Pain in upper back between shoulder blades and chest

If you’ve ever experienced upper back pain between your shoulder blades, also known as interscapular pain, you know just how uncomfortable it can be.

This is becoming an increasingly common condition, especially with the increased use of laptops, smartphones and tablets. Using these devices can contribute to poor posture, decrease of range of motion, tightness and pain. [6][9][11][12]

In this article we’ll outline some of the common causes and treatment options you can explore from your home.

What Is Pain Between Shoulders Blades? (What does it feel like)

Upper back pain between the shoulder blades can be felt on one side or both sides of your body. It may be acute (meaning that the pain lasts a relatively short time) or chronic (meaning the pain lasts for weeks or months). You may experience the following symptoms:

• • • A sharp, short burst of pain (spasm)
    • Dully achy pain that lingers
    • A burning ache
    • Pain when you take a deep breathe
    • Pain that’s local to the area between the shoulder blades, or pain that spreads to your arms or other areas of your back.

  [1][7][14]

Main Areas You May Feel Pain In:

– Shoulder Blades
– Neck
– Shoulders
– Arm/s

Main Muscles that are affected:

– Rhomboids
– Upper Trapezius
– Levator Scapula
– Scalenes
– Rotator Cuff muscles
– Latissimus Dorsi
– And others

Leon’s Notes: It is important to note that the pain you feel in and around your shoulder blades may actually be referred from your neck. Most often you’ll need to address both the neck and shoulder areas. [7][8][9][14]

Common Causes of Back Pain Between Shoulders Blades:

Using a Smart Phone & Computer For long periods of time

• Using smart phones and computers can lead to poor neck and shoulder posture and thus can cause pain and tightness in shoulders and shoulder blades. [11][12]

• The muscles around the neck and shoulder blades can strain from overuse during computer work. [15]
Related: Rhomboid muscle pain relief

Psychologic/Psychosocial Stress

• High psychologic distress was significantly associated with shoulder and upper back pain. [5]

• High stress during work increase muscle activation of the Upper Trapezius muscle (A muscle in the upper back). [16]

Poor Posture (Slouched Posture)

• Forward head posture and Rounded shoulders can contribute to pain to the upper back and shoulder blades area. [6]

• Sitting in front of the computer with poor posture can increase pain in the shoulder area. [11]

• Certain muscles may be overused while other muscles aren’t working enough, contributing to poor posture. [10]

Shoulder Injuries or Syndromes

The shoulder joint and scapula (Shoulder blades) are interdependent on each other, so any of the following conditions can cause pain/dysfunction:
– Subacromial impingement syndrome
– Rotator cuff tendinopathy
– Shoulder instability.[3]

Altered Scapula Motion & Position (Scapular dyskinesis)

• This refers to how your shoulder blade (aka Scapula) moves and sits on your ribcage. [3]

• There is some relation between weakness and/or tightness of the muscles around the shoulder blades and shoulder dysfunctions/pain. [3]

Scapular Winging

• This is when the shoulder blades stick out and don’t sit properly on the rib cage. [13]

• This condition can cause pain and tightness in and around the shoulder blades. [13]

• This can result from a paralysis of the Serratus Anterior Muscle. [14]

Related reading: Winged Scapula Exercises

Disc Herniation In Neck

• A herniated disc or bulged disc in the neck can refer pain into the shoulder blades area. [8]

• Typical symptoms include numbness, tingling, and/or pain in one or both arms. [17]

Related Read: Cervical Herniated Disc Treatment

Arthritis/Degenerative Changes

• Degenerative changes in the neck and upper back can cause referred pain that is felt between the shoulder blades. [8]

Other Causes Can Include:

• Carrying a Backpack [18]
• Lifting a heavy object
• Sports Injury
• Trauma
• Fracture [18]
• Osteoporosis [18]
• Ankylosing Spondylitis [18]
• And More

———-

For the remainder of this article, we’re going to focus on muscular imbalances and poor posture as the underlying cause of your upper back pain between shoulder blades and what you can do to help alleviate your symptoms.

Your Upper Back & Neck Posture Is Crucial

Considering that muscle imbalances and poor posture can result from sitting at a computer/looking at smart phones, let’s discuss what happens when you’re in this position – typically, this is what happens:

• Your Head will protrude forward (aka Forward head posture)
• Your shoulders will roll forwards (aka Rounded Shoulders)
• Increased Kyphosis (The curve of your upper spine will bend forward)

Over time, this abnormal positioning can lead to certain muscles and ligaments being overused (overactive), while other muscles and ligaments become underused (underactive/weak) – This can lead to pain. [6][10][12]

———-

8 Ways to Alleviate Pain In Upper Back & Shoulder Blades:

Leon’s notes (Founder of backintelligence.com):
There are several ways to approach shoulder blade pain relief and our goal was to give you some techniques for both short term and long term relief.

1-3 techniques below will focus on giving you temporary relief by using self massage techniques and stretching for the actual painful areas.

4-8 will focus on stretching and activating the muscles that will help you to carry yourself in a better posture – This is the long term strategy.

Please note, if your pain persists for a long time, you may want to see a professional in-person to address your situation.

