Shoulder blade pain is a common cause of chronic pain that affects between seven and 67% people in the U.S. during their life. It is difficult to determine exactly how many people suffer from pain between their shoulder blades, because many choose not to seek treatment or think it will simply go away on its own. If you’re suffering from moderate to severe shoulder pain, though, know that shoulder blade pain relief is possible. Here are 15 shoulder blade pain causes and seven treatment options that can help.
Where do people typically feel shoulder pain?
The shoulder is a complex ball-and-socket joint that connects the clavicle (collarbone), upper arm bones (humerus), and scapula (shoulder blade). Muscles and tendons that surround the joint work to stabilize it.
Major muscle groups in this area of the back include:
- Trapezius and rhomboids: V-shaped cape of muscle that originates across the tops of the shoulders and attaches to the thoracic spine
- Teres major and teres minor: Bands of muscle that starts underneath the armpit and tucks under the rhomboids
- Latissimus dorsi: Wide bands of muscle that support the mid-back, tucking underneath the teres minor and rhomboids below the shoulder blade
While not a weight-bearing joint like the knee, we ask a lot of our shoulders without thinking about it. We take for granted that we will be able to lift our kids, swing a bat, and haul groceries in from the car, but shoulder blade pain can interfere with many daily activities.
Shoulder blade pain can be felt anywhere along the tops of the shoulders and the back plane of the body. This includes:
- Pain below the shoulder blade
- Back pain between the shoulder blades
- Shoulder blade muscle pain in the muscles that surround the shoulder blade
What causes shoulder blade pain?
Shoulder blade pain is caused by anything from accident and injury to more complicated (and surprising!) health issues. These may include:
- Tendon sheath inflammation
- Rotator cuff injuries and tears
- Adhesive capsulitis, or frozen shoulder syndrome
- Spinal stenosis
- Neck pain
- Mouse shoulder
- Heart attack
While muscular-based pain is common, other conditions and injuries can also lead to shoulder blade pain. For example, the flat bones of the shoulder blade may not feel pain in the dead center of each scapula, but as part of the spine and shoulder joint, bone and spinal issues can wreak havoc and cause shoulder blade pain.
Stress related causes
The most common stress-related cause of shoulder blade pain is due to muscle tension. Stress causes muscles to contract. This contraction can eventually lead to shoulder blade pain that ranges from mild to moderate.
As humans, we tend to hold a lot of our stress in our neck and shoulders. This is especially true for those who work at a computer all day.
Most people think of whiplash as an injury that affects the neck only, but the entire back chain of the body comes into play when this occurs.
As in a car accident, the impact of the car stops the car while the body continues to travel forward. When the body reaches the end of its travel (assisted hopefully by a seatbelt), the violent snap back all along the spine cause whiplash from the sacrum at the bottom of the spine to the skull (where a concussion may occur).
This violent action can cause injury to the ligaments, tendons, and muscles all along the spine, including those surrounding the shoulder blades.
Tendon sheath inflammation (tenosynovitis) or ligament damage
Ligaments connect the head of the humerus (upper arm bone) to the scapula (shoulder blade). Torn or damaged ligaments can occur with improper use, overuse, or trauma (e.g., a car accident or a fall).
Tendons attaching the muscles of the shoulder blade to the shoulder blade itself are covered in the synovium, a sheath that allows them to move. Injury to the muscle may cause the synovium to stop making fluid that lubricates movement, which can result in pain and inflammation.
Ligament and tendon injuries heal very slowly and can restrict movement of the shoulder blades on the back. In some cases, this can lead to frozen shoulder.
Rotator cuff injuries or tears
Rotator cuff injuries occur in the muscles of the shoulder. These injuries can also occur when tendinitis, tears, or bursitis is present.
Tendinitis is an inflammation of the tendons that attach the clavicle to the scapula or humerus. Bursitis is also an inflammatory condition occurs when the fluid-filled cushions of the shoulder joint (the bursa) become irritated and inflamed.
Symptoms of rotator cuff injuries or tears include pain in the front and side of the shoulder, increasing shoulder pain at night or when the arms are lifted over the head, but the involvement of teres minor means that some patients feel pain below their shoulder blade as well.
Adhesive capsulitis, or frozen shoulder syndrome
Adhesive capsulitis, more commonly known as frozen shoulder syndrome, occurs when scar tissue forms in the shoulder joint.
This can occur when an injury does not allow a complete range of motion in the shoulder. Without movement over time, the ligaments and tendons shorten to the range of motion needed and stay that way.
There are over 100 different types of arthritis. At the root of each is inflammation. Inflammation in a joint in the body can cause significant pain, and the shoulder blade is no exception.
Pain due to inflammation can occur between shoulder blades or where the scapula meets the humerus in the joint capsule.
Spinal stenosis is the narrowing of the spinal column that can cause significant lower back pain. Because the skeleton is a system that works together, this narrowing can also place considerable stress on muscles, joints, tendons, and ligaments all the way up the back, including the shoulder blades.
