Pain Between Shoulder Blades: Do You Suffer Upper Back Discomfort?

pain between shoulder blades

Shoulder Blade Pain?

Quite often a patient would come into the Chiropractic clinic and tell me they have an upper back discomfort that is causing a pain between their shoulder blades. The patient will then usually want to show me the area where their dull ache or stabbing pain is by touching my own thoracic spine. Most people can’t reach the painful area on their own backs so they need to help me to know exactly where it is hurting.

This type of patient will usually say that what they are experiencing in their upper back region can be described as: a burning ache, stabbing or a sharp pain between shoulder blades. Maybe the neck or arm is involved as well.

Today you are going to learn a lot about the symptoms of middle to upper back pain, common and serious causes for pain between shoulder blades and treatment tips for getting relief from aches and pain in-between the shoulder blades in your back today.

Thoracic Spine Pain

Don’t worry pain in your middle back (thoracic spine) is quite common. It is not quite well reported in journals¹ unfortunately so doesn’t get the attention like neck and back pain do.  First I think you should know a bit of the general anatomy of the area concerned.

The area of the upper back (spine) between the two shoulder blades is called the thoracic spine.

The shoulder blades are called scapula.

Upper Back PainThe major muscles of the thoracic spine are the:

  • Rhomboid Major,
  • Rhomboid Minor,
  • Upper Trapezius,
  • Lower Trapezius
  • Levator scapula,
  • Thoracic Erector Spinae,
  • Infraspinatus,
  • Supraspinatus.

Looking at the picture on the right you will see from Gray’s Anatomy a drawing of the mid-back, upper-back and the surrounding back muscles.

Can you see where your shoulder blade pain could be now?

I hope this anatomical picture helps you visualise your mid-back and upper-back structure better.


As I mentioned earlier there are many times a person will come into see a chiropractor for treatment because of this pain in-between the shoulder blades and spine that they cannot get rid of.

These are some of the symptoms of what I might hear people complain about:

  1. It’s sore to take a deep breath,
  2. I need to push my shoulder into the corner of the wall to get some relief,
  3. The pain is a deep ache,
  4. It’s sore to put my chin to my chest,
  5. It hurts to try stretch the muscles between my shoulder blades,
  6. I want to twist my shoulders to try get a click in my back for some relief,
  7. I have a right or left shoulder blade pain just on the inside of the shoulder blade,
  8. It feels like I have a muscle knot stuck underneath my shoulder blade.

Do some of these symptoms sound familiar to you at all? These are just some of the typical things I might hear people say about a problem in their muscles, joints or nerves of the thoracic spine.

Risk Factors

Interestingly teenagers (adolescents) are a big group to suffer this type of back pain. Though I know adults, like me, get suffer it too. Some possible risk factors¹ for developing this type of pain include:

  1. Having another muscle or joint pain somewhere in your body
  2. During periods of growing and physical change (childhood growing pains stages)
  3. Using a backpack
  4. Poor posture
  5. State of mind (think stress)
  6. Environmental factors (workplace ergonomics)

The Causes

Of course once your told your chiropractor your symptoms you’ll want to know what causes this shoulder blade pain. This is the next question I want to help you answer.

Below are some of the normal mechanical causes and then the more serious causes of thoracic pain.

Mechanical Back Pain

  1. Rib Dysfunction
    Does it feel like you got a rib out? You have twelve ribs on the left and right side of your thoracic spine. The ribs move like a bucket handle, going up and down with breathing in and out. There are times movement of the rib head on the vertebral body can cause pain. I usually find the 3rd and 4th ribs are the most tender to touch.
  2. Muscle Trigger Point
    A trigger point is basically a muscle knot. I easily find a common problem in these thoracic muscle trigger points in one of the upper back muscles, especially the levator scapulae. This is the time when you want people to rub your shoulders or you try to get something hard like a golf ball or tennis ball to push into your back. Trigger points can cause referred pain away from where themuscleknot is found. Here is a picture of some thoracic trigger points in the neck,scapula and thoracic muscles.

    Spine Pain

    Trapezius Muscle Knots

  3. Thoracic Dysfunction
    The spinal joints (facets) can, like the ribs, move abnormally causing a pain in the middle of the spine. Maybe you have heard your chiropractor mention a condition called, T4 syndrome. I find that a lot of people have tenderness over the T4-5-6 vertebrae region. I think this is because of our seated posture when we tend to slump our shoulders through this area. This in turn over time will cause stiffness to move and tenderness to touch.
  4. Nerve Pain
    Got a trapped nerve in neck pain? Mechanical neck pain can also be a cause of pain near the shoulder blade and top of the shoulders. A cervical spinal nerve refers pain away from the neck commonly down the inside of the shoulder blade and outer arm. So your pain could be coming from your neck where there is a pinched nerve condition.

