Why does the back hurt between the shoulder blades and how to treat it?

Pain between the shoulder blades is not a typical location for back pain. Usually, if the back hurts, it hurts in the lower back or certain vertebrae.

Compression, burning, or pulsation in the upper back between the shoulder blades may cause confusion – such a problem is not well-known and rarely discussed. Therefore, a person who has encountered such a situation searches for answers on the Internet to questions such as “Why does the back hurt between the shoulder blades? What kind of doctor should I see for back pain between the shoulder blades? And how to treat pain in the shoulder blade?”

Pain in the shoulder blades: what can be the causes? The average person is well aware of what a shoulder blade is – it is a flat triangular paired bone in the upper back. But why does it hurt?

The most likely causes can be:

  • Problems with the spine, injuries. Poor posture, spinal curvature, osteochondrosis lead to compression of nerve endings and the emergence of pain symptoms.
  • Diseases of internal organs: pneumonia, pleurisy, angina pectoris, pericarditis, gastritis, and stomach perforation due to ulcers are accompanied by pronounced pain in the upper back.
  • Muscle problems: myalgia, inflammation of the muscles (myositis) cause aching pain in the shoulder blades.

In addition to the above mentioned, pregnant women at different stages may also experience pain between the shoulder blades, which is considered normal for them.

However, the problem can be more serious – tumors (both benign and malignant) in the chest or abdominal cavity can cause similar symptoms. But don’t panic and worry – even stress can indirectly lead to pain between the shoulder blades due to muscle tension and stooping. Similar symptoms can be caused by excess weight, incorrect posture at work or during sleep.

Types of pain between the shoulder blades: The symptom itself – that is, the nature of the pain between the shoulder blades – says a lot about the underlying disease. The pain can be acute and spasmodic, or chronic (constant), and it also varies in type and intensity.

Dull pain between the shoulder blades: In most cases, dull pain between the shoulder blades indicates pathology of the vertebrae and spine. Scoliotic deformities of the spinal column, osteochondrosis or intervertebral disc herniation can cause such symptoms. Dull pain can also be a manifestation of peptic ulcer disease – in this case, a gastroenterologist should be consulted.

Burning sensation in the area of the shoulder blades: The onset of burning pain in the shoulder blades tells us about potential heart problems, such as ischemic heart disease. Such pain is not dependent on movement, is rarely prolonged and disappears soon after taking nitroglycerin. The second option is pinched nerves between the intervertebral discs. Nitroglycerin will not help here, but nonsteroidal anti-inflammatory drugs will help. Relief comes when changing the body position to a more comfortable one. In addition to the listed causes, a burning sensation can occur with the reflux esophagitis (reflux of stomach contents into the esophagus).

Dull pain between the shoulder blades: As a rule, patients describe the pain that occurs with pathologies of tendons, ligaments, and muscles as “dull”. The same characteristic is given to painful sensations in diseases of internal organs – cholecystitis or cholelithiasis.

Pulsating pain in the shoulder blade

An injury to the ribs, shoulder blades, or vertebrae can cause characteristic pulsating pain in the area of the shoulder blades. This pain may become more pronounced when coughing or sneezing. If you experience such symptoms, do not delay seeking medical attention from a traumatologist.

Pressing pain in the shoulder blade Inflammatory processes in the muscles surrounding the shoulder blade can cause a feeling of compression. In addition to pronounced pain, myositis (muscle inflammation) leads to a limited range of motion in the shoulder and arm.

Sharp pain between the shoulder blades

Beginning gastric ulcer, an attack of gallstone colic or pyelonephritis manifests as piercing sharp pain. In case of ulcer perforation, pain begins in the stomach, accompanied by nausea, heartburn, and bloating. In pleurisy, the patient will also experience sharp pain in the area of the shoulder blades, but it will be accompanied by coughing.

