Shoulder Blade Pain: Causes, Symptoms, Treatment & More 

Introduction

Ever felt a discomfort or stiffness between your shoulder blades after sitting too long, working on a laptop, or carrying a heavy bag? That uncomfortable feeling is quite common, especially with poor posture or repeated strain¹. Shoulder pain may range from mild (sore muscles) to more intense and long lasting. In some cases, it may even indicate some underlying conditions such as nerve damage, joint problems, or even issues with internal organs like the heart¹.

In this article we will discuss what is shoulder blade pain, its causes and symptoms, how it is diagnosed, some home care tips and medical treatment available. These will help you understand how to better manage shoulder blade pain. 

What is Shoulder Blade Pain?

Shoulder blade is a flat, triangular bone, at the back of the shoulder and the muscles that help move the upper arm are attached to it². The discomfort felt around, between (intrascapular)³ or under the shoulder blade is called shoulder blade pain. The pain may feel dull, aching, sharp, or like muscle tightness, and it may occur on one side or both sides. The most common causes of this pain include poor posture, prolonged sitting, repetitive use of arms or shoulders, nerve injury, neck problems, etc¹. 

Shoulder pain can significantly affect a person’s quality of life and daily functioning. People with shoulder related pains can often experience reduced shoulder movement and poorer physical function, making it harder to perform everyday activities such as reaching, lifting, or dressing. It might also affect a person’s physical and emotional health, making it more difficult to stay independent and maintain overall well-being⁴.

Causes of Shoulder Blade Pain

Shoulder blade pain causes may range from simple to severe. Following are some among them. 

• Poor Posture: Poor posture, especially while using electronic devices such as mobile phones, or tabs. It can give more load around the shoulder blade. Over time, this load might lead to muscle tightness, imbalance, and pain, making poor posture a common cause of shoulder blade pain⁵.
• Shoulder Injuries: Shoulder injuries such as rotator cuff (a group of muscles and tendons around the shoulder joint) injuries, inflammation of the shoulder joint, or frozen shoulder (stiff shoulder) might change the normal movement and position of the shoulder. This might cause the muscle around the shoulder to work harder to support the arm, causing muscle strain, tightness and shoulder blade plain¹. Overtime, this might lead to persistent pain around the shoulder, making daily activities hard to perform. 
• Muscle Strain or Overuse: Repeated movements such as pushing, pulling, lifting or carrying heavy objects might overwork the muscles, tendons, and joints of the shoulder. This might cause muscle soreness, fatigue, tightness, or discomfort around the shoulder blade⁵.
• Scapular dyskinesis: Scapular dyskinesis is an abnormal position or movement of the shoulder blade during shoulder and arm movements. This might mainly occur due to injury or weakness of muscles that stabilise the shoulder blade. This in turn might cause intense pain and discomfort around the shoulder blade while trying to move the shoulders⁶.
• Neck Problems: Neck-related issues such as neck stiffness or cervical spondylosis (neck arthritis) might irritate the nerves that travel to the shoulder blade region. As a result, this might cause a radiating pain from the neck to the shoulder blade area, often combined with stiffness and discomfort⁷.
• Nerve Issues: Nerve issues such as upper back nerve damage might weaken the muscle that holds the shoulder in place. This might cause the shoulder blade to protrude out and cause discomfort (scapular winging). This may be due to nerve pressure, accidents, or heavy lifting⁸.
• Organ-Related Issues: Problems in internal organs might sometimes cause shoulder blade pain. Sudden pain in the left shoulder might be an indication of a heart issue such as heart attack¹. Pain in the shoulder blade might also be an early sign of serious lung problems, like advanced lung cancer⁹.

 Symptoms of Shoulder Blade Pain

Symptoms of shoulder blade pain mainly depend on its cause. Following are some common symptoms. 

