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7 Possible Causes of Pain Under Your Shoulder Blade

Pain under the shoulder blade is one of the leading complaints in adults that has debilitating effects on their life, mood, sleep and work. If you cannot identify the reasons behind your upper back pain, visit Redefine Healthcare, a leading pain management center in New Jersey, for the best advice on what may be causing it. Dr. Eric Freeman is a board-certified interventional spine and pain management specialist and uses the most cutting-edge techniques to find out the source of pain and address it successfully. With his highly trained and skilled team, Dr. Freeman helps you find the best solutions for your shoulder blade pain and keeps it from recurring.

Experiencing pain under or near your shoulder blade, the triangular bone that forms the back of the shoulder, is distressing. It not only limits or makes arm movement difficult, but also interferes with routine activities, affecting your work and life. If you have sharp or burning pain between the spine and shoulder blade, persistent tenderness, or an ache that sweeps across the shoulder blade, it may be a result of certain conditions.

There are several factors to consider when dealing with shoulder pain symptoms. Discussed below are some possible causes of pain under the shoulder blade that will help you better understand the type of discomfort you are suffering from and what to do about it.

7 Possible Causes of Pain Under Your Shoulder Blade

Cause No. 1 – Inappropriate Posture

Inappropriate posture can cause structural changes to the spine that result in upper back pain, including pain in the shoulder blade. Certain activities weaken your muscles and put unnecessary pressure on the spinal discs, muscles, and ligaments, contributing to upper back pain. Sitting for a long period with poor posture, hunching your back, keeping the head tilted down, or sitting to one side while working work on a desk or reading from a cellphone routinely can weaken or imbalance specific muscles.

This imbalance is known as an upper cross syndrome in which muscles that hold and stabilize the shoulders and back become weak. This lack of stability not only causes pain under the shoulder blades but can also lead to other complications, including weakness in the cervical spine.

Cause No. 2 – Inappropriate Lifting Techniques

Lifting weights above your head without appropriate technique can harm your body, especially the shoulder blades, and cause upper back and shoulder injury. Placing undue pressure on the upper back by carrying more weight than the body can handle increases the risk and results in spine misalignment.

If you lift weights regularly or end up lifting some heavy object anytime, it is essential to understand the proper way of holding things right. Inappropriate lifting techniques can lead to muscle strain, sprain the ligaments or potentially injure the shoulder joint or spine that causes pain under or near the shoulder blade.

Cause No. 3 – Overuse of Muscles

Many activities can put your upper back and shoulders through more work than they are used to doing, such as painting a ceiling, moving furniture, or participating in a softball game after a long time. Overuse of these muscles can result in tight muscle spasms, muscle strains, and ligament sprains which can cause pain in the upper back, mostly between the shoulder blade and spine.

Scapulothoracic bursitis is another condition, also known as snapping scapula syndrome, which causes pain under the shoulder blade. In this condition, the bursa between the shoulder blade and thoracic syndrome becomes inflamed and causes pain due to overuse or injury.

Cause No. 4 – Cervical Disc Herniation

Cervical disc herniation occurs when the inner portion of a disc in the cervical spine or neck ruptures through the outer wall of the disc. The outer layer of the disc can rupture due to a sudden jerk, such as putting a brake in the car suddenly, or weak neck and shoulder muscles that lead to instability. As the disc’s outer layer tears, the inner layer starts to leak out and causes intense pain and inflammation of nearby nerve roots that radiates pain down into the shoulder, arm, and hand.

A disc herniation in the lower cervical spine is more likely to cause sharp pain in or an area closer to the shoulder blade. Although it is less common, there are chances that a disc herniation in the thoracic spine or upper back can also result in shoulder blade pain.

Cause No. 5 – Dislocation of a Rib

It may be a less common cause, but a misaligned rib can result in sharp pain under the shoulder blade. A rib may pop out of place after repetitive strain, too much pressure imposed on the ribs, or reaching for an item overhead. Dislocation of a rib can cause agonizing pain under the shoulder blade, similar to a knife stuck in the back, which makes it difficult to engage in physical activities and even breathe.

Also known as subluxated rib, this condition usually occurs in people who are stressed and suffer from a cycle of sympathetic chest breathing. This accentuated breathing from the upper back, neck, and chest instead of a calm breath from the belly leads to more rib movement. The ribs can get stuck in a flexed position, which can worsen pain under the shoulder blade.

