretches, it’s crucial to do them gently and avoid overstretching, which can lead to further injury. Focus on maintaining a comfortable range of motion and gradually increase your flexibility over time.