Pain Between Shoulder Blades – Causes, Symptoms, Treatment & Exercises

The majority of people who experience pain between shoulder blades thinks that it is a common, harmless problem and the pain resulted from working too much or poor sleeping position. Others think that it’s a minor problem which will heal itself with time.

We do agree that bad posture or excessive movement can indeed cause the muscular discomfort in upper back; it could also be a sign of a some impending disease. Therefore, rather than simply ignoring the pain, you should seek an advice of a health professional.

Being that said, if you are looking for some more insights regarding these type of pain, here is what our experts says about it.

Shoulder blades are situated on the upper back area which is also called as thoracic region.

Before we dwell into the causes, symptoms, treatment and prevention of these pains, it is better to understand the anatomy of a thoracic region.



The spine section located in the upper back is referred to as the thoracic spine.

The thoracic spine starts from the base of your neck and extends down to the rib cage.

Understanding the main parts of thoracic spine as well as how they work will help you better take care of your upper back problem.

The thoracic spine is composed of 12 vertebrae named T1-T12. The thoracic spine is specifically built for stability. The stability is crucial for protecting vital organs located in the chest and also for keeping the body upright.

There are two useful anatomic terms that relate to the thoracic spine and they are anterior and posterior.
Anterior simply refers to the front part of the spine while posterior means the back of your spine.

Subsequently, the front part of the thoracic spine is aptly called anterior thoracic area while the back part is called posterior thoracic area.

The most important structures of the thoracic spine are:

  • Spinal segment
  • Bones and joints
  • Connective tissues
  • Nerves
  • Muscles


Pain between the scapulae can be caused by a whole host of things.

In most cases, the pains come and go, and are mostly caused by tired muscles. If that is the case, it shouldn’t take long before your pains disappear naturally.

However, there are some causes that are due to disorders or complications that may need prompt attention. Below, we explain the different causes of this kind of pain.

Poor posture

More than 80% of Neck & Back problems are a result of tight, achy muscles brought on by years of BAD POSTURE.

Duke Orthopaedics

This is one of the main causes of discomfort between shoulder blades.

Whether you are sitting or standing, hunching forward puts a huge amount of pressure on the muscles of your neck. This is partly because the weight of your head especially if it’s not in its proper, erect position.

When your head is held in an erect position, the muscles offer stability, which needs far less effort. Therefore, the pain that you experience between your shoulder blades may be due to tired muscles which have become inflamed or irritated.

Poor Posture Quote By Morihei

The right posture, coupled with exercise, can usually cure the problem effectively.

Swollen facet joints

swollen facet joints may produce sharp pains in the upper back.

Facet joints are nothing but the synovial joints that found between the articular of our spinal vertebrae. It is these joints that give the spine its flexibility.

In other words, these joints enable you to make different kinds of movements. If used too often or too hard, they become swollen and damaged. Most of the time this leads to pain in lower back and upper spinal area.

Though, swollen facet joints rarely cause pain in upper back, one should also keep this possibility in mind.

A herniated disc

This is yet another problem that can be very painful.

Spinal discs refer to rubbery pads located between the spinal column and vertebrae and they function as shock absorbers.

The disks are filled with gel in childhood but as we become older, they start solidifying. By the time we reach middle age, the discs become not only inflexible but also rubber-hard and they become more susceptible to injury.

With stress or injury, the inner material of the disc may swell outwards and push through the outer shell. It presses against the nearby nerves and render the area more susceptible to injury.

Heart attack

Sometimes, the reason for the pain between your scapulae could be a heart attack or an impending one.

This tends to less common in men than it is in women. In the event of a heart attack, you will first feel the discomfort in the chest after which it will radiate to the shoulders and left hand.

In some cases, this pain may also travel to the upper section of the back, where it could center between the shoulder blades.

This is not to say that pain in the upper back is the most reliable indicator of a heart attack since heart attack normally has many symptoms. Still, any unusual pain, or one that’s not easy to explain, should be treated carefully.

