Shoulder Blade Pain: Causes and Treatment

Let’s talk about shoulder blades!

Have you ever given a thought to those pieces of bone on your back, just below your shoulders? Probably only when they’re hurting; and what does it mean when they are? Read on…

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What are Shoulder Blades?

Shoulder blade or scapula, is a triangular shaped bone located in your upper back, behind each of your shoulders, which connects the upper arm bone (humerus) with the collar bone (clavicle).

Pain in this area is not easy to figure out, since it could indicate something serious, like a heart attack, or something temporary and mild, like having slept in an awkward position. So here’s everything you need to know about it…

Causes of Shoulder Blade Pain

Poor posture or an awkward sleeping position

Sleeping in an uncomfortable position or sitting with bad posture for prolonged periods of time can cause pain in the shoulder blade area, but most of this pain is muscular and doesn’t mean there is an injury, so it can be easily treated via physical therapy and practicing better posture.

Direct injury to the scapula bone

Trauma, falls or taking a hard blow can injure the scapula. It can be bruised or even fractured. Scapula fractures can be type I, II, or III, depending on their severity and bone displacement, and might need surgery to be reset when they are severe, though most don’t.

When surgery is not needed, treatment is usually pain medication, temporary immobilization and physical therapy. These fractures are usually common in car accidents, and can be accompanied by chest trauma and other fractures, but they’re not among the most common fractures in the country.

Mild or severe shoulder or rotator cuff injury

The shoulder has an amazingly wide range of motion, which means it needs a lot of soft tissue and bone support in order to work properly. Since it has so many connections, it can easily get injured or swollen with bad movements or by lifting too much weight. These injuries cause shoulder blade pain and can make it more sensitive to touch.

Joint or bone conditions

Conditions that cause pain and affect the bones and joints, could also cause shoulder blade pain. These conditions are: arthritis (more specifically ankylosing spondylitis), osteoporosis, scoliosis, spinal stenosis, fibromyalgia and frozen shoulder. They cause pain in different bones and joints and can affect the scapula, but their treatment depends on the condition, though applying heat or cold packs, and being careful with movement, usually helps.

Pain irradiated from an organ in distress – referred pain

Since the lungs and heart are so close to the scapula, they can cause pain in its general area when they are malfunctioning. However, other organs and conditions can cause shoulder blade pain, such as back problems, a slipped disk, gallbladder disease, liver problems, peptic ulcers, pancreatitis, or abdominal surgery.

The body is connected, so different conditions can cause pain in seemingly unrelated areas, which might be confusing. In this case, the original condition needs to be treated before the referred pain can go away. However, pain medication can sometimes help while the treatment is completed, but it’s healthier to stick to natural solutions, like heat packs, or CBD oil.

Heart Issues

Particularly in women, heart issues can cause sharp shoulder blade pain. The conditions that specifically cause this are: heart attack, a tear in the aorta, and inflammation of the lining of the heart, which is why it’s important to pay attention to other alarming symptoms that occur at the same time.

Lung issues

The lung issues that are known to cause shoulder blade pain are lung cancer, blood clots, or a collapsed lung. These conditions may also cause difficulty breathing, fainting, or other complications.

Cancer

Lung cancer, breast cancer and colon cancer can cause pain in the shoulder blades. Though extremely rare, heart cancer also causes feelings of pain and tightness in the chest and possibly in the back.

Nerve damage or neuropathy

Nerve damage in the area, or Brachial Plexus Neuropathy can also cause pain in the area where the shoulder blades are and the shoulders. A pinched nerve in the shoulder can cause pain as well.

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Positioning of the Pain

Depending on the disease and the organ, pain can present in different sides of the body, or can be accompanied by other symptoms.

Pain behind left shoulder blade – Left shoulder blade pain in women

Heart attack mostly causes pain in the left shoulder blade, and, for some reason, women are more likely to experience this symptom than men are. However, strain or trauma to the left arm, shoulder, or back can also cause this particular pain.

Pain in upper back between shoulder blades

When the pain is located between the shoulder blades, the cause could be a little different. It could be related to acid reflux, which affects the esophagus and could cause referred pain towards the middle of the upper back. However, pain between shoulder blades in women is also a common occurrence in heart attacks, so don’t ignore it, just pay attention to the way it presents.

Scoliosis, vertebral compression fractures , or epidural anesthesia, can also cause interscapular pain. But, when it comes to epidural anesthesia, the pain should go away as the anesthetic wears off.

Pain behind right shoulder blade

Gallbladder disease generally causes pain in the right shoulder blade, since it is located on the right side of the torso. However, strain or trauma to the right arm, shoulder or back can also cause this pain.

What causes knots under shoulder blade?

Knotting can be painful and annoying. Though it is usually not very serious. These muscle spasms are caused by prolonged bad posture or position, by tension in the neck and shoulders, or by muscle strain and overuse.

It can happen mostly on the dominant side for each person, since it’s the one we put more strain on, but can also happen on both sides.  

Treatment

The appropriate treatment for shoulder blade pain depends on its cause.

For overuse, strain, bruising, or bad posture, the recommended treatments involve rest, hot/cold compresses, painkillers (if absolutely necessary), stretching, massages, physical therapy and light movement exercises.

For cancer and other conditions that cause pain to irradiate to the shoulder blades, the necessary treatment is the designated one for that particular condition (like chemotherapy for cancer, or medication for heart issues). 

When it comes to knotting and tension, massages and hot compresses are the best options, since massages can help undo the spasms and heat relaxes the tense muscles.

People have also reported feeling some relief while using CBD supplements. This is probably due to the component’s antispasmodic properties as well as mild pain relieving effects.

When should I see a doctor for shoulder blade pain?

Though muscle strain or mild pain caused by poor posture is not really a reason to go to urgent care or schedule a doctor’s appointment, when it has been bothering you for more than 3 months, then a visit to an orthopedist, physiotherapist or chiropractor might be a good idea.

You should see a doctor immediately when the pain is so intense that you are unable to move, or if it’s accompanied by:

  • Sharp chest pain
  • Breathing difficulties
  • Tachicardia
  • Slurred speech
  • Dizziness
  • Vision problems
  • Any other alarming symptoms that significantly affect your ability to function as usual

Prevention and Tips

  • Be aware of your posture and correct it if necessary
  • Don’t lift items that are too heavy, and be careful when pulling or lifting any weight (like when carrying children or heavy suitcases).
  • If you spend a lot of time sitting behind a desk, get up and stretch, walk around and check your posture often.
  • Cut down on sugar and inflammatory foods, which can cause joint pain and muscle weakness. Some inflammatory foods, though not all of them, are: processed meats, sugar, fried foods, refined wheat (white bread, white pasta) and gluten.

I hope this was informative and helpful! Sometimes shoulder and shoulder blade injuries can feel like they will never heal, but you might be able to manage them and improve mobility and pain by changing your lifestyle, being very careful and conscious with your movements, and, believe me, physical therapy works wonders.

I was injured after carrying a heavy suitcase during a three week trip, and for months there were tight knots under my shoulder blades and I couldn’t lift my left arm or walk for too long without feeling excruciating pain on my left shoulder blade and neck.

After months of pain, I finally saw an orthopedist, who sent me to a physical therapist. After three months of careful therapy and applying hot packs on my back, I was moving my arm again, not being woken up by pain, and a lot less annoyed.

Of course, my soft tissue is still injured and will never heal, which is why I need to be careful about a few things, like about sleeping on my left side for too long, lifting my arm too high without being careful, or lifting things that are too heavy… But it no longer feels like it did before, which was as if I would never use my left arm for much again.

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