Cause No. 6 – You Have a Heart or Lung Condition

If your left shoulder blade is hurting, it could be a sign of certain heart conditions such as pericarditis or aortic dissection. Aortic dissection is a serious, life-threatening condition that occurs when the largest artery of the heart develops a tear. It can cause severe pain that can move near or under the shoulder blade. Sometimes a heart attack may also feel as pain in the upper back or shoulder, particularly in women.

Lung cancer sometimes also manifests itself as shoulder blade pain. Shoulder pain accompanied by other symptoms such as shortness of breath, dizziness, or chest pain may be resulting from an unidentified heart or lung condition.

Cause No. 7 – Compression Fracture

A compression fracture occurs when a vertebral bone, usually in the upper back, weakens and compresses, causing back pain that feels better with rest or is sensitive to the touch. Compression fractures usually take place in the thoracic and lumbar sections of the spine and result from traumatic injury.

The most common reason for a compression fracture in older adults is osteoporosis, as bones weaken with age and compress. It can also cause intense pain upon touch.

The list of possible reasons behind the pain under the shoulder blades gives you an idea of how you can start feeling better.  If any back or shoulder pain does not subside in a few weeks or begins to affect your daily activities, consult a doctor. If the pain is severe or accompanied by other symptoms that make you feel uncomfortable such as headache, tingling, weakness, or nausea, rush to the emergency room to prevent complications.

When to See a Doctor for Your Shoulder Blade Pain?

If you are having severe or unusual pain under your shoulder blade that does not seem to be going away, call your doctor. Persistent or increasing pain is a sign that something is wrong, and you must get it checked. The specialist will take thorough medical history and conduct an extensive physical exam to rule out critical conditions.

Your condition may not be serious, but any of the above-mentioned causes may be the reason behind it. Seek immediate medical attention if your shoulder blade is accompanied by other symptoms, such as:

  • Shortness of breath
  • Chest pain
  • Lightheadedness
  • Excessive sweating
  • Pain, swelling, or redness in your legs
  • Coughing up blood
  • Fever
  • Rapid or irregular heart rate
  • Sudden difficulty speaking
  • Loss of vision
  • Paralysis on one side of your body
  • Loss of consciousness

Proper diagnosis is essential as it can prevent severe consequences and help you find the best treatment. Most of the time, overused muscles or a muscle strain is the culprit behind the pain, and it can be easily relieved with medication and physical therapy.

Read more:
Shoulder Blade Pain: Your Guide to Pain Relief
7 Causes of Burning Knee Pain

How to Find Relief From the Pain Under Your Shoulder Blade?

Treatment and relief from shoulder blade pain depends on the type of pain and its cause. Most cases of shoulder blade pain can be treated with a little time and rest if it is not resulting from any underlying condition. It is best to consult your doctor if your pain does not seem to be subsiding after a few days.

Some efficient ways to alleviate shoulder blade pain include:

  • Stretching and exercise to strengthen your back and loosen tense muscles
  • Massage and physical therapy to relieve that pain that comes and goes after injury or compressed nerve
  • Over-the-counter anti-inflammatory medications that reduce inflammation and soreness

If needed, your doctor may also recommend medications to strengthen weak muscles to ensure you do not have to go through this pain again. Research shows that 90% of people experiencing pain in their shoulder blades respond positively to rest and exercise.

Consult a spine specialist if you continue to experience pain under your shoulder blade or if the spasms are resulting from some preexisting condition. There are many reasons you may be experiencing a nagging ache or soreness under the shoulder blades, and it may escalate if you do not seek timely medical attention. At Redefine Healthcare, Dr. Freeman and his team help to minimize the pain and its after-effects using advanced non-surgical pain relief therapies and treatments that address the source of that pain. You can look forward to comprehensive, cutting-edge care at New Jersey’s premier pain management practice and enjoy long-term relief from pain and discomfort. 

Page Updated on Dec 12, 2022 by Dr. Freeman (Pain Management Specialist) of Redefine Healthcare


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Dr. Eric D. Freeman

Dr. Eric D. Freeman is a top-rated, best-in-class pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New Jersey and the country. He is an award-winning expert and contributor to prominent media outlets.

Dr. Eric D. Freeman has been recognized for his thoughtful, thorough, modern approach to treating chronic pain. He has been named a “top pain management doctor in New Jersey” and one of “America’s Top Physicians” for advanced sports injury treatments.

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