Serious Causes of Shoulder Blade Pain

  1. Visceral Pain
    There are times when you can get an organ in your body causing back pain.This is called visceral pain. You can experience referred pain from an internal organ like your liver, gall bladder, stomach, spleen, lungs, or pericardial sac. If you want to find out more about visceral pain you could read medical student Brad’s post about referred organ pain. You can see a picture below of visceral pain referral patterns in the front and back of us.

    Organ Pain Referral Patterns

    Internal Organs Pain Patterns

  2. Shingles
    You might also experience shingles around tour chest. If you are stressed out and immune system run down the typically dormant, herpes zoster virus, can become active. The herpes zoster virus lays dormant in our spinal nerves near the ribs waiting to attack when we are down. You might get the typical shingles rash only after the chest pain starts.
  3. Trapped Wind
    Trapped wind pain is typically caused by indigestion in the stomach. Trapped wind discomfort can though be a sign of a more serious heart attack. Heart attack symptoms are of suddenly break out into a sweat, go pale, feel nausea, pain down the left arm and around the shoulder blade and a tight closing in chest pain.

Chiropractic Treatment

You can watch the video below of a chiropractor performing a basic mechanical assessment of the middle and upper thoracic spine. Mobilising the thoracic spine can release a lot of spinal tension.

How to Get Pain Relief

So now you know what some of the symptoms and common causes of shoulder blade pain.

Now lets look at some of the things you could do to get relief from your pain between the shoulders:

  1. See a Chiropractor/Doctor
    As you may have read above there are times severe back pain can be coming from a more serious cause. If you are worried it is easy to have a health professional help you out. You can find a UK chiropractor here to be assessed.
  2. Heat
    Warmth is a simple self-treatment for muscle tension. Using a microwaveable wheat bag, hot water bottle or a warm moist towel apply the heat to the painful muscle to try relax the muscle knot. I prefer using heat in the neck and upper back.
  3. Massage
    You could try using a chair or hand-held massager machine to try relax any muscular tension between the shoulders. You probably have asked a loved one for a muscle rub. You could also see a massage therapist for a deep tissue massage for chronic tension in the upper back and neck.
  4. Cat Stretch
    The cat stretch is when you slowly try round your shoulders as much as you can whilst pushing your spine backwards to get a stretch between the shoulder blade muscles. Sometimes this is easier when you are warm, like after a shower or bath.
  5. Good Night Sleep
    It is amazing how a good night sleep can help the body to heal itself. So try get a good nights sleep to see if that helps the pain go away.
  6. Improve Your Posture
    Sometimes having poor posture for too long causes our muscle knots and irritated rib or spinal joints. If you have been doing lots of sitting with desk work or computer work then try go do some gentle exercise to see if it can help stimulate your spinal posture. Avoid the 23 and half hours disease.
  7. Shoulder Blade Push-Ups
    I mentioned above how you need to exercise for upper back pain. For a weak back and poor upper body posture take a look at doing shoulder blade push-ups. I love these exercises as you can do it now at home to reset your thoracic kyphosis spinal curve.
  8. Mindfulness Training
    Have you been told you need to chill out? Do you know how to reduce stress? Emotional or mental stress can increase our muscle tone leaving us with tight tense muscles running into the neck,top of the shoulders and upper back. This is a normal flight and fight response. The ubber simple mindfulness training technique can help solve this problem.
  9. Thoracic Spine Mobilisation
    Watch the video below on how to use a foam roller on the thoracic spine. movement with breathing to try get some pain between the shoulder blades relief.

I hope this helps you understand a pain between shoulder blades bit better. The above self-treatment list for upper back pain is not meant to be exhaustive, but it is something very simple for you to try if you wish.

