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Shoulder Blade Pain: Your Guide to Pain Relief

Shoulder blade pain is a common problem experienced by many people. If the area around or under the shoulder blade is achy, and sore and begins to affect your normal movements, such as turning the head or reaching out for an object with your arm, it needs medical attention. Visit Dr. Eric Freeman at Redefine Healthcare to find out what could be causing your upper back pain and what treatment options will work best for your condition. At New Jersey’s premier pain management practice, the specialists focus on your injury or discomfort in the first place to come up with a successful way to provide relief.

The shoulder blade is the triangular bone that makes the back of your shoulder. Any injury, trauma, or weakness to the bone or upper back can result in agonizing pain and land you in a lot of trouble.

An accurate diagnosis of what is causing this pain, combined with timely medical attention, can play a significant role in seeking long-term relief.

Here is a complete guide to shoulder blade pain that discusses in detail the causes, treatment options, and ways to prevent this pain from happening again.

Common Causes of Shoulder Blade Pain

There are many reasons you are experiencing a nagging ache or soreness under the shoulder blades. It may be resulting from some trauma or inflammation in the area, or it may be referred pain from other parts of the chest or abdomen. It could also be something as simple as a mild muscle strain or something as serious as a heart condition or lung cancer.

Here are some of the most common causes of pain under the shoulder blade:

Muscle Knots or Tensed Muscles

A muscle knot or tensed muscles is the most frequent reason for pain in the shoulder blade. The area around the muscle will feel tight touch to touch, or tender. Muscles can become tense from doing too much too soon, which usually happens in sports or exercise. For instance, throwing a ball repetitively for some time may result in a muscle knot or tender spot under the shoulder blade. It may also develop as the result of pain in the neck and shoulder.

These knots or tensed muscles limit your ability to function normally and affect your daily routine. Reaching out for an object on a high self or twisting your torso also becomes difficult. Fortunately, muscle knots can be easily treated with a massage technique, known as myofascial release. During the massage, moderate pressure is applied to the spot, which releases the stuck tissue and provides relief from pain.

Shoulder Blade

Muscular Injury

Shoulder blade pain can also result from a muscle injury or strain, also known as a pulled muscle. It usually occurs from overuse or stress on the arms or upper back.

Sometimes a muscle may also become strained if you are sleeping in a new bed, a new position, or even with a new exercise program. Bad posture can also play a significant role in causing muscle injury or strain. When you slouch forward for a long especially while using a computer or working at a desk, it puts stress on the muscles in the upper back, which leads to shoulder blade pain.

Certain Neck Conditions

Arthritis of the neck may result in local neck pain as well as shoulder blade pain due to tense muscles. Spinal stenosis or a narrowing of the space inside the backbone, a pinched nerve in the neck spine due to slipped disc, or arthritis and other issues with the discs in between the bones of the spine can also lead to radiating pain in shoulder blades.

Conditions Affecting Shoulder

In certain cases, a rotator cuff tear or a frozen shoulder may cause pain around the shoulder blade. If you have experienced a shoulder injury recently, the inflammation or the infection resulting from the damage could be the reason behind the soreness or stiffness.

Thoracic Spine Condition

The thoracic spine is the part of the spine that sits between the shoulder blades. Arthritis in the thoracic spine may cause pain around the shoulder blades either because of radiating pain or tense muscles.

In such conditions, exercise, including stretching and strengthening, is an effective way to reduce the pain and provide the necessary support to the areas of the body that need it.

Fracture in the Shoulder Blade

A fracture in the shoulder blade causes severe pain at the onset of the injury. Fractures are serious medical conditions and need immediate medical attention to prevent complications. It is essential to avoid the affected side and use a sling till the doctor recommends the most appropriate treatment.

Osteoporosis increases the risk of shoulder blade fractures. It is a condition when the body loses bone tissue, resulting in lower bone density, which makes the bones brittle and easy to break. For people diagnosed with osteoporosis, strength training goes a long way in strengthening the body and joints and preventing fractures.

Shoulder blade fracture is not common as the scapulae or the two flat triangular bones on each side of the shoulder are considered some of the hardest bones to break. It is often caused by a direct blow or trauma such as a high-speed car accident or a fall from a height.

An Inflamed Nerve in the Shoulder Blade Region

Inflammation in a nerve in the shoulder blade region can also cause pain and soreness in the upper back. Such inflammation can result from carrying a heavy load on the shoulder or back, like a heavy backpack or some infection.  It can lead to widespread pain around the shoulder blades as well as impaired muscle function.

