Shoulder blade pain is one of those pesky, difficult-to-nail-down aches that appear for any number of reasons—sometimes after a grueling workout, other times out of the blue. Although it is usually nothing to worry about, shoulder blade pain may be an indication of something serious on occasion. Here’s a rundown of the 10 most frequent reasons for shoulder blade pain, how they tend to feel, and when to call your doctor.
1. Muscle Strain
A simple muscle strain is one of the most frequent reasons for shoulder blade pain. Whether it’s from lifting something heavy, working out too much at the gym, or just sitting over your laptop for hours with your shoulders hunched over, the muscles around your shoulder blade (or scapula) can tighten up and become sore. Twisting sports such as golf or tennis can also cause this type of strain. The pain is typically dull or achy and worsens when you move.
2. Rotator Cuff Injuries
The rotator cuff is a set of muscles and tendons that keep your shoulder from moving too far in any direction. If these muscles become torn or inflamed, you may have pain that travels to your shoulder blade, particularly when you reach overhead or lift your arm. You may also experience your shoulder becoming weak, you’ve lost some motion, or there’s a clicking or popping sensation when you move your shoulder.
3. Joint Issues and Osteoarthritis
The joints in your spine or shoulder will degenerate overtime, resulting in osteoarthritis. This can result in stiffness, tenderness, and pain in the region surrounding the shoulder blades. If arthritis is present in your upper spine, you can also develop headaches or experience some swelling in this region.
4. Bulging or Herniated Discs
Problems with the discs in your upper back or neck—such as herniation or degeneration—can compress surrounding nerves and cause pain in your shoulder blades. You may also have numbness, tingling, or weakness in your hands or arms, particularly when you move your neck in some directions.
5. Heart Conditions
Not all chest pain is due to heart issues. Heart attacks, particularly in women, may present as a dull, steady ache in the middle back between the shoulder blades. Other conditions of the heart, such as pericarditis (heart lining inflammation) or an aortic dissection (tear in the large artery), can also cause back pain between the shoulder blades. If your back pain is accompanied by aching in the chest, shortness of breath, or lightheadedness, seek emergency attention immediately.
6. Lung and Chest Conditions
Some lung diseases are the cause of shoulder blade pain. They include pulmonary embolism (a blood clot in the lung), pneumothorax (a collapsed lung), and certain forms of lung cancer, such as Pancoast tumors. Shingles—a viral illness that attacks the nerves—can also bring sharp pain in this region, even before a rash appears.
7. Pleurisy
Pleurisy is inflammation of the lining surrounding your lungs. It most often results in sharp, stabbing pain that worsens with deep breathing or coughing. Pleurisy can occasionally radiate into your back or shoulders. Pleurisy may be caused by infections, autoimmune disorders, or even a blood clot in your lungs.
8. Digestive and Gallbladder Issues
Your digestive system pain may occasionally radiate upward and appear close to your shoulder blades—a condition referred to as referred pain. Acid reflux, gallstones, peptic ulcers, liver disease, or pancreatitis are all possible causes of this type of pain, particularly after a fatty meal or during an exacerbation of gastrointestinal symptoms.
9. Cancer
Though not common, some cancers do lead to chronic pain in the area of the shoulder blades. These include cancers that originate in or metastasize to the lung, esophagus, liver, or bone. Pancoast tumors (a form of lung cancer located at the apex of the lung) are the classic cause of shoulder blade pain. Other options include lymphoma or metastatic breast cancer.
10. Trauma and Fractures
Accidents, falls, or sports injuries can result inbroken bones, dislocated shoulders, or torn ligaments. If you’ve fractured your scapula or injured your upper back, the pain will usually be severe and might come with swelling, bruising, or a visible deformity.
When to See a Doctor
So, when do you panic? If the pain develops suddenly, is severe, or occurs with other symptoms such as chest pain, shortness of breath, dizziness, or unintended weight loss, seek medical attention immediately. Persistent pain that doesn’t improve with rest, ice, and over-the-counter medication should also be evaluated.
Determining the cause of shoulder blade pain typically begins with a thorough medical history and physical examination. Your physician may inquire about injury in the recent past, other symptoms, or your history. In order to arrive at an understanding, imaging studies such as X-rays or MRIs and blood work or heart and lung tests may be required. Based on the cause, treatment may range from easy rest and physical therapy to medications or even surgery in the most serious of cases.
Shoulder blade pain is not uncommon, but it’s not always clear-cut. Staying in touch with your body and recognizing when to find help can be the difference between getting the proper treatment and recovering that much sooner.
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