Inflammation under the diaphragm

This is a kind of pain felt in different parts of the body where the problem actually is.

At first, it might not appear as though there is a logical relationship between the area between the shoulder blades and diaphragm.

The diaphragm refers to a large and dish-shaped muscle that assists you in breathing. It usually moves up and down as your lungs expand and contract. As we inhale, the upper back muscles are also involved.

In case any of these upper back muscles experiences a strain, breathing can become painful.

Subsequently, if a swelling below the diaphragm affects its actions, it can affect the back muscle’s actions indirectly. If the muscles are made to function in an abnormal way, they may become sore as well as painful when in motion.


If the pain in the upper back is caused by osteoarthritis, the pain will tend to worsen early in the morning as well as late in the evening, and tends to taper off during the day when you are more active.

At first, the pain will be concentrated in the spinal area but later extend to shoulder area as well as beyond.
Typically, osteoarthritis only affects the joints, and, contrary to rheumatoid arthritis, it’s not a systematic ailment.

Other possible causes include spinal stenosis, which simply refer to the abnormal constricting of the spinal canal, cervical spondylosis, which is a condition where neck vertebra or even the disks found between them, has started degenerating, and gall bladder disease.

Common Symptoms

Numbness, burning or tingling are all symptoms of nerve damage, and this can be from nerve compressions such as broken vertebra in neck spine or herniated disk, or from a neurological disease such as brachial neuritis, shingles multiple sclerosis or transverse myelitis. Other things that might cause tingling are a migraine or increased muscle tension.

Crepitus: this is a grating sound that you hear when you move the arms or press upon the shoulder blades. It could mean broken ribs or shoulder blades.

Other symptoms include:

Soreness – You feel sore when taking a deep breath

Deep Muscular pain – The pain aches deeply

• You need to push your shoulder into a wall corner so as to get the pain relief

• You feel sore when you put your chin to your chest

• Stretching the muscles between your shoulder blades hurts

• You feel left or right shoulder blade pain inside the blade

If you feel that these symptoms are familiar in your case, it could be that you are suffering from upper back pain between shoulder blades. You need to get medical attention fast.



In order to relieve yourself from this kind of pain, you may want to make certain changes in your activity habits and rest.

It is the first treatment method of relieving the pain between shoulder blades. You need to take a break from any activity that may irritate and worsen your condition.

Where stress is a serious issue, you may want some mindfulness training as this will teach you how to reduce stress and meditate.

Though meditation does not directly help to relieve pain, it can help to relax your mind & body. Less stress means that your muscles will loosen up and this will be followed by the pain going away.


As the area between shoulder blades includes large muscles in the upper back, strengthening exercises & stretching can play a major role in relieving the pain.

Simple exercises and stretches of neck & upper back muscles should be considered as a part of pain relieving treatment.

Below are some of the exercises that can help you:

Back Flexion Exercise

While lying flat with your back on a yoga mat, pull your knees up slowly to the chest, while at the same time flexing your head.

Keep this position for 8 to 10 seconds at a time.

You do not have to force yourself into this position. What matters is that you keep a comfortable stretch. If your pain permits do the 7 to 10 reps of this exercise.

These stretches are specially designed to relieve tension on your back muscles.

Knee to chest stretch

while lying flat on the floor, have your knees bended and ensure that your heels remain rooted. Using both hands, hold the back of one of your knee and then gradually bring it back in the direction of your chest & hold for 5 to 10 seconds.

Repeat this procedure with another knee.

As stated previously, it’s very important that you maintain a comfortable stretch. There is no need of pushing yourself to perform the exercise.

Upper Back Exercises

These include dips and pushups and they will be advantageous to your arms. These exercises also strengthen your shoulders as well as the muscles between.

Learn more about upper back pain exercises.

Mid-back exercises

These include chin-ups and pull-ups and will benefit your back most. These exercises are special because of the fact that they develop the lateral muscles.