1. Trigger point release in between shoulder blades (Using massage ball)

How it helps:

The first thing you need to do is relieve the trigger points that may have formed in and around your shoulder blades. By using a massage ball you can find a tender spot and apply pressure in the exact spot that you feel pain.

How to do it:

• Begin lying on your back
• Place a massage ball in between the shoulder blades
• Once you find a tender spot, just hold the ball in that place and apply more pressure with your body weight.
• Hold the pressure on that spot for at least 30 seconds (Don’t roll back and forth)
• Find the next spot and repeat the same process

2. Trigger point therapy using Self Massage Tool for Upper Back/Shoulders

How it helps:

A manual trigger point massager can really pinpoint the trigger points in your upper back and shoulder blades.

How to do it:

• In a standing position, position the hook over your shoulder in the tight area
• Push your left arm slightly downwards to apply pressure to the spot
• Keep applying pressure until you feel the trigger point release. At least 30 seconds in one spot
• Move through the muscles surrounding the scapula, applying pressure at other trigger points.
• Perform this release on all tender spots around the area

Recommended Program:
The Complete Posture Fix (With Dr. Oliver) – Fix your posture, get out of pain and increase your mobility.
Learn More

3. Shoulder Blade Stretch

How it helps:

After some self massage you can move on to stretching the rhomboids and deltoids area, which will help release tension in that area further.

How to do it:

• Place right elbow on left elbow
• Now take your left hand and interlace it around the right arm
• In this position you can apply more pressure to feel your upper back opening
• Hold the end position for 20-30 seconds
• Repeat on the other side

4. Upper Trapezius Stretch

This will stretch out the neck and upper back muscles (Scalene & Upper Trapezius) which can get very tight on individuals with this forward neck syndrome.

• Start either in a standing or seated position.
• Place one of your hands on the opposite side of your head and tuck the other hand behind your back.
• Now bring the head down towards your shoulder.
• Use the hand on top to press your head down – to get a deeper stretch (Not too hard).
• Hold for 20-30 seconds and do both sides

5. Door frame stretch

How it helps:

This stretch helps to release tight chest muscles that may contribute to your poor posture, and therefore contribute to shoulder blade pain. It’s important to stretch pectoralis major and minor muscles to bring the back into proper posture.

How to do it:

• Begin placing 2 arms on both sides of a door frame at a 90 degree angle
• Now step forward through the door with one leg and apply pressure
• Avoid sticking your head forward, or arching the low back
• Hold this stretch for 30 seconds
• Aim for 3 repetitions of this stretch

6. Levator Scapulae Stretch (Neck Release)

How it helps:

This exercise stretches and releases the Levator Scapulae muscle which runs from the neck to the shoulder blade. It is a muscle that often times gets very tight and causes pain and tightness in and around the shoulder blades area.

How to do it:

• Begin by sitting in a chair in an upright posture.
• Place the right arm on the back of the head
• Now, turn your head to the right (Towards right shoulder)
• Now bring your head down, as if you’re looking down at your armpit.
• You can intensify the stretch with the hand on top.
• Hold this stretch for 20-30 seconds.
• Switch sides and do this stretch on the left side.

7. Scapular Retraction (Using Resistance Bands)

How it helps:

This exercise will help strengthen the muscles between your shoulder blades and on the back of your shoulders to ultimately allow you to have the strength to maintain proper posture.

How to do it:

• Begin standing with a good posture
• Holding a resistance band (level of resistance you use depends on your individual strength level) with both hands, straighten your elbows and bring your arms out in front of you.
• While keeping your elbows locked, slowly move your arms out and back behind your body. You should feel the muscles between your shoulder blades contracting/squeezing.
• Only go out as far as comfortable. Some muscular discomfort (burning) is ok, but pain in the arms or neck is not.
• Avoid shrugging your shoulders toward your ears.
• Repeat 2×10, gradually increasing to 3×10.
• By the time you get to repetition number 8, 9, 10, this should be challenging. If it is not, increase the level of resistance on the band.

8. Y & W Exercise (For Rhomboids and Lower traps)

How it helps:

The Y & W exercise targets the rhomboids and lower trapezius muscles which help stabilize your shoulder blades and posture.

How to do it:

• Begin by extending both arms into a “Y”
• Now pull your elbows down into your stomach area – Creating a “W” and squeezing your shoulder blades together and down
• Breathe through out this exercise
• Do 10 repetitions, 2-3 sets slowly

Lastly:

Be mindful of your posture while using your phone, working at your computer, when you drive, and sleep. To learn about how to sit with proper posture go here.