Nerve inflammation can lead to a condition where the shoulder blade is sticking out from the back, instead of being pulled close to the chest.

Specific Heart or Lung Condition

Pain in the left shoulder blade could be a sign of certain heart conditions such as heart attack, pericarditis or inflammation of the lining of the heart, and aortic dissection or a tear in the lining of the main artery leaving the heart. It is best to monitor your symptoms and consult your doctor for timely treatment.

Lung cancer also manifests itself as shoulder blade pain. A type of lung tumor called a Pancoast tumor grows on top of the lungs and usually causes pain in the shoulders, shoulder blades, and arms.  Pain in the shoulder blade accompanied by other symptoms such as shortness of breath, dizziness, or chest pain must not be ignored as they can turn serious and lead to life-threatening consequences.

Fibromyalgia or Widespread Pain

Fibromyalgia is a chronic condition that causes pain and tenderness throughout the body with mood issues, fatigue, and sleeping problems. This long-lasting disorder affects 3 to 6% of people, and its symptoms are similar to that of a muscle strain. It causes widespread musculoskeletal pain in the body, affecting the upper back and shoulder blades.

Symptoms often begin after an event, such as physical trauma, surgery, infection, or psychological stress. In some cases, symptoms gradually accumulate over some time without any triggering event. Researchers are not sure what causes it, but people affected by fibromyalgia have an increased sensitivity to pain.

Determining the exact cause of shoulder blade pain is often difficult, especially if you cannot recall how or when it started. People experiencing shoulder blade pain need to know the possible reasons behind the pain to alleviate the discomfort and seek relief. Knowing the possible causes can also help to take the necessary precautions and prevent further complications in the long run.

Read more:
7 Possible Causes of Pain Under Your Shoulder Blade
Back Pain From Sitting | Possible Reasons and Treatments

How to Reduce Shoulder Blade Pain?

Reducing shoulder blade pain should be your priority, as it is the only way to prevent it from taking over your life. Various treatments and therapies can ease the pain and help you get back to your routine activities.

Treatment depends on the underlying causes, as well as the severity of the pain you are experiencing. For most forms of shoulder blade pain, you can use the following methods to seek relief.


Exercise is the best treatment for reducing pain in most conditions. It not only helps to build strength to support the injured areas, but it also relieves tension in the stressed muscles. However, it is necessary to stop exercise if the pain worsens as it could be some underlying condition causing the pain.

Preventative exercises and stretching can help you bounce back after shoulder pain. It is best to seek a professional physical trainer to learn about exercises that ease shoulder blade pain resulting from muscular tension, injury, or conditions resulting from shoulder and arthritis.

Slow Down and Rest

Slowing down and resting is a good idea if your pain worsens when you perform certain activities and movements. Avoid all activities or movements for 24-48 hours and give your body time to heal and rest, especially if the pain is resulting from muscle overuse. Try easing back to regular activities after a few days of rest but keep the weight and pressure off the muscles and reduce the length of your activities as a precaution.

The human body is capable of healing itself and needs a little time to get back. If the pain has occurred after an intense workout, micro-tears may have occurred in the muscle tissue, and your body may need some time to adapt. You need to pace yourself more than usual and gradually do a bit more each day rather than doing it all in one day. The body will heal tears and help the muscle tissues withstand similar future loads.

Taking a break can also help to prevent overuse and reduce pain. If the pain does not get better after rest and slowing down, seek medical advice to avoid further complications.

Cold or Heat Therapy

Ice therapy is a quick way to relieve pain and inflammation. Wrap the ice pack or a bag of frozen vegetables in a towel before applying it to your skin. Keep it on the affected area for about 20 minutes. After 45 minutes or so, use a heating pad. It is best used for 15 or 20 minutes at a time, with no more than one treatment every 2 hours.

Ice or cold reduces blood flow to the affected area and eases inflammation and swelling, and as a result, you feel less pain. Heat relaxes the local muscles and promotes the flow of blood, which enhances circulation and provides relief. It is usually helpful with many types of shoulder pain, particularly if your muscles feel sore and tense.

Some people prefer heat over cold. Alternate between hot or cold packs to see which is better for relieving your pain. Make sure to protect your skin by including a layer between the ice or heat source and your skin.

