Pain between the shoulder blades is a common discomfort, ranging from a mild ache to severe sensations. Understanding its potential origins is important for relief.
Musculoskeletal Contributors
Many instances of pain between the shoulder blades stem from issues within the muscles, ligaments, and bones that make up the upper back. Poor posture, such as prolonged slouching, can strain muscles in the upper back like the rhomboids, trapezius, and erector spinae. This sustained stress can lead to muscle fatigue, tightness, and painful trigger points.
Repetitive movements, common in activities like heavy lifting or extended computer use, can overwork these muscles, leading to strain or overuse injuries. Repeated stress without adequate rest can cause micro-tears, resulting in inflammation and pain. Sudden awkward movements or trauma can also cause acute muscle strains and inflammation.
Ligaments supporting the thoracic spine (mid-back) can also be a source of pain. Overstretching or injury to these ligaments, often due to trauma, can lead to sprains. When damaged, surrounding muscles may spasm as a protective mechanism, contributing to stiffness and pain.
Improper shoulder blade movement, known as scapular dysfunction, can also cause discomfort. This occurs when muscles controlling the scapula become weak, imbalanced, or injured, affecting its normal function. Pain and tenderness around the shoulder blade may occur during movement or at rest, sometimes with a “snapping” or “crunching” sensation.
Spinal and Nerve-Related Conditions
Issues directly involving the spine and nerves can also cause pain between the shoulder blades, often presenting with more specific or radiating symptoms. A herniated or bulging disc in the cervical (neck) or thoracic (upper back) spine can compress nearby nerves, leading to pain that may radiate to the area between the shoulder blades. While less common in the thoracic region, this can cause sharp, burning, or aching pain, sometimes with numbness or tingling.
Spinal arthritis, particularly osteoarthritis, results from wear and tear on spinal joints, leading to inflammation and pain. This degenerative process can affect facet joints in the upper back, contributing to localized discomfort. Bone spurs and thickened ligaments from arthritis can also narrow the spinal canal, a condition known as spinal stenosis.
Thoracic spinal stenosis, though rare, involves narrowing of the spinal canal in the mid-back, compressing the spinal cord or nerve roots. This compression can lead to pain, numbness, tingling, or weakness in the chest, abdomen, or legs, depending on the affected nerves.
Referred Pain and Systemic Factors
Sometimes, pain between the shoulder blades is not due to a problem in the back itself but is “referred” from other parts of the body, meaning the pain originates elsewhere but is felt in the upper back due to shared nerve pathways. Heart conditions, such as a heart attack or angina, can cause pain in the chest, arm, jaw, or upper back, including between the shoulder blades. This referred pain can be a significant symptom of a cardiac event.
Gastrointestinal issues are another common source of referred pain. Gallbladder problems, including gallstones or cholecystitis, frequently cause pain in the upper right abdomen that radiates to the right shoulder blade or mid-back. Acid reflux (GERD), stomach ulcers, or gastritis can also cause abdominal discomfort extending to the back, particularly after meals or when lying down.
Pulmonary conditions affecting the lungs or pleura can also cause pain. Pleurisy, an inflammation of the lung lining, can lead to sharp chest pain that worsens with deep breaths or coughing and may radiate to the upper back. Pneumonia, a lung infection, can cause back pain due to inflammation, fluid buildup, or muscle strain from persistent coughing.
Less common but serious systemic conditions can also cause referred pain. Shingles, caused by the varicella-zoster virus, can produce pain or a burning sensation before a rash appears. Rarely, certain cancers, such as lung cancer, can cause referred pain to the upper back. If back pain includes concerning symptoms like chest pain, shortness of breath, unexplained weight loss, fever, or persistent severe pain, seek medical evaluation.