Lower back exercises

These include sit-ups, pilates bridge, hyper-extensions, floor hyper-extensions and leg lying raises.


A chiropractor uses spinal manipulation techniques to relieve you’re the pain between the shoulder blades. Chiropractors are licensed and are very effective in healing these pains.


Another option would be to visit a licensed masseur to teach you the exercises to increase flexibility and strength in your shoulders.

Self-massage gear

There are handheld wooden massage devices that are very helpful in loosening the muscles as well as alleviating the upper back pain.


Simple anti-inflammatory drugs like ibuprofen or steroid prescribed by a doctor, whether delivered through pill or injection, can give you some much-needed relief from pain between the shoulder blades.


Where exercise and rest refuse to work, your doctor may recommend surgery. Surgery may involve removing a scar tissue, repairing tendons or even completing reconstruction of affected shoulder.


Experts often recommend cold or hot compresses for reducing pain.

Begin with a cold pack for initial injury after which you should use it on and off for the next 48 hours. Next, move to hot compress. Let it there for about 15 minutes every four hours for all the compresses.

Preventive measures

Correct your Diet

What you consume as your food really plays an important role in your overall health.

What matters most in the preventive stage is moderating your food intake. This does not mean that you stop eating certain foods. In fact, you can eat any food that you like.

The key here is to avoid consuming too much of one kind of food that can cause stomach irritation and can trigger muscular diseases.

Regular Exercise

Exercise is very important in overall health.

In terms of keeping pain between shoulder blades at bay, exercise does much more than simply developing back strength.

It also reinforces your spine’s joints, which is needed to ensure that your intervertebral discs remain healthy. Exercising also helps your body better utilize proteins and fats contained in the food that you eat. This will prevent osteoarthritis from developing.

Maintaining proper posture

It is important that you mind how you stand and sit to improve your posture.

You may even want to use an ergonomically correct chair. Also, get a proper pillow to ensure that you get the right sleeping posture.

Equally important for people with pain between shoulder blades is a proper mattress. It can play a very important role in reducing back pain. It is very important to maintain a proper position while sleeping. On average, a person should sleep for 8 hours a night.

While there is not much that you can do about your aging, but staying physically fit can help you prevent muscle weakness.

Exercising regularly provides better flow of blood to the muscles and at the same time also improves flexibility and strength. Just ensure that you do your warm up stretches first.

If you want to prevent future reoccurrence of shoulder pains, it is very important to perform stretches.

Another way of increasing flexibility and strength in the shoulder blades without stressing your joints too much is swimming.

If you can manage great exercises regularly, you can think of taking up racquet ball or tennis. You can think of any other exercise but just ensure that it does not put a lot of strain on your muscles.


Pain between shoulder blades might seem minor discomfort, but that’s not always the case.

It could even signify the onset of a heart attack or any other serious muscular disorder. This is why you should pay immediate attention to & consult your doctor to have your pain assessed.

Do not make the assumption but instead, seek the expert opinion of a medical professional. These professionals are better placed to evaluate your condition and also give you proper treatments for the kind of pain.

References +

1. Tanaka Y et al, 2006, Cervical roots as origin of pain in the neck or scapular regions (Link » PubMed )
2. Heart Attack Symptoms and Warning Signs (Link » John C. Lincoln Health Network )
3. A Patient’s Guide to Thoracic Spine Anatomy (Link » eOrthopod )

Dr. Sachin

Click Here to Leave a Comment Below 2 comments
Ks sandhu - April 25, 2017

I have been diagnosed wt o e degerative disease with lesio s on spine. I am in pain always below the soulder blades. Could it be gout or nerve disorders. Pain killers help.
Pls help
Ks sandu

    Dr. Sachin - April 28, 2017

    It’s difficult to comment anything with such a minimum information. I suggest you see what your doc says and see if he advise you some test and scanning etc.


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