Pain Relieving Medications

Over-the-counter pain-relieving medications provide a quick and effective respite from the pain and inflammation resulting from the upper back. They include aspirin, ibuprofen, naproxen, and acetaminophen. These medications relax the muscles and alter pain signals in the brain. However, it is important to avoid long-term usage or over-dosage as it can lead to gastrointestinal issues and other side effects. These medications are only intended for short-term use.

If your pain and condition do not get better with over-the-counter medications, it is best to get it checked by a healthcare professional. The doctor may recommend prescription medications that include corticosteroid medications, injections, ointments, and muscle relaxers to improve your quality of life.

Go For a Massage

A massage is also a good option for reducing shoulder blade pain that feels like a tight knot due to a muscle spasm. It can loosen the muscles, get more blood to the affected areas and bring relief.

If you cannot go out for a massage, there are self-massage techniques and home options you can try. A foam roller or massage ball is a great alternative. Roll the foam roller or ball under the shoulder blade until you locate the tender spot. Once you have identified the spot, slowly roll side to side, up and down, or in a circular motion. Continue this for a minute or more.  This activity should feel like good pain as if you are releasing a tensed or stressed muscle. You can use this self-massage method once or even twice a day.

Acupuncture Works

Acupuncture is a traditional Chinese therapy in which extremely fine needles are inserted into the skin at specific acupoints. These needles, when inserted into specific points, are believed to stimulate the central nervous system, which in turn, releases endorphins, the body’s natural pain-killing chemicals into the muscles, spinal cord, and brain. These biochemical changes may stimulate the body’s natural healing abilities and promote physical and emotional wellness.

Some people are very responsive to this technique and feel better after acupuncture therapy.

When to Seek Medical Help for Shoulder Blade Pain?

Unless you have had a serious injury or develop sudden continuous pain, you can treat your shoulder pain without visiting a doctor. However, if none of the treatments and therapies work for you and there is no relief, seek medical guidance to prevent further pain and complications. If you cannot explain recurring or nagging pain and discomfort in the upper back, consult a doctor as it may be a sign of some underlying issue.

Call your doctor immediately if your upper back pain is accompanied by any or a few of the following symptoms:

  • Symptoms that warrant immediate attention include:
  • Chest pain
  • Shortness of breath
  • Rapid or irregular heartbeat
  • Sudden difficulty speaking
  • Lightheadedness
  • Pain or swelling in the legs
  • Coughing up blood
  • Fever
  • Vision problems
  • Paralysis on one side of the body
  • Excessive sweating
  • Loss of consciousness

The pain management specialists evaluate your condition, identify the source of pain and guide you through a treatment plan tailored to strengthen and stretch your upper back, neck, and core muscles. They may also provide manual manipulation, using hand maneuvers to relieve strain and loosen stiff muscles or misaligned joints.

How to Prevent Shoulder Blade Pain?

If you have found the right way to relieve your pain, the next step is to prevent it from coming back.  You must focus on the techniques and methods to keep this pain away for good. Exercise is the most effective way to avoid shoulder blade pain.

Stretching and massaging the vulnerable area of the previously injured region can avoid pain in the long run. It is essential to slowly ease into exercise without overusing the muscles or stressing them out with rigorous activity.

Here are some key tips that can help you live a pain-free life:

  • Regular exercise is the key to long-term relief. You must continue to train for many months without giving up.
  • Incorporate strengthening exercises into your routine. Do them at least two or three times a week, with only a one or two-day pause. Stretching exercises should be performed daily for the best results.

The trial and error approach works best with these tips. Try a combination of these treatment ideas to see what reduces your pain.

Preventive steps may also include:

  • Avoiding potential fall risks
  • Wearing a seatbelt in a car
  • Easing into a new workout routine
  • Changing sleeping positions

Most types of shoulder blade pain can be prevented. If you want to avoid more pain in the future, start practicing healthy steps today.

Pain in the body is a sign that something is wrong, and it must never be ignored. At Redefine Healthcare, Dr. Eric Freeman offers the most advanced pain management treatments available today and ensures you get the best advice for alleviating the pain and keeping it down. He starts by evaluating your pain and diagnosing your condition most accurately to ease your discomfort and enhance your quality of life. With his highly experienced and skilled team, Dr. Freeman offers comprehensive, cutting-edge care that focuses on your long term physical health and well-being.

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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