• Pain: People might feel aching, dull, or sharp pain around the shoulder blade. The pain may radiate from the neck to the shoulder blade and then down the upper arm and forearm, sometimes reaching the fingers. It may feel burning at times, indicating nerve involvement^7,10.
• Mobility Issues: Individuals with shoulder blade pain might often have difficulty in raising their hands above the shoulder height. This might be mainly due to stiffness or tightness, which makes the movement more difficult and painful, affecting everyday activity¹.
• Weakness: People might have a feeling of fatigue or tiredness around their shoulder muscles and blade. This might happen while performing repetitive moves such as lifting, pulling, or stretching⁸.
• Physical Changes: People with shoulder blade pain may experience swelling or redness around the shoulder blade. Sometimes there might also be visible protrusions of the blade. This might be due to rotator cuff injury, or nerve issues such as scapula winging caused as a result of accidents or heavy lifting^1,8.
• Audible Sensations: People might feel clicking, grinding, or crackling sounds when they move their shoulder blade over the rib cage (snapping scapula syndrome). This happens particularly during physical activities and might be a cause of muscle imbalance around the shoulder blade¹¹.

Diagnosis of Shoulder Blade Pain

To identify the exact cause of shoulder blade pain, doctors will take a thorough history, do a proper check-up and advise some diagnostic tests. Following is the course of action for diagnosing should blade pain. 

1. History  

• The doctor will ask you about the onset, duration, and nature of pain (sharp, dull, burning, or radiating). 
• He will question on recent injuries, repetitive activities, posture habits, or underlying medical conditions, if any, which might help identify the possible cause. 
• He might ask for symptoms such as numbness, tingling, weakness, or organ-related signs (e.g., chest pain, shortness of breath). 

2. Physical Examination 

• The clinician will examine for shoulder issues- difficulty in moving, any protrusion, pain or swelling, neck issues-tightness or stiffness^7,10.
• He will perform a range of motion tests such as lifting, rotating, or moving the arm, to see whether these triggers the pain. 
• He can assess muscle strength and shoulder blade stability to check for weakness or unusual movement (such as in scapular winging)⁸. 

3. Imaging Tests 

• X-ray: Helps identify bone fractures, arthritis, structural abnormalities of the shoulder, spine or ribs^1,11.
• Magnetic Resonance Imaging (MRI): May be useful for evaluating soft tissues, including muscles, tendons, ligaments, and nerves, bone issues and rotator cuff tears. 
• Ultrasound: May be useful for evaluating soft tissues like muscles, tendons, nerves, etc, and rotator cuff tears¹².
• CT Scan: Helpful in identifying winging of scapula, bone abnormalities, or suspicious growths¹¹.

4. Nerve Tests / Electromyography (EMG) 

• These tests are helpful in identifying nerve related involvement or problems (tingling, numbness, or weakness) in shoulder issues^7,8.

5. Laboratory Tests 

• Laboratory tests such as blood tests (blood count or ESR) might be helpful for conditions such as inflammation, infections, systemic dieases^1,11.

 Home Remedies for Shoulder Blade Pain

To help manage or reduce your shoulder blade pain, you may try some home care methods. Following are some tips that might help you in shoulder blade pain relief. 

1. Cold Therapy

Applying a cold pack for 15 minutes may help reduce shoulder pain, inflammation or strain^1,7. Cold works by the narrowing blood vessels in the region, reducing swelling and providing a temporary sensation of numbness. It is best to place a cloth between the skin and cold pack/ice to avoid excessive risk of frostbite. 

2. Heat Application

Applying heating pads might also help relax muscles and reduce neck stiffness or inflammation⁷. However, always be careful and not use high heating levels to avoid risk of burns.   

3. Gentle Stretching Exercises

Gentle stretching exercises for neck, shoulders, and upper back might help you ease muscle tightness and improve mobility. It might also strengthen rotator cuff tendons and shoulder muscles¹.

4. Massage Therapy or Foam Rolling

Gentle massage or foam rolling might help you reduce pain and improve shoulder movement^7,13 by relaxing tight muscles and improving the blood flow. 

5. Posture Correction

Correcting the rounded upper back (thoracic kyphosis) and strengthening the shoulder muscles might help you keep the shoulder blades properly aligned¹⁴. Also, maintaining proper posture while sitting, standing, and using electronic devices can reduce strain on the shoulder blade muscles, thereby helping ease should blade discomfort.  

Note: The above given homecare tips are meant for temporary or mild problems only. It is advised not to over-do these techniques in order to avoid further strain or injury. Please consult a doctor if your shoulder issues do not resolve or worsen.  

Treatment for Shoulder Blade Pain

If even after following home care tips you are still experiencing shoulder discomfort and not sure how to relieve shoulder blade pain, consult a doctor for proper diagnosis and treatment. Here are some medical management options that your doctor may suggest. 

