Pain between the shoulder blades when breathing in is a common concern. This discomfort, also known as interscapular pain, can manifest as a dull ache or a sharp twinge. Understanding its potential origins is helpful for seeking appropriate care.
Musculoskeletal and Postural Contributors
Musculoskeletal factors frequently contribute to pain between the shoulder blades, often intensified by breathing. Muscle strain from activities like repetitive motion, heavy lifting, or overexertion can lead to tension and pain in the upper back. Poor posture, particularly prolonged sitting with slouching or hunching, places stress on the upper back muscles, contributing to discomfort. This can cause muscles like the rhomboids and trapezius to become tense.
Rib dysfunction, where one or more ribs are misaligned or injured, can also cause pain that radiates through the upper back and shoulder blade, especially when taking a deep breath. This can occur from impact injuries, twisting movements, or awkward sleeping positions. The muscles between the ribs may become overworked when the ribs are out of place, leading to strain. Costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, can cause sharp chest pain that may spread to the shoulder and back, often worsening with deep breaths.
Nerve impingement in the thoracic spine can also result in pain between the shoulder blades. This occurs when pressure is placed on nerves in the spinal column, causing sharp pain, tingling, or burning sensations. Dysfunction of the costovertebral joints, which connect the ribs to the thoracic vertebrae, can also cause localized pain between the shoulder blades, exacerbated by breathing or twisting movements.
Internal Organ-Related Causes
Pain between the shoulder blades can sometimes be a sign of issues originating from internal organs, a phenomenon known as referred pain. This occurs when sensory nerve fibers from internal organs converge in the spinal cord, causing pain to be perceived in a different location. Referred pain often feels deep and aching.
Respiratory conditions can cause pain that refers to the shoulder blade area. Pleurisy, an inflammation of the lining around the lungs, typically causes sharp chest pain that worsens with deep breaths and can spread to the shoulder or back. Pneumonia, a lung infection, can also lead to upper back pain, especially if inflammation spreads to the pleura, irritating the nerves. Fluid buildup around the lungs due to pneumonia can also compress the pleura, causing pain with deep breathing.
Cardiac issues can sometimes cause referred pain to the upper back and shoulder blade. A heart attack can manifest with pain in the neck, left shoulder, or back, alongside chest pain and shortness of breath. Pericarditis, inflammation of the sac surrounding the heart, can also cause pain that radiates to the shoulder blades.
Gastrointestinal issues may also refer pain to the area between the shoulder blades. Gallstones can cause severe pain in the upper right abdomen that radiates to the back or under the shoulder blades, often triggered by fatty meals. Acid reflux and esophageal spasms can also present with pain in the chest or upper back due to irritation of the esophagus.
When to Consult a Healthcare Professional
Certain symptoms accompanying pain between the shoulder blades warrant prompt medical attention. Sudden, severe pain, especially if it does not improve with rest, should be evaluated by a doctor. The presence of chest pain, particularly if it spreads to the arms, neck, or jaw, or lasts for 15 minutes or more, requires immediate medical care. Shortness of breath, dizziness, or lightheadedness, alongside shoulder blade pain, are also serious indicators.
Other red flag symptoms include fever, coughing up blood, or unexplained weight loss. Pain that radiates down an arm or into the jaw, or pain accompanied by numbness or weakness in the legs, also suggests a need for professional evaluation. These symptoms indicate conditions requiring timely diagnosis and treatment.
Management and Preventive Measures
For pain between the shoulder blades not stemming from a serious medical condition, several strategies can provide relief and aid in prevention. Improving posture is a primary step, especially for those who sit for extended periods. Maintaining a straight back, relaxed shoulders, and keeping the computer monitor at eye level can help alleviate strain. Ergonomic adjustments at a workstation, such as using a supportive chair and proper arm support, can also reduce tension.
Gentle stretching exercises can effectively relieve muscle tension and improve flexibility in the upper back. Examples include shoulder blade squeezes, doorway stretches, and cross-body arm stretches. Applying heat or cold packs to the affected area can help reduce pain and inflammation. Ice is often recommended for acute pain, while heat can relax tight muscles. Over-the-counter pain relievers, such as ibuprofen, can also provide temporary relief.
Stress reduction techniques are beneficial, as emotional stress can lead to muscle tension in the upper back and neck. Mindfulness, deep breathing, and regular physical activity, like walking or yoga, can help manage stress and reduce muscle tightness. Maintaining a healthy weight and incorporating regular movement breaks throughout the day also contribute to preventing and managing this type of pain. These measures offer relief and prevention but do not replace medical diagnosis if serious causes are suspected.