Shoulder blade pain is a common experience. This discomfort, located around the triangular bones on the upper back, can stem from various sources. While often a temporary issue, understanding the potential origins of this pain can help in determining when it might signal a more serious underlying condition.
Common Causes of Shoulder Blade Pain
Pain around the shoulder blade often arises from musculoskeletal issues, due to daily activities or posture. Muscle strain is a primary culprit, resulting from lifting heavy objects, engaging in repetitive overhead movements, or overexerting muscles. Such strains can cause sharp pain and inflammation in the upper back.
Poor posture contributes significantly to shoulder blade discomfort, with prolonged sitting or slouching. This habit weakens upper back muscles and places undue stress on spinal structures. This can lead to muscle imbalances and chronic pain.
Nerve impingement can also refer pain to the shoulder blade area. Conditions like cervical spondylosis, involving wear and tear in neck discs, can compress nerves. This compression may manifest as pain over the shoulder blade, extending to the arm or fingers, often worsening at night or with certain neck movements. Similarly, a herniated disc in the cervical spine can inflame nerve roots, causing radiating pain into the shoulder blade region. Rotator cuff injuries, involving muscles and tendons stabilizing the shoulder, frequently lead to pain in the shoulder and upper arm that can spread towards the shoulder blade. This pain often intensifies with arm movement or at night.
When Shoulder Blade Pain Could Signal Cancer
While less common, shoulder blade pain can rarely be a sign of certain cancers, due to tumor growth or metastasis. Pancoast tumors, a lung cancer developing in the upper lung, are known to cause pain in the shoulder, shoulder blade, and arm. This pain can be persistent and may not respond to typical pain relief measures.
Breast cancer can also manifest as shoulder blade pain if it metastasizes, to the bones in or near the shoulder bones. When cancer cells settle in these areas, they can weaken the bone structure, leading to deep, aching pain that might worsen at night or with movement. Breast cancer spreading to the liver can cause referred pain to the right shoulder blade.
Primary bone cancers, such as sarcomas, can originate directly in the scapula itself, causing localized pain. Lymphomas, lymphatic system cancers, can also involve bone and present with shoulder pain. The pain associated with cancer tends to be persistent, may progressively worsen over time, and often is not relieved by rest or conventional pain medications.
Important Accompanying Symptoms to Note
Shoulder blade pain accompanied by other systemic symptoms warrants further investigation. Unexplained weight loss is a concerning sign, particularly if it involves losing a noticeable amount of weight, such as more than 5% of body weight, within a 6 to 12-month period without intentional dieting. This type of weight loss can occur because cancer cells alter the body’s metabolism or interfere with nutrient absorption.
Persistent fatigue that does not improve with rest or sleep is another significant symptom. This exhaustion is often described as overwhelming and can severely impact daily activities, distinguishing it from ordinary tiredness. Unexplained fever and drenching night sweats, especially if they are severe and recurrent without an obvious cause like an infection, are also important indicators. These “B symptoms” are particularly associated with certain blood cancers like lymphoma and leukemia.
Neurological changes, such as new or worsening numbness, tingling, or weakness in the arm or hand, should also prompt medical evaluation. These symptoms can indicate nerve compression or involvement, which in rare cases, might be linked to a tumor.
When to Seek Medical Attention
It is advisable to seek medical attention for shoulder blade pain if it is persistent, worsening over time, or does not improve with rest or common pain relief measures. Pain that begins without an obvious injury or trauma also warrants professional evaluation.
Immediate medical attention is necessary if shoulder blade pain is accompanied by certain acute symptoms. These include chest pain, shortness of breath, rapid heart rate, dizziness, or excessive sweating. Additionally, if the pain occurs alongside any of the “red flag” symptoms such as unexplained weight loss, persistent fatigue, unexplained fever, night sweats, or new neurological issues, a medical consultation is important.