What Causes Shoulder Blade Pain and How to Relieve It

Pain between the shoulder blades is a common complaint but it’s also one that can leave you wondering whether it’s just muscle tension or something far more serious. While it’s often caused by poor posture or overuse, shoulder blade pain can also signal issues with your spine, heart, lungs, or digestive system.

Understanding the type of pain you’re feeling and whether it’s accompanied by other symptoms is key to getting the right treatment and peace of mind.

Common Causes of Shoulder Blade Pain

1. Muscle Strain

This is the most common cause and typically results from:

• Poor posture (especially leaning forward while sitting)

• Lifting heavy objects

• Sports or twisting activities like golf or tennis

• Unsupportive mattresses or awkward sleep positions

Symptoms: Achy or sore muscles, stiffness, and pain that worsens with movement
What to do: Rest, apply ice or heat, take over-the-counter pain relievers like ibuprofen, and practice stretching or posture exercises.

2. Trauma or Injury

Falls, car accidents, or sports injuries can affect the muscles, joints, or even bones between your shoulder blades.

Conditions may include:

• Rotator cuff tears

• Shoulder dislocation or separation

• Thoracic spine fractures

What to do: Seek medical evaluation if you experience severe pain, visible deformity, or loss of function.

3. Herniated or Bulging Disc

Disc issues in the cervical or upper thoracic spine can compress nerves and cause pain that radiates between the shoulder blades.

Symptoms: Sharp or burning pain, numbness, tingling, or weakness in the arms
What to do: Physical therapy, posture correction, medication, and in severe cases, surgery

4. Spinal Arthritis

Degenerative arthritis, including osteoarthritis or rheumatoid arthritis, can cause inflammation in the spine, leading to upper back pain.

Symptoms: Stiffness, limited range of motion, tenderness
What to do: Anti-inflammatories, stretching, physical therapy, and lifestyle modifications

When Shoulder Blade Pain Is a Warning Sign

5. Cardiac Events (Heart Attack or Pericarditis)

Heart problems don’t always present with chest pain. In women especially, shoulder blade pain can be an early symptom of a heart attack.

Red flags include:

• Dull, persistent upper back pain

• Chest discomfort or pressure

• Shortness of breath, dizziness, or sweating

Aortic conditions, such as dissection or rupture, may cause sudden, tearing pain between the shoulder blades and require immediate emergency care.

What to do: Call 911 if you suspect heart-related pain, even if you're unsure.

6. Gallbladder Disease

Gallstones or inflammation can cause referred pain, especially after eating fatty meals.

Symptoms:

• Sharp pain in the upper right abdomen

• Nausea

• Pain that radiates to the back or shoulder blades

7. Lung or Esophageal Cancer

Certain cancers, including Pancoast tumors at the top of the lungs, can cause pain that spreads to the shoulder blades due to nerve involvement.

Other cancers that may cause similar symptoms include:

• Esophageal cancer

• Liver cancer

• Lymphomas

• Breast cancer (especially if it has spread to the spine)

8. Pulmonary Embolism (PE)

A PE occurs when a blood clot blocks a lung artery. It’s a life-threatening condition that may present as:

• Sudden, sharp pain between the shoulder blades

• Shortness of breath

• Chest pain, rapid heart rate, or leg swelling

What to do: Seek emergency care immediately.

9. Gastroesophageal Reflux Disease (GERD) or Pancreatitis

Acid reflux or inflammation of the pancreas can cause pain that radiates to the back.

Symptoms: Heartburn, indigestion, upper abdominal pain

10. Shingles

Caused by the varicella-zoster virus, shingles can result in intense, burning pain on one side of the back often near the shoulder blades followed by a rash.

11. Scoliosis

Spinal curvature in the thoracic region can cause imbalanced shoulder positioning and pain.

Symptoms: Uneven shoulders, chronic back pain, or changes in posture

12. Myofascial Pain Syndrome

Trigger points in tight muscle fibers can refer pain to the shoulder blades common in people who work at desks or spend hours at a computer.

When to Seek Medical Attention

See a healthcare provider if your shoulder blade pain is:

• Severe or persistent

• Accompanied by numbness, tingling, or weakness

• Not relieved by rest, stretching, or medication

• Paired with shortness of breath, chest pain, or dizziness

Call 911 immediately if you suspect a heart attack, pulmonary embolism, or aortic dissection.

Diagnosis

A provider will evaluate:

• Your medical history and symptoms

• Pain location, duration, and intensity

• Activities or injuries that may have triggered pain

You may also need:

• X-rays or MRI

• Blood tests (to check for inflammation or cardiac issues)

• CT scan or ultrasound (to assess organs or blood vessels)

Treatment Options

Treatment depends on the cause but may include:

• Muscle-related pain: Rest, NSAIDs, heat/ice, stretching

• Disc or spine issues: Physical therapy, medication, surgery (if severe)

• Heart conditions: Emergency intervention, medication, or procedures

• Digestive causes: Dietary changes, medications, or gallbladder removal

• Cancer: Treatment plans involving oncology care

• Pulmonary embolism: Blood thinners or surgical intervention

Prevention Tips

While not all causes are preventable, you can reduce your risk of shoulder blade pain with:

• Good posture and ergonomic work setups

• Regular upper body strength and mobility exercises

• Avoiding heavy lifting or using proper technique

• Maintaining a healthy weight

• Stretching and movement breaks during long periods of sitting

• Getting prompt care for new or worsening symptoms

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