Pain in the right shoulder blade when breathing can be a concerning symptom. While often benign, stemming from common musculoskeletal issues, it can also signal more serious conditions involving the lungs, heart, or digestive system. Understanding potential origins helps in seeking appropriate care.
Musculoskeletal Causes
Discomfort under the right shoulder blade, especially when breathing, often stems from musculoskeletal issues. Muscle strain is a common culprit, resulting from activities like lifting heavy objects, repetitive overhead movements, or poor posture. Overworked or injured muscles in the upper back and around the shoulder blade cause localized pain that intensifies with deep breaths, coughing, or sneezing.
Rib dysfunction can also cause this pain. A rib might become misaligned or dislocated due to sudden movements, trauma, or poor posture. This forces surrounding muscles to work harder during respiration, causing sharp, stabbing pain under the shoulder blade that worsens with breathing or upper body movements.
Myofascial pain syndrome, characterized by sensitivity and pain in specific muscle points, can refer pain to the shoulder blade. Trigger points in shoulder and upper back muscles cause a dull ache or sharp pain exacerbated by movement, including chest expansion during breathing. Cervical spine issues, like herniated discs or facet joint dysfunction, can also refer pain to the shoulder blade, sometimes causing a stinging or tingling sensation.
Respiratory and Other Internal Organ Causes
Pain in the right shoulder blade can be referred from internal organs due to shared nerve pathways. Lung conditions are notable sources. Pleurisy, an inflammation of the lung lining, causes sharp chest pain that worsens with deep breaths, coughing, or sneezing, and can spread to the shoulder or back.
Pneumonia, a lung infection, can cause sharp, stabbing chest pain that intensifies with deep breathing or coughing, radiating to the shoulder, upper chest, or neck. Other lung issues, like a pulmonary embolism (blood clot) or certain lung cancers, can also cause shoulder blade pain, often with shortness of breath.
Digestive issues can also refer pain to the right shoulder blade. Gallstones commonly cause pain radiating to the right shoulder or between the shoulder blades. This happens because gallbladder inflammation can irritate the phrenic nerve, which connects to shoulder nerves. Gallstone pain is often sudden, severe upper abdominal pain that spreads to the back or shoulder blade, worsening after fatty meals.
Acid reflux (GERD) can also cause pain between the shoulder blades, although it is more commonly felt in the chest. When acid reflux leads to inflammation in the esophagus, pain signals can be sent to the back, particularly between the shoulder blades. This referred pain can feel like a burning sensation and might be triggered or worsened by acidic foods or large meals. Cardiac conditions, such as a heart attack, can sometimes manifest as referred pain to the shoulder blade, particularly in women.
When to Seek Medical Attention
While often not serious, certain symptoms with right shoulder blade pain warrant immediate medical evaluation. Seek prompt attention if pain is severe, sudden, or worsening. Any pain with shortness of breath, chest tightness, or difficulty breathing requires immediate assessment by a healthcare professional.
Concerning signs include fever, chills, or a cough that produces phlegm, as these can indicate an infection such as pneumonia. Dizziness, sweating, nausea, or pain radiating to other areas like the jaw, arm, or left side of the chest, especially if associated with cardiac symptoms, also necessitate immediate medical care. Unexplained weight loss or persistent pain that does not improve with self-care measures should also prompt a visit to a doctor.
Initial Self-Care Measures
For mild discomfort in the right shoulder blade not accompanied by any severe or concerning symptoms, several initial self-care measures can provide temporary relief. Rest is often beneficial, as it allows strained muscles and tissues to recover. Avoiding activities that aggravate the pain can prevent further irritation.
Applying ice or a cold compress to the affected area for 15-20 minutes several times a day can help reduce inflammation and pain. After the initial inflammation subsides, some individuals find that applying heat can help relax muscles and improve blood flow.
Gentle stretching and massage of the muscles around the shoulder blade may also alleviate tension. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be used to manage pain and discomfort, always following package directions. Improving posture, particularly if prolonged sitting or computer use contributes to the pain, can also be a helpful long-term strategy.