That Pain Between Your Shoulder Blades Might Not Be a Shoulder Problem
You reach behind your back and feel it.
A dull ache between your shoulder blades.
Maybe it feels tight after a day at the desk. Perhaps it appears after driving, lifting, training or spending hours looking down at your phone.
It is easy to assume the shoulder itself must be the problem.
But pain between the shoulder blades can come from several areas, including the upper back, neck, muscles and surrounding joints.
In some cases, the shoulder may be involved.
In others, the shoulder blades are simply where you notice the symptoms.
Understanding that distinction can be useful when the pain keeps returning.
Why does pain between the shoulder blades happen?
Your shoulder blades sit over the upper part of your rib cage and connect the movements of your arms with your upper back.
They do not operate independently.
Every time you reach, push, pull, lift or rotate your upper body, multiple muscles and joints contribute.
This means discomfort between the shoulder blades can be influenced by what is happening in several nearby areas.
Common contributors can include:
- prolonged sitting
- repetitive arm movements
- lifting or carrying
- working overhead
- neck or upper-back stiffness
- changes in exercise
- previous injuries
- muscle fatigue
- spending long periods in one position
There is rarely one explanation that applies to everyone.
Your upper back may be involved:
The thoracic spine is the middle section of your spine, running from the base of your neck towards the lower ribs.
It has to move as you breathe, rotate, reach and perform everyday activities.
If you spend much of your day sitting or working in one position, you may notice stiffness or discomfort through this area.
For example, imagine spending eight hours at a computer.
Your arms are in front of you.
Your eyes are focused on a screen.
Your upper back barely changes position.
By late afternoon, you may notice an ache between the shoulder blades.
That does not necessarily mean your posture is damaging your spine.
It may simply be that your body has spent a long time doing relatively little movement.
Your neck can contribute to shoulder blade pain:
This is one reason the location of your pain can be misleading.
The neck and upper back work closely together.
Problems involving the neck can sometimes produce pain or discomfort around the shoulder blade, even when the shoulder itself moves normally.
You might notice:
- neck stiffness
- pain when turning your head
- discomfort spreading towards the shoulder blade
- symptoms after prolonged computer use
- upper-back tension alongside neck symptoms
If your shoulder blade pain regularly appears alongside neck symptoms, it is useful information to mention during an assessment.
What about your shoulder itself?
Of course, the shoulder can still be involved.
The shoulder is a complex region involving the ball-and-socket joint, shoulder blade, collarbone, muscles and tendons.
Certain shoulder problems can produce discomfort around the shoulder blade or upper back, particularly during reaching, lifting or overhead activity.
However, the relationship is not always straightforward.
You may have shoulder pain without significant shoulder blade symptoms.
Or you may feel pain around the shoulder blade when the main contributing factor is elsewhere.
This is why looking at how the whole area moves can be more useful than focusing on the painful spot alone.
What if it hurts when you take a deep breath?
This is an important distinction.
Pain around the shoulder blade can sometimes be influenced by the muscles and joints involved in breathing.
However, pain associated with breathing should not automatically be assumed to be a muscle or joint problem.
Seek urgent medical attention if shoulder blade or upper-back pain occurs with symptoms such as:
- significant or sudden shortness of breath
- chest pain or pressure
- coughing up blood
- fainting or severe dizziness
- a very fast or irregular heartbeat
- severe or rapidly worsening pain
If you are unsure whether symptoms could be something other than a musculoskeletal problem, seek appropriate medical advice.
Can a chiropractor help with shoulder blade pain?
Depending on the cause, chiropractic care may be appropriate for some types of musculoskeletal pain around the shoulder blade and upper back.
An assessment may consider your neck, upper back, shoulders and shoulder blade movement, as well as your work, exercise, previous injuries and daily activities.
Management may include hands-on care, exercises, movement advice or modifications to activities, depending on your individual presentation.
If your symptoms suggest that another type of healthcare assessment is more appropriate, referral may be recommended.
FAQ
Why do I have pain between my shoulder blades?
Pain between the shoulder blades can have several possible contributors, including prolonged sitting, repetitive movements, physical work, exercise, muscle fatigue and problems involving the neck or upper back.
Can neck problems cause pain between the shoulder blades?
Yes. The neck and upper back are closely connected, and problems involving the neck can sometimes produce symptoms around the shoulder blade.
Is pain between the shoulder blades a shoulder problem?
Not necessarily. The shoulder can contribute, but pain in this area may also come from the neck, upper back or surrounding muscles and joints.
Why does my shoulder blade hurt after sitting?
Long periods in one position can make upper-back and shoulder discomfort more noticeable. Changing position regularly and incorporating movement into your day may help.
Why does pain between my shoulder blades get worse when I breathe?
Some musculoskeletal structures around the ribs and upper back move during breathing, so certain conditions can produce discomfort with deep breaths. However, pain associated with breathing can also have non-musculoskeletal causes and should be assessed appropriately, particularly if it occurs with shortness of breath or chest symptoms.
When should I see someone about shoulder blade pain?
Consider an assessment if pain persists, keeps returning, affects your movement or interferes with everyday activities. New weakness, numbness, significant injury or concerning chest or breathing symptoms require appropriate medical attention.
If you keep getting pain between your shoulder blades and cannot work out where it is coming from, an individual assessment may help. Wellbeing Chiropractic with clinics across Melbourne, Sydney and Brisbane. Book an appointment to discuss your symptoms and have your neck, upper back and shoulder movement assessed based on your history and examination findings.