Pain when inhaling

If pain occurs or intensifies during inhalation, it may signal lung disease or intercostal neuralgia. Pain with neuralgia has a shooting, girdling character. And with lung disease, coughing, general malaise, weakness, and fever usually accompany the pain.

Whatever the nature of the pain between the shoulder blades, if it does not subside within 1-1.5 days, it is recommended to visit a doctor.


Which doctor to see for back pain between shoulder blades?

Since the etiology of pain between the shoulder blades is quite diverse, first you need to make an appointment with a therapist. The doctor will evaluate the situation, gather medical history, conduct a primary diagnostic examination, and guide you towards which specialist to see for the most productive relief of pain in this location.

Further treatment may be provided by traumatologists, orthopedists, neurologists, gastroenterologists, cardiologists, pulmonologists, and other specialized doctors.

How to diagnose pain in the shoulder blades In addition to gathering complaints, examination, and careful palpation of the causal area, the doctor may need to conduct a series of additional diagnostic procedures:

General and biochemical blood tests, urine analysis. X-ray examination (if more in-depth study is necessary, computer tomography (CT)). Magnetic resonance imaging (MRI) to evaluate the condition of internal organs, ligaments, tendons. Ultrasound diagnostics may be useful in determining kidney and intestinal function. Electrocardiogram for diagnosing heart disease. Fluorography when suspecting lung problems. Gastroscopy to study stomach function.

Treatment for pain between the shoulder blades

After reading this article, you understand that pain between the shoulder blades can be a sign of various different conditions. If you don’t have any chronic illness and are experiencing pain between the shoulder blades for the first time, you can try to treat the symptoms. First, make sure that you’re not experiencing constant muscle tension due to an uncomfortable sleeping or working position. You can take a pain reliever once or twice. However, if this doesn’t help, you shouldn’t delay seeing a doctor any further.

How to ease an episode of pain between the shoulder blades

When the pain suddenly arises and disables you, the best thing you can do is try to alleviate the pain. Taking analgesics (Nimesulide, Ibuprofen, Ketorolac) will temporarily relieve the pain. You can also apply a cream with the same active ingredients to the painful area on your back.

We do not recommend massage or self-massage in such cases. We also advise against using any warming compresses or heating your back in any other way. All of these can only worsen the problem.

How to treat pain between the shoulder blades?

A doctor of the corresponding specialty should be responsible for treating the condition that caused the symptom of pain between the shoulder blades. This can be a very serious pathology, and treatment should be approached carefully. We won’t delve into cardiology and gastroenterology, but we’ll talk about restorative and general strengthening procedures that will be useful for any of the possible conditions.


Therapeutic exercise. Gradual return to physical activity plays a significant role in the rehabilitation of patients with spinal column and joint diseases. Of course, this should not be done during the acute phase of the disease when every movement is difficult. However, during the recovery phase, therapeutic exercise and physical therapy have a positive effect on the body as a whole by strengthening muscles and working on joints.

Kinesiotherapy. Kinesiotherapy is prescribed for fast and functional recovery after injuries and diseases of the musculoskeletal system. This exercise program, using one’s own body weight or specialized equipment, helps to restore mobility to damaged joints gently and without overloading the body. In addition, the stimulating effect of kinesiotherapy on immunity and metabolism has been proven. Regular exercise can slow the progression of a disease to a chronic stage and prevent a recurrence of the illness.

Therapeutic massage. The beneficial effects of massage are hard to overestimate. In addition to its physiological effects on the body, massaging and kneading muscles also have an effect on a person’s psychological state. By stimulating blood circulation and metabolism, recovery occurs faster and more harmoniously.

Acupuncture reflexotherapy. An experienced acupuncturist can stimulate specific points (acupuncture points), activating the body’s internal reserves to fight disease. The indications for the use of acupuncture reflexotherapy are so broad that it is difficult to name a disease in which it would be ineffective. This is an effective way to relieve pain, muscle tension, and spasms. According to research, acupuncture reflexotherapy, combined with other physiotherapeutic procedures, can reduce the duration of treatment.

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