This stress may occur as shoulder blade muscle pain or pain beneath the shoulder blade.
Osteoarthritis is a degenerative joint disease experienced by more than 33% of adults over 65 in the U.S.
Cartilage in and around the joint begins to break down, causing friction and inflammation as the joint moves. Muscle pain between the shoulder blades can also be due to the body attempting to compensate for pain in the shoulder joint itself.
Small cracks or fractures in any area of the shoulder joint or its bones can cause back pain between the shoulder blades.
Some of the pain may be due to inflammation, but in many cases, overcompensation by the body to balance out the workload while the fracture heals may be the main culprit of shoulder blade pain.
A dislocated shoulder occurs when the humerus pops out of the socket of the shoulder. This can occur due to a fall or other trauma like a car accident.
When this happens, tendons, ligaments, and muscles can be strained and torn, causing pain that spreads down the arm and across the top and back of the shoulders.
Fibromyalgia is a widespread pain disorder characterized by symmetrical pain points in the body.
Four of these pain points are located on the back in the region of the neck and shoulders and the upper inner shoulder (essentially the area located in the middle of the shoulder blades).
An autoimmune disorder whereby the immune system cannot distinguish healthy tissue from bad, lupus can cause extreme back pain, including shoulder blade pain, as an overactive immune system causes widespread pain and inflammation. All tissues and organs of the body can be affected.
Often referred to as “schneck pain,” shoulder blade pain can actually originate in the neck. Common symptoms of this type of pain include:
- Pain that radiates down the arm but not below the elbow
- Tingling in the fingers
- Radiating pain into the shoulder blade
The neck has 14 nerves and eight pairs of joints in a very small space, so if you experience these particular symptoms the cause may be in your neck.
This relatively new phenomenon in shoulder pain causes is part of a long line of repetitive stress injuries. People who find themselves using a mouse to control a computer for hours at a time may also notice creeping pain between shoulder blades.
Mouse shoulder fatigues the small muscle groups needed to control the clicks and glides of a mouse, causing larger muscles groups to take over and in turn become fatigued themselves. This falls in the same category of text neck, a head-forward, slump-shouldered posture that is also a major shoulder blade pain culprit.
Finally, although most heart attack patients describe pain or tightness that occurs in the front of their chest, some patients report back spasms right before (or during) their heart attack.
These different symptoms are more likely to occur in women than in men, and because they are relatively rare and not well known, many people will dismiss them as simple back pain. If you experience pain between your shoulder blades and other signs of heart attack, get to your nearest emergency room.
How can I find shoulder blade pain relief?
The most important way to find shoulder blade pain relief is to figure out the cause of it. Treating just the symptoms of the pain without getting at the root cause will not solve your long-term health issue. Visiting your doctor for a proper diagnosis is the first step to successfully shoulder blade pain treatment.
Once you have a diagnosis, a few general guidelines apply to many types of shoulder blade pain, especially muscular issues.
During the acute phase of any injury or muscle tension, it’s important to use the RICE method. Rest, ice your shoulder, add compression with a brace if warranted, and take anti-inflammatory medications as needed.
If you suffer from an injury or a tear to your shoulder joint, it may be necessary to rest the joint for the first few days while treating for inflammation. Ice packs applied as directed by your doctor and over-the-counter non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can help relieve painful swelling.
Bring back some gentle movement, if permitted
Frozen shoulder is a more serious shoulder condition that is directly related to not getting enough movement in the joint.
As soon as is safe and allowed by your doctor, begin to move your shoulder gently in all directions to maintain a good range of motion. Always talk to your doctor about any stretching or strengthening routines you should do, or work directly with a physical therapist for more severe cases.
Change your environment
If your shoulder blade pain is related to repetitive stress injuries at work, switch to ergonomic office furniture and supplies to relieve the pressure.
Supportive braces and assistive lifting devices can also help with physical labor that leads to shoulder blade pain.
Practice alternative medicine
Chiropractic care, acupuncture, and massage can all work together to treat shoulder blade pain. For shoulder blade pain caused by stress or repetitive motion, massage can be very effective in getting to the small muscles around the edges of and underneath the shoulder blades.
Acupuncture is also showing promise as a first-line treatment for chronic pain, and some patients are finding that regular chiropractic care has wide-ranging positive effects on their whole body. At a minimum, these treatments are a relaxing, non-invasive way to care for yourself as you recover.
Investigate your medical options
There are a number of medical interventions that can help relieve shoulder blade pain. However, you should only attempt these after non-invasive complementary therapies have failed to work.
From there, move to interventions that are minimally invasive. Joint injections are one example of a minimally invasive technique to relieve pain. In rare cases, surgical interventions may be necessary to restore your movement and comfort in the shoulder joint. Surgery can remove scar tissue and help repair torn tissue, but for most people this step is only a last resort.
If you are experiencing shoulder blade pain and would like to explore your treatment options, it may be time to talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.