Pain between the shoulder blades, or interscapular pain, is a common complaint. This discomfort can range from a dull ache to a sharp sensation. The thoracic region of the spine, in the upper and middle back, is a complex area of bones, muscles, nerves, and joints. Understanding the origins of this pain can clarify its significance.
Understanding Common Causes
Pain between the shoulder blades often stems from musculoskeletal issues. Muscle strain and spasm are common culprits, affecting the rhomboid and trapezius muscles that stabilize the shoulder blade and aid arm movement. Activities like heavy lifting, repetitive motions, or sudden awkward movements can overstretch or tear these muscle fibers, leading to pain.
Poor posture contributes to discomfort in this region. Prolonged slumped or rounded-shoulder positions, common with desk work, place chronic stress on the thoracic spine and its surrounding muscles. This sustained stress can lead to muscle tension and imbalances, disrupting the spine’s natural alignment and resulting in persistent pain.
Issues within the thoracic spine can also cause pain. Facet joint irritation, involving the small joints connecting vertebrae, can cause sharp, localized mid-back pain that may worsen after inactivity, such as first thing in the morning. This discomfort often lessens with movement throughout the day. Minor disc problems in the thoracic region, though less common than in the neck or lower back, can also contribute to localized pain.
Pain between the shoulder blades can sometimes originate from the neck, known as referred pain. A pinched nerve or herniated disc in the cervical spine can send pain signals to this area. This referred pain might be described as a dull ache, throbbing, burning, or electric-like sensation.
When Pain Signals Something More
While many instances of shoulder blade pain are musculoskeletal, less common causes can indicate more serious conditions, often involving referred pain from other body systems. Cardiac issues, such as angina or a heart attack, can manifest as pain radiating to the back, including the area between the shoulder blades. This pain is frequently accompanied by symptoms like chest pain, shortness of breath, or dizziness.
Gastrointestinal problems are another source of referred pain to the upper back. Conditions like gallstones, stomach ulcers, or pancreatitis can cause discomfort that radiates to the region between the shoulder blades. This pain is usually experienced alongside other gastrointestinal symptoms, such as severe abdominal pain or nausea.
Pulmonary conditions, though less common, may also present with upper back pain. Lung issues like pleurisy (inflammation of the lung lining) or certain lung cancers can cause pain between the shoulder blades. This pain might be persistent and accompanied by respiratory symptoms.
More severe spinal issues can also lead to pain between the shoulder blades. A herniated disc in the thoracic spine, though rare, can compress nerves or the spinal cord, leading to radiating pain, numbness, or weakness in the legs. Spinal stenosis, a narrowing of the spinal canal, can also cause nerve compression and symptoms like pain, tingling, or weakness that might extend to the arms or legs. In rare instances, spinal tumors or infections can cause persistent, worsening back pain.
Recognizing Warning Signs
Recognize when pain between the shoulder blades warrants professional medical attention. Seek immediate care if the pain is accompanied by chest pain, shortness of breath, dizziness, or excessive sweating. These symptoms could indicate a cardiac event requiring prompt evaluation.
Numbness, tingling, or weakness in the arms or legs are also warning signs. These neurological symptoms suggest nerve compression or damage requiring timely assessment. If the pain radiates down an arm, into the jaw, or across the neck, it may signal a more serious condition.
Other indicators for medical consultation include pain that worsens at night or is not relieved by rest, suggesting underlying inflammatory or systemic conditions. Unexplained fever, chills, or unintentional weight loss alongside back pain are also symptoms to note. If the pain follows trauma or injury, such as a fall, seek medical evaluation. Finally, persistent pain that does not improve with self-care after a few days to a week should be assessed by a healthcare provider.
Strategies for Relief and Prevention
For common musculoskeletal pain between the shoulder blades, several self-care strategies can offer relief and aid prevention. Practicing good posture is key, both while sitting and standing. Ensuring your back is supported, shoulders relaxed, and head aligned over your spine can reduce strain.
Making ergonomic adjustments to your workspace can also help. Position your computer monitor at eye level to prevent neck strain. Ensure your keyboard and mouse allow elbows to be bent at approximately a 90-degree angle, keeping wrists neutral. Your chair should provide adequate lumbar support, allowing feet to rest flat on the floor. Taking frequent short breaks to stand and move throughout the day can also alleviate tension.
Gentle stretching and strengthening exercises can improve flexibility and muscle support in the upper back. Simple movements like shoulder blade squeezes, where you gently pull shoulder blades together, can help strengthen these muscles. Chest stretches can counteract the rounding of shoulders often associated with poor posture.
Applying heat or cold therapy can provide symptomatic relief for muscle soreness and inflammation. Cold packs are beneficial in the first 48 hours after an acute injury to reduce inflammation and numb the area. After this initial phase, or for chronic muscle stiffness, heat therapy can help relax muscles and increase blood flow, promoting healing. Alternating between hot and cold applications can sometimes be effective.
Managing stress can also reduce muscle tension and associated pain. Stress can cause muscles in the back, neck, and shoulders to tense, leading to stiffness and discomfort. Incorporating relaxation techniques, such as deep breathing or mindfulness, can help alleviate this stress-induced muscle tension.