• Pain-Relief Medications (Nonsteroidal Anti-Inflammatory Drugs- NSAIDs): NSAIDs medicines such as ibuprofen and diclofenac help reduce pain and inflammation by decreasing swelling around the affected muscles, thereby improving comfort and movement¹. Topical pain relief gels containing diclofenac are available over-the-counter and can be used if simple home remedies don’t work, however, any oral painkillers should best be taken under your doctor’s guidance only. 
• Physiotherapy and Strengthening Exercises: Physiotherapy and strengthening exercises might help relax your muscles and shoulder blade, improve your posture and help restore your normal movements or activities^1,14. A physiotherapist can help you work this better. 
• Scapular Bracing: Scapular bracing, which is the technique that might use a brace or support to help keep the shoulder blade, might be helpful in improving your posture, provide comfort and reduce pain, while working on a laptop or desk work¹⁵. Your doctor will advise how and when to use a shoulder brace. 
• Injection Therapy: Injection therapy includes corticosteroid injections, which are anti-inflammatory medications. These might temporarily help you get relieved of the shoulder blade pain by reducing inflammation¹. These will be administered by your doctor’s if needed. 
• Surgical Management: Surgeries, though rarely done, might help you with structural abnormalities, nerve pressure, or growths (for example, lung tumours causing shoulder blade pain), if other methods don’t help^1,8,9.

Prevention Tips for Shoulder Blade Pain

Adopting practical options may be more helpful in reducing shoulder blade pain than seeking therapies or management. Following are some safety tips that you may follow. 

• Maintain good posture: Follow a good posture while sitting at a desk, using a phone, or working on a computer; keep your back straight and shoulders relaxed. This keeps the shoulder muscles and tendons stay in proper alignment¹.
• Sleep properly: Avoid sleeping on stomach or affected shoulder for a long time to reduce stain and use a soft pillow; proper sleep posture might help reduce the risk of shoulder pain¹⁶.
• Strengthen Muscles: Strengthen your tendons and shoulder muscles¹ choose exercises focusing on upper back, shoulders, and core to support proper shoulder blade movement and reduce strain. 
• Stretch Regularly: Perform gentle stretches for neck, shoulder, and upper back; these might help you to improve flexibility and reduce stiffness¹. 
• Keep your workspace comfortable: Sit comfortably by adjusting your chair height, desk position, and screen level; this might help reduce strain on neck, shoulder, and shoulder blades¹⁵.
• Avoid repetitive movements or sudden strains: Avoid overuse of muscles by repetitive movements; adopt proper techniques- straight back, bent knees, no twisting. This might free your body from overload and keep the muscles relaxed. 
• Take Breaks: Take one-minute microbreaks while at work; this might help you reduce muscle fatigue¹⁷ and shoulder strain. 

When to See a Doctor?

Though home care tips and medical management approaches might alleviate your shoulder issues, there are some instances which you should not ignore. You should seek immediate medical attention: 

• If you think you are having sudden shoulder pain combined with dizziness, breathing difficulty, or sweating and the pain runs through your chest, left jaw, arm, or neck. 
• If you get a sudden fever, swelling, or redness along with shoulder pain. 
• If your shoulder pain retains for more than 2 or 4 weeks, even after performing homecare tips. 
• If your shoulder area attains unusual colours like blue or red¹.
• If your shoulder blade gets dislocated or changes position, causing intense pain and discomfort⁶.
• If the conditions such as numbness or weakness, persist and are getting more worse⁷.
• If you get a sudden shoulder injury after falling from a height, motor vehicles or sporting accidents⁸.

Conclusion

Shoulder blade pain is a common problem that can range from mild discomfort to more serious issues. Most cases may be manageable with early intervention, proper posture, regular stretching, and strengthening exercises for a period of time. But always notice the changes your body shows; consult a doctor if pain is severe, persistent, or accompanied by other symptoms to ensure proper diagnosis and management. 

Frequently Asked Questions (FAQs)

References

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14. Yoo W gyu. Effects of thoracic posture correction exercises on scapular position. J Phys Ther Sci. 2018;30(3):411-412. doi:10.1589/jpts.30.411. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5857448/

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