Image Credit: Some rights reserved by Vix Walker


  1. Briggs, AM et al. 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: 77. PMID=19563667
  • Colin

    Im 17 and I’ve had this sort of intense ache in my right rhomboid for about a year from an injury carrying a heavy backpack over 1 shoulder and overcompensation from a shoulder surgery. I used to be insanely athletic and a good competitive swimmer but it’s been to painful to work out anymore. I’ve been to doctors who were usless and just gave me pain killers. had an MRI with contrast showed nothing. Ive been to PT and chiropractors which helped a bit with the huge knots in my right rhomboid but there continues to be a crazy ache that drives me insane and never goes away. Ive tried using tennis balls, domain rollers, heat, ice, etc. It’s caused me to go from happiest guy in the world to one really depressed teen. Anyone have any suggestions to get rid of this pain?

  • machelle

    I have unbearable pain between shoulder blades when t1 or t4 is rubbed on right side of spine it swells up like an egg it hurts to use my arms t7 is herniated half way across spinal cord they will not operate because its behind my heart I have plates and screws in neck c5_6 also lumber herniated disc at L5 not much remove left there for nerves I have DDD scolois dylamantion disorder in brain clonic ditiverloios iam so tired of hurting all kinds of meds shots in spine physical therapy but I believe I have vertebrae out between t1_t4 lots more to list is crazy HELP

  • Andrew Shirley

    Any vomiting? That would strain your muscles.

  • Sunil Sharma

    How can i confirm if i have a visceral (referred) pain or not? Are there any tests which could reveal such a problem. Please help.

  • Keiron costello

    Hi I’m a 34 year old guy, have always worked in the building industry doing physical work. I was a ground worker laying kerbs and slabs for eight years and now I’m a plumber.I constantly suffer with this dull ache/pains directly below my left shoulder and on breathing it seems sore. At night when going to sleep I constantly switch sides to try and help it but on awakening in the morning if I roll both my shoulders back I get a crunching feeling on the left hand shoulder side where this pain comes from. I have had lots and lots of various massages and every time the masseur will pinpoint knots in shoulder areas and always clicks my upper back on breathing in and out. I suffer a lot with heartburn, and have a full tight feeling in the centre of my chest along with slight pins and needles down left arm every now and then. I have been to the gp thinking its a heart/chest problem he sent me for ecg and blood test , results came back fine and he said it sounds muscoskeletal.

    This tightness/pain/ache is now getting into my head making me more anxious and worried and it does seem worse later in the day on when I’m feeling tired, I have also noticed that when active during work it does not seem as bad. But is that because I’m busy and I don’t notice it as much.

    Can anybody help



  • Tiff johns

    I agree I have this for bout seven yrs.I can’t get relieve I’m thinking bout a chiropractor but dnt really know yet but would be great to get rid of this pain

  • John Webb

    Hi, im 40, ive had severe upper back spasms now scince I was 27/28 years old started a few weeks after I recovered from broken rib. Ive re injured the rib a few times and it looks and feels defirmed in my chest. It is on the same level that I get my spasms. Ive been scanned and told that ive a prolapsing disc in thoracic spine and on Cervical spine… Surgeons refuse to give me steroid injections but will only consider surgery.. Which im quite afraid of… Do I have any other options? Anyone else had this pain? Starts in between ribs at back.

  • Hey Maggie, there are lots of people reading this who could probably relate to what you are going through. There can be lots of different inflammatory markers in the blood which means maybe the common ones show up as normal in you, but there might be others that aren’t. In particular pro-inflammatory cytokines. These are involved with the widespread body pain which might be one avenue to consider if you haven’t already.

  • Maggie

    I’m 39 years old female and at my wit’s end trying to work out what is going on with my body. I feel like I’ve gone from a woman who was pretty well healthy all the time to feeling like an old woman. In the last year my body is always sore. Especially my back but shoulders neck and muscles when I stand up I hobble and limo around and feel like i have to unfold myself to get moving. I cannot sit comfortably in the floor withoutpain in my back. The gp did tests for inflammatory disorders which were all negative and xray on my pelvis and hip (pain and inability to move right hip freely) were all clear no evidence of arthritis or poor bone density. I do have endometriosis so not sure if that’s anything to do with it. Have also had pins and needles in hands at night in bed and sore arms and some numbness in my thumb when using scissors for a long period. Best i can describe it is i feel like the day after some heavy physical activity all the time now. HELP! I want the old me back.

  • CuriousGorgeous2611

    All of the things mentioned in the Symptoms is stuff I have but I have suffered for years even after visits to the chiropractor and heat therapy, stretching and massage There must be a more permanent cure. .

