Pain behind the shoulder blade can result from a number of conditions. Common causes include a muscle strain (pulled muscle) or overuse. A misaligned rib or compression fracture can also cause this pain.
If back or shoulder pain persists for more than a few weeks or interferes with daily activities, see a doctor. Persistent pain can indicate a serious condition such as heart disease or lung cancer.
Causes
A wide variety of conditions and injuries can cause pain behind the shoulder blade. It is important to see a medical professional for proper diagnosis and treatment, particularly if the pain is sudden or severe.
Tense muscles or muscle knots can cause pain that radiates into the area between the shoulder blades. This is called referred pain. These tight knots of muscle may develop due to overuse, injury or conditions resulting from neck and back problems such as arthritis.
Acid reflux or peptic ulcer disease can also cause pain in this area. The pain will typically be accompanied by upper chest symptoms. Pancreatitis and gallstones can also cause pain in this area if the nerves that service the scapula are affected.
A sprained or injured rib can also cause shoulder blade pain if it causes a change in the position or movement of the scapula. This type of pain is often aggravated by breathing deeply, especially when doing activities that require a lot of rib cage expansion.
Symptoms
The pain may be sharp, achy or burning. It may be localized in one area or more widespread around the shoulder blade, upper back and neck. It can be a continuous or episodic pain, recurring from time to time. It can also be accompanied by difficulty breathing, fatigue and weight loss.
If the shoulder blade pain is sudden and severe, it can indicate a serious condition like a heart attack or blood clot. A medical professional will check for these serious conditions and recommend prompt treatment.
A common reason for shoulder blade pain is a tense muscle or a “muscle knot.” To relieve this, try using a foam roller to find a tender spot and rolling over it lightly until you feel relief. Taking an anti-inflammatory medication and applying ice a few times a day can also help. Some people benefit from a gentle massage called myofascial release, where moderate pressure is applied to the knotted muscles.
Diagnosis
In most cases, individuals will find their pain can be traced back to an incident that caused it, such as a sudden strain or falling on the shoulder. In other cases, the cause will be unclear. When individuals cannot identify the cause of their pain, they should contact their doctor as it may be a warning sign of a serious underlying condition.
Heart problems such as aortic dissection and pericarditis may cause pain in the chest, upper back, or space between the shoulders. These conditions can also affect the lungs and thoracic wall. Pain in these areas may be referred from other parts of the body, including cancer, heart attack, a lung tumor, or pulmonary embolism.
Other symptoms that can indicate a serious underlying issue include chest pain or pressure, difficulty breathing, and irregular or rapid heartbeats. A doctor can assess these issues and order blood tests such as complete blood count (CBC), C-reactive protein, and liver function tests. Imaging tests such as a chest X-ray and computed tomography (CT) scans can assess structures in the chest and abdomen.
Treatment
If the pain under your shoulder blade is caused by a pulled muscle, treatment usually includes rest and physical therapy. You may also try applying ice or a heating pad to the area for 15 to 20 minutes at a time, every 2 hours. If the pain isn’t relieved by these treatments, your doctor may recommend a corticosteroid injection.
You can prevent shoulder pain by practicing good posture – stand tall and sit up straight. It’s also important to maintain a healthy weight and avoid sleeping on your stomach. If your shoulder pain is accompanied by chest pain or shortness of breath, seek emergency medical attention right away. This could be a sign of a heart condition or lung disease.
If the pain feels like a knot, you can use a massage technique called myofascial release to ease the pressure on the tissue. You can also try foam rolling, which involves using a roller or a small ball to find the tender spot and then rolling over it with moderate pressure.pain behind shoulder blade