Pain between the shoulder blades is a common complaint that can arise from various factors. While many people associate this discomfort with musculoskeletal issues, a less commonly recognized cause is gastroesophageal reflux disease (GERD). This article explores the link between GERD and pain experienced between the shoulder blades.
Understanding the Connection
Gastroesophageal reflux disease (GERD) can cause pain between the shoulder blades through referred pain. Referred pain occurs when irritation or discomfort in one part of the body is perceived in a different, often distant, area. In GERD, stomach acid frequently flows back into the esophagus, irritating its lining.
The esophagus and upper-to-mid back share nerve pathways that transmit sensations to the brain. When the esophagus becomes inflamed or irritated by acid reflux, it sends pain signals. Due to this shared nerve network, the brain can misinterpret these signals, perceiving the pain as originating from the back, specifically between the shoulder blades.
This referred pain often feels like a dull ache or a burning sensation. It may intensify after eating, particularly after consuming acidic foods, or when lying down, which are typical triggers for GERD symptoms. The vagus nerve, which transmits sensations from internal organs, contributes to how esophageal irritation can manifest as discomfort in the shoulder blade area.
Other Reasons for Shoulder Blade Discomfort
Pain between the shoulder blades, while potentially linked to GERD, also has many other common causes. One frequent reason is muscle strain, which can result from poor posture, heavy lifting, or overuse, such as prolonged computer work or repetitive motions. These activities can strain muscles like the trapezius or rhomboids located in the upper back.
Other musculoskeletal issues contributing to this pain include conditions affecting the spine, such as herniated or bulging discs in the neck (cervical spine) or upper back (thoracic spine), and arthritis in the facet joints of the spine. Nerve impingement can also lead to discomfort radiating to this area. Less commonly, pain in this region can be a symptom of more serious conditions like certain heart issues, such as a heart attack or aortic dissection, or even lung conditions like a pulmonary embolism.
Strategies for Relief
Managing GERD symptoms can help alleviate associated pain between the shoulder blades. Lifestyle modifications are often the first approach to reducing acid reflux. This includes dietary adjustments, such as avoiding foods and beverages that commonly trigger reflux, like high-fat foods, spicy dishes, citrus fruits, chocolate, caffeine, and carbonated drinks. Eating smaller, more frequent meals can also reduce pressure on the stomach and prevent acid reflux.
Not lying down for at least two to three hours after a meal can prevent stomach contents from flowing back into the esophagus. Elevating the head of the bed by six to eight inches during sleep can use gravity to help keep stomach acid down. This can be achieved by placing blocks under the bed legs or using a wedge pillow, which is more effective than stacking pillows. Maintaining a healthy weight and quitting smoking are also beneficial, as excess weight and nicotine can worsen GERD symptoms.
Over-the-counter medications can also provide relief for GERD symptoms. Antacids neutralize stomach acid, offering quick relief for mild heartburn. H2 blockers reduce the amount of acid produced in the stomach, providing longer-lasting relief, typically for 8 to 12 hours. Proton pump inhibitors (PPIs) are stronger acid reducers that can help heal the esophageal lining and are available over the counter for frequent heartburn.
When to Consult a Doctor
Seeking professional medical advice is important for persistent or severe pain between the shoulder blades, especially if accompanied by other concerning symptoms. If the pain is severe, sudden, or lasts for more than a few days, a medical evaluation is recommended. This is particularly true if accompanied by symptoms such as chest pain, shortness of breath, lightheadedness, excessive sweating, or pain radiating to the arm or jaw. These additional symptoms could indicate a heart attack or other serious cardiac conditions that require immediate medical attention.
A doctor can help determine if GERD is the cause of the shoulder blade pain or if another condition is responsible. They can also rule out more serious underlying issues. If GERD symptoms, including referred pain, are frequent, severe, or do not improve with over-the-counter medications and lifestyle changes, a healthcare provider can offer further diagnostic testing and treatment options.