Shoulder blade pain is a common condition. People with shoulder blade pain aka scapula pain usually experience discomfort near the shoulder blade (scapula), and often have difficulty with everyday activities.
The most common causes of shoulder blade pain is muscle strain or injury.[1] However, in some rare cases, it can be caused by a more serious medical condition.
Normally, the pain between the shoulder blades resolves on its own or with exercises. Sometimes you may need to speak to your doctor to discuss further options to help your pain.
Read more about the common causes, symptoms, and treatment options below.
What are the symptoms of shoulder blade pain?
The main symptom of shoulder blade pain (scapula pain) is an ache or tenderness in the upper back, near or between the shoulder blades. Other symptoms include weakness in the shoulder, reduced range of motion, ‘snapping’ or ‘crunching’ noises, or shoulder fatigue.
Pain between the shoulder blades may also make it difficult to reach for objects or perform everyday tasks. You may also notice a protrusion of the shoulder blade, called ‘winging’, or poor posture as a result of pain.
What causes shoulder blade pain?
The most common causes of scapula pain include overuse, strains, sleeping awkwardly, and rotator cuff issues. These problems are often related to the muscle groups surrounding the shoulder, including the arm muscles.
It commonly arises from a muscle strain or injury due to:
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Poor posture
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Incorrect exercise technique
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Repetitive activities
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Lifting heavy objects
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Sedentary lifestyle
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Sitting at a desk for prolonged periods
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Weakness or muscle imbalance
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Sleeping position
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Various other activities.
Shoulder blade pain is commonly associated with other injuries in the shoulder region, such as neck stiffness, rotator cuff injuries, referred pain, bursitis, or nerve impingement.
Sometimes, shoulder blade pain (scapula pain) can be caused by a medical condition such as a fracture, bone spur, or an accident, such as a fall from a bicycle. Other medical causes include:
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Herniated or bulging disc near the shoulder region
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Degenerative changes in the spinal joints
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Dislocation
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Scoliosis
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Narrowing of the spinal canal, or ‘stenosis’
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Osteoarthritis in the shoulder, neck, or spinal joints
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Referred pain from the neck or shoulder
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Trauma
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Fibromyalgia, or non-specific chronic pain
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Gastroesophageal reflux disease (GORD)
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Shingles
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Gallstones
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Some cancer types, such as lung cancer, oesophageal cancer, lymphomas, or bone cancer.
It is important to speak to your doctor if you think your scapula pain may be caused by a medical condition.
In some rare cases, shoulder blade pain can be a sign of:
Some heart conditions can present as pain in the upper back or shoulder blade, more commonly in women than men. This often coincides with signs and symptoms such as shortness of breath, pain down the arm, or chest pain.
- Aortic rupture/dissection
The aorta is a large blood vessel that connects your heart to the rest of your body. It is a rare but extremely dangerous situation in which the aorta can rupture or dissect. This can cause sharp pain in the upper back, abdomen, or side body, often alongside a drop in blood pressure or loss of consciousness. If this occurs, blood flow is severely disrupted and is therefore a medical emergency.
In rare instances, a blood clot can form in the lungs and obstruct blood flow, called a pulmonary embolism. People often report difficulty breathing, alongside a sharp, deep pain in their shoulder blades or chest.
If you experience any of these symptoms, seek immediate medical attention as these are considered dangerous medical emergencies.
When to get help from a doctor
Some cases of shoulder blade pain (scapula pain) get better on their own. However, you should consult your doctor if your pain has not improved, if you experience severe or strange symptoms, or if your pain keeps you awake. Your doctor can examine your shoulder region to check for any problems and rule out any serious causes for your shoulder blade pain.
It is also important to be aware of the ‘red flags’ that may accompany your shoulder blade pain. Seek emergency medical attention if you experience:[2]
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Shortness of breath
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Severe, sharp, unrelenting pain
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A drop in blood pressure
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An irregular or increased heart rate
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Confusion
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Excessive sweating
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Coughing up blood
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Blurred or loss of vision
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Difficulty speaking or forming sentences
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Loss of consciousness
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Paralysis.
Treatment for shoulder blade pain
Treatment for shoulder blade pain (scapula pain) varies depending on the cause of the pain. However, the following are some common treatments that can help with pain.
Exercise
Exercise can help strengthen the muscles in your shoulder, back, and neck, and help relieve shoulder blade pain.[3] Your physiotherapist can prescribe exercises such as rows, push-ups, or scapular stability exercises to restore balance in your muscles and help with your pain.
Stretches
Stretches help keep muscles flexible and healthy, and can be beneficial for your pain. Stretching programs such as yoga or tai chi can help improve mobility and blood flow to muscles and joints.
Speak to your physiotherapist about some stretching exercises that can help with your pain.
Rest
Rest is a great short-term strategy to help with pain, especially if the cause of pain is an overuse injury or a muscle strain. However, it is also important to eventually return to light activity, as resting too long may cause joints to stiffen and can make your symptoms worse.
Heat and ice therapy
Shoulder blade pain may be relieved by applying a heat or ice pack. Try using a heat or ice pack for 10-15 minutes, every three or four hours. Ensure you use them correctly so as to not cause a heat or cold injury to your skin.
Diet
A good diet is important for overall health. Avoid processed and high fat foods that can cause inflammation and affect your symptoms. Instead, eat at least five fruits or vegetables and choose food with omega-3 fatty acids, like salmon.
Therapies
Physiotherapy
A physiotherapist is trained to assess, treat, and manage musculoskeletal conditions, such as shoulder blade pain. Your physio can use exercises and techniques to relieve your symptoms and help get you back to your everyday activities.
Massage Therapist
Massage therapy can help treat the muscle tension that may be contributing to the pain around your shoulder blades. Passive treatments such as handheld devices can also help relax your muscles.
Medications
Some medications can help with the symptoms you may be experiencing. For example, medications such as ibuprofen (Advil, Nurofen) are anti-inflammatories and can help relieve pain in some instances. In other cases, your doctor may prescribe steroids to target pain and inflammation, or muscle relaxers to help with your symptoms.
Surgical Options
Most cases of shoulder blade pain (scapula pain) will improve with conservative treatment, including exercise, rest, and medications. However, in rare cases, you and your doctor might decide to pursue a surgical option if your shoulder blade pain is severe and has not responded to nonsurgical treatments. This may consist of tendon repair or scar tissue removal in your shoulder region.
Important to consider
It is important to note that if there is an underlying medical condition, such as a heart condition or disease, this needs to be addressed by a medical practitioner before the treatment options above are considered.
Prevention of shoulder blade pain
Ways to prevent shoulder blade pain include:
Good posture can help you develop strength and avoid developing pain. Be conscious if you slouch, and instead sit or stand tall in a relaxed manner. Use a lumbar roll or supportive pillow to help with your sitting and sleeping positions, respectively.
It is important to frequently move and stretch, especially if you are working for prolonged periods or have a sedentary lifestyle. Ergonomic options, such as a standing desk, can help with your body position throughout the day.
- Proper lifting techniques
Incorrect lifting techniques can trigger pain around your shoulder blades. If you are required to lift heavy items, ensure you bend your knees and use your legs rather than putting pressure on your arms and back.
Ensure you have a good diet, get a good night’s sleep, and exercise regularly. This can help keep your body healthy and strong, and help prevent pain.
Long-term outcomes
The long-term outcome for shoulder blade pain depends on the cause and the severity of your condition.
In most cases, shoulder blade pain resolves with the proper treatment techniques and time. However, if left unaddressed, scapula pain can persist for long periods of time. It is important to speak to your doctor or physiotherapist about your shoulder blade pain.