Recommended Program:
The Complete Posture Fix (With Dr. Oliver)
Fix your Rounded shoulders & Fwd Head posture, get out of pain and increase your mobility.
Learn More

Check Out This Video For More Info:

Related Articles:
How to fix forward head posture
How To Ease Lower Back Pain Naturally
Ice Or Heat For Back Pain Relief
What are trigger points
How To Sleep With Lower Back Pain – The Dos And Don’s
Severe Back Pain During Pregnancy? 5 Causes & 10 Remedies

Sources:

[1] Bokshan S, DePasse J, Eltorai A, Paxton E, Green A, Daniels A. An Evidence-Based Approach to Differentiating the Cause of Shoulder and Cervical Spine Pain. Am J Med. 2016;129(9):913-918. doi:10.1016/j.amjmed.2016.04.023

[2] Dabholkar A, Yardi S. Effects of scapular muscle strengthening on shoulder function and disability in shoulder impingement syndrome (SIS) – A Randomized controlled trial. International Journal of Therapies and Rehabilitation Research. 2015;4(4):26. doi:10.5455/ijtrr.00000062

[3] Nodehi Moghadam A, Abdi K, Shati M, Noorizadeh Dehkordi S, Keshtkar A, Mosallanezhad Z. The Effectiveness of Exercise Therapy on Scapular Position and Motion in Individuals With Scapular Dyskinesis: Systematic Review Protocol. JMIR Res Protoc. 2017;6(12):e240. doi:10.2196/resprot.8011

[4] Kang J, Choi H, Jeong D, Choi H, Moon Y, Park J. Effect of scapular stabilization exercise on neck alignment and muscle activity in patients with forward head posture. J Phys Ther Sci. 2018;30(6):804-808. doi:10.1589/jpts.30.804

[5] Cho C, Hwang Y, Cherng R. Musculoskeletal Symptoms and Associated Risk Factors Among Office Workers With High Workload Computer Use. J Manipulative Physiol Ther. 2012;35(7):534-540. doi:10.1016/j.jmpt.2012.07.004

[6] Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis C. Incidence of Common Postural Abnormalities in the Cervical, Shoulder, and Thoracic Regions and Their Association with Pain in Two Age Groups of Healthy Subjects. Phys Ther. 1992;72(6):425-431. doi:10.1093/ptj/72.6.425

[7] Shah J, Thaker N, Heimur J, Aredo J, Sikdar S, Gerber L. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM&R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024

[8] Louw A, Schmidt S. Chronic pain and the thoracic spine. Journal of Manual & Manipulative Therapy. 2015;23(3):162-168. doi:10.1179/2042618615y.0000000006

[9] Ortega-Santiago R, Maestre-Lerga M, Fernández-de-las-Peñas C, Cleland J, Plaza-Manzano G. Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain. Pain Medicine. 2019;20(7):1379-1386. doi:10.1093/pm/pnz020

[10] Czaprowski D, Stoliński Ł, Tyrakowski M, Kozinoga M, Kotwicki T. Non-structural misalignments of body posture in the sagittal plane. Scoliosis Spinal Disord. 2018;13(1). doi:10.1186/s13013-018-0151-5

[11] Sun A, Yeo H, Kim T, Hyun J, Kim J. Radiologic Assessment of Forward Head Posture and Its Relation to Myofascial Pain Syndrome. Ann Rehabil Med. 2014;38(6):821. doi:10.5535/arm.2014.38.6.821

[12] Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017;16(3):220-229. doi:10.1016/j.jcm.2017.03.004

[13] Gooding B, Geoghegan J, Wallace W, Manning P. Scapular Winging. Shoulder Elbow. 2014;6(1):4-11. doi:10.1111/sae.12033

[14] Le Nail L, Bacle G, Marteau E, Corcia P, Favard L, Laulan J. Isolated paralysis of the serratus anterior muscle: Surgical release of the distal segment of the long thoracic nerve in 52 patients. Orthopaedics & Traumatology: Surgery & Research. 2014;100(4):S243-S248. doi:10.1016/j.otsr.2014.03.004

[15] Yoo W. Changes in Pressure Pain Threshold of the Upper Trapezius, Levator Scapular and Rhomboid Muscles during Continuous Computer Work. J Phys Ther Sci. 2013;25(8):1021-1022. doi:10.1589/jpts.25.1021

[16] Shahidi B, Haight A, Maluf K. Differential effects of mental concentration and acute psychosocial stress on cervical muscle activity and posture. Journal of Electromyography and Kinesiology. 2013;23(5):1082-1089. doi:10.1016/j.jelekin.2013.05.009

[17] Eubanks J. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;18(1):33-40.

[18] Briggs A, Smith A, Straker L, Bragge P. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10(1). doi:10.1186/1471-2474-10-77

Licensed chiropractor, DC (Owner of Forme Clinic, Stoney Creek, ON, L8G 1B9)

Dr. Shaina McQuilkie graduated from Brock University in 2004 with a Bachelor of Kinesiology (Honours). She then attended D’Youville College, in Buffalo, New York and obtained her Doctorate of Chiropractic Degree in 2008. After graduating, Dr. McQuilkie practiced in a multi-disciplinary healthcare facility based in Hamilton, Ontario gaining experience treating a variety of musculoskeletal injuries.

Co Authors :

Corrective Exercise Specialist (NASM-CES), Certified Personal Trainer (NASM-CPT), Professional Dancer

As a long time back sufferer Leon found unique methods to alleviate his pain using natural methods including self massage, exercise/stretching and postural habits. He founded Backintelligence.com to empower others to fix their postures and ease their back pain from home.