Aching pain between the shoulder blades is a common complaint that often comes and goes. But sometimes, it can be a sign of something more serious. Understanding the potential causes can help you get the right treatment.
Common Causes of Aching Pain Between the Shoulder Blades
Many cases of shoulder blade pain stem from issues with the muscles, spine, or joints. One frequently overlooked cause is scapulothoracic bursitis, which involves inflammation of the bursa located between the shoulder blade and the rib cage.
Scapulothoracic Bursitis
This condition involves inflammation of the bursa between the shoulder blade and rib cage. It may cause aching or burning pain that worsens with shoulder movement, especially during overhead activities or repetitive motions like rowing or lifting. Patients sometimes report a grinding or snapping sensation, known as “scapular crepitus.” Physical therapy focused on scapular mechanics is usually the first line of treatment.
Muscle Strain or Overuse
Overusing your upper back muscles can lead to soreness. This is common in people who:
- Sit at a desk for long periods
- Perform repetitive motions
- Lift heavy items improperly
Cervical or Thoracic Spine Problems
Spinal issues like degenerative disc disease, cervical facet arthropathy, or thoracic facet joint arthritis can cause aching pain between the shoulder blades. The pain may worsen with movement or certain positions.
Vertebral Compression Fractures (VCFs)
A broken backbone in the thoracic spine can result in aching pain between the shoulder blades. These fractures often occur in people with osteoporosis or after trauma. VCFs can cause localized pain, irritation of nearby nerves that leads to tingling or numbness, and reduced mobility.
Thoracic Radiculopathy
This condition occurs when a spinal nerve in the thoracic region is compressed. It may cause sharp or aching pain that radiates around the ribs and between the shoulder blades.
Mechanical Back Pain
Poor posture, weak core muscles, or spinal misalignment can lead to mechanical pain. This type of pain usually feels dull or aching and may improve with rest.
Other Medical Conditions That Cause Pain Between the Shoulder Blades
While musculoskeletal issues are the most common cause, other health problems can also lead to this type of pain:
Gastrointestinal Conditions
GERD or a peptic ulcer can cause referred pain to the upper back due to shared nerve pathways between the esophagus, stomach, and thoracic spine. This pain often occurs with other symptoms like heartburn or nausea.
Respiratory Problems
Conditions like pneumonia or pleuritis can cause pain in the upper back, especially during deep breathing or coughing.
Cancer
Although rare, aching pain between the shoulder blades can be a sign of cancer. Cancers that may cause this type of pain include:
- Lung cancer
- Esophageal cancer
- Spinal metastases from breast, prostate, or lung cancers
If you have a history of cancer or develop other concerning symptoms, it’s essential to seek medical evaluation.
Diagnosing the Cause of Pain Between the Shoulder Blades
A thorough medical evaluation is key. Your provider may:
- Take a detailed history of your symptoms
- Perform a physical exam
- Order imaging tests like X-rays, MRI, or CT scans
They may also look for red flags such as unexplained weight loss, fever, or weakness.
Treating Aching Pain Between the Shoulder Blades
Treatment depends on the underlying cause. Most people start with conservative options.
Medications
- NSAIDs (e.g., ibuprofen) to reduce inflammation
- Acetaminophen for pain relief
- Muscle relaxants for spasms
Physical Therapy
Targeted exercises can strengthen the muscles around the spine and shoulders. Manual therapy and posture training are also helpful.
Heat and Ice
Applying heat or ice can help relieve muscle tension and pain.
Adjunctive Therapies
- Acupuncture
- TENS (transcutaneous electrical nerve stimulation)
- Ultrasound therapy
Interventional Pain Management
If conservative measures fail, interventional options may help:
- Corticosteroid injections for inflamed joints or nerves
- Radiofrequency ablation (RFA), which uses heat to target painful nerves and provide longer-term relief
- Vertebroplasty or kyphoplasty for compression fractures
Surgery
Surgery is rare and usually reserved for spinal instability, tumors, or severe nerve compression.
When to Seek Medical Help
If your symptoms are persistent or worrisome, timely medical evaluation is important. See a doctor if you experience:
- Pain that lasts more than a few weeks
- Sudden, severe pain
- Pain with fever, night sweats, or weight loss
- Weakness, numbness, or trouble walking
- A history of cancer
Final Thoughts
Aching pain between the shoulder blades can result from many causes. Most are not serious, but it’s important to get checked—especially if symptoms persist or worsen.
Effective treatments range from medications and physical therapy to advanced pain procedures. If you’re struggling with upper back discomfort, don’t ignore it. Early treatment—such as physical therapy, medications, or posture correction—often leads to better outcomes.
If you or someone you know is dealing with upper back or shoulder blade pain, we can help. Red Butte Pain Solutions specializes in diagnosing and treating the root cause of pain. Call us at 602-633-4334 or schedule now to get started.