Pain between the shoulder blades is upper back pain in the area between the shoulder blades and the spine. Most often it comes from tense muscles in people who sit for long hours, at a computer or with a phone in their hand. The pain can spread to the shoulder blade, neck or shoulder. It is usually harmless, but sometimes another condition is behind it, so please also read the warning signs at the end of the page.
Symptoms
- A dull, tight pain between the shoulder blades that gets worse towards the end of the day.
- Burning or a stabbing pain at one point beside the shoulder blade, as if a knife were stuck there.
- Pain in the shoulder blade and neck, sometimes with a headache.
- Painful knots in the muscle that you can feel (trigger points).
- Stiffness when you turn your body or breathe in deeply.
The pain is usually worse in the evening, after a long day at the desk, and milder in the morning after sleep. If it is the other way round and the pain wakes you at night, tell Kaloyan.
Why it happens
- Sitting for long periods with rounded shoulders and your head pushed forward.
- Weak muscles between the shoulder blades and tight chest muscles.
- Carrying a heavy bag on one shoulder.
- Working with your hands in front of your body all day: driving, sewing, working on a till.
- A locked joint between a rib and a vertebra, which hurts when you move and when you breathe.
- Stress: many people tense their shoulders without realising, and only notice when it starts to hurt.
- Less often, the pain comes from the neck (a herniated disc in the neck) or from internal organs.
How we treat it
Kaloyan looks at your posture, checks the mobility of your neck, upper back and ribs, and feels the muscles to find the painful points. Most often he starts with a partial body massage of the back and neck, focused on the tight muscles between the shoulder blades. If the tension also reaches your lower back, shoulders or buttocks, a full-body therapeutic massage is more suitable.
For stubborn trigger points that massage doesn’t release, Kaloyan uses dry needling. He frees locked joints between the ribs and vertebrae with a manual technique, and when the pain comes from the neck, he works on it too. Massage and needling ease the pain, but without a change in posture and regular breaks it often comes back. Many people feel relief after the first or second visit, and 2–5 visits are usually needed for a more lasting change. Kaloyan also gives you 2–3 exercises for posture and for the muscles between your shoulder blades to do at home. If you work at a desk, he will ask how your workstation is set up and suggest small changes: screen height, chair, position of the mouse.
What you can do yourself
- Put your screen at eye level so that you don’t push your head forward.
- Get up from your desk at least once an hour and move your shoulders.
- Carry your bag on both shoulders, or switch sides.
- A warm shower or a heat pad on your back in the evening relaxes the muscles.
- If you breathe shallowly with your shoulders raised, breathe in slowly into your belly a few times a day. This relaxes your shoulders and neck.
When to see a doctor first
Pain between the shoulder blades is rarely serious. See a doctor straight away if it:
- comes with shortness of breath, chest pain, sweating or nausea;
- started suddenly and is very severe;
- started after a fall or a blow;
- comes with a fever or a cough;
- comes with numbness in your arm or a weaker grip.