  • donna

    Hi, ive suffered with left side chest, umder arm and shoulder blade pain for about 3 years its that bad i cry at nite at times doctor’s said frozen shoulder, costercondritis, muscle strain etc. Would love to get to the bottom of it. Was sent to physio it was worse at first then got better. A few weeks later back to square one. My left shoulder seems higher than my right one. Pyhsio mentioned something about thoracic spine where the problem was. Im fue back to physio nxt week. I now suffer with left hip pain too. Im of work on holiday now too so its not like im sraining myself. It can go for a bit then just comes back out the blue but uts there most of the time

  • Cris

    Hi, I’ve been suffering from right upper back & shoulder blade pain for almost a year now. I am undergoing physiotherapy up to present. It started when I fell from the stairs last year. It worries me alot because the pain never leave me. X ray result is clear only shows swollen tissues when it happened. But now although I have had the physical therapy, exersice massage etc… the pain seems always present although it is a bearable pain but it really affects my everyday activities. Pain starts from heaviness, numbness & heat and even my breathing affects too. Any suggestions aside from exersice? Thanks

  • Ann

    Woke up on Sunday fine, it since then am struggling to move, pain seems to only be there when I move, feels like whole half of my middle back is falling into my bottom, what could be problem .

  • Sarah

    Shelleljay, did you get a response about your pain? The symptoms you described are 100 percent the same as I have had for a couple years now. Chiropractic s, physical therapy and yoga have helped but it still flares up almost daily and it would be really nice to know what causes this

  • Hi Julie, instead of an x-ray I’d see someone who could refer you to the x-ray department as there needs to be a clinical reason why the x-ray is needed i.e. what is the doctor trying to see on the x-ray. If you are feeling like you are getting nowhere with your GP as to what the cause is you can either try another GP for a second opinion or see a local chiropractor to have your daughter assessed to get a plan of action in place. There are private x-ray facilities available if needed to have it done quicker.

  • Julie Wilkinson

    My 16 year old is in a lot of pain around her shoulder blades,as soon as you touch it its very painful,shes had this for months now and just wont go away,should i take her to get an x-ray just to get it checked out,we have already been to the doctors but just gave her pain killers but done nothing,gp said its proberly a muscle strain but shes in agony

  • shelleljay

    Hi im 28 female and been having pain for a few years now getting worse. The pain is down the right side of my neck under right shoulder blade and under right arm across my right side of my chest. Its a deep ache that when its bad I feel sick and my arm is weak. I constantly need to twist my neck to make it crack and bend my back to find some relief. I also suffer from jaw pain. Do you think a chiropractor could help alleviate this? Thanks

  • Hi Medo, if I were you I would first be considering a peptic or duodenal ulcer being a cause of the symptoms. The heartburn tells me you might have a hiatus hernia which will feel worse with stress. So best to speak with a GP about your stomach referring the pain between your shoulders and let them do a physical exam on you to get it sorted. A good blood test to consider with stomach ulcers is to test for something called Helicobacter pylori. A course of antibiotics could be all you need if that is the final diagnosis.

  • Medo

    Hello Gary,

    Thanks a lot for this article it really helped me a lot. here is my condition so you maybe know more. I have this pain between my shoulders for few months now. It is started as discomfort. Now it became like a nightmare for me. It really worsen when I sleep, after 5-6 I will wake up in total pain that I can’t move and have to sit for a while so the pain ease and I can get back to sleep again, then the same thing happens.

    Now I am having another problem, that my chest is killing me when too, I wake up with pain like my ribs are squeezing my chest and the muscles around them are so stiff and tight. I barely can move to sit down and rest. I’ve tried many things, changed my bed and slept on the ground, stretched my back etc.

    I have a heatr burn for very long time now. And I know that the stress is Causing my stomach problems.
    I am 43 year old male.

    Thanks a lot

  • anne hallows

    I’ve just ran a 10k run for the first time and now a couple of days later my back and chest between my shoulder blades are really hurting and its hard to breath what do you suggest I do the make it stop please

  • SpitefulGOD

    I had a major pain in the back followed by what felt like my sternum ripping apart…. after wrapping my arms behind my knee and rolling back and forward along my spine on hard floor… I heard a few clicks and within a few minutes the pain was gone… aint the body weird?

  • Hi Barbara,yes I would get your situation reviewed. Having constant pain and loss of function are concerns I would start with. Your doctor can review your personal health situation to see should you be on medication, if you are are you on the best ones at the correct dosage needed, could you try lifestyle changes to change inflammation in your blood tests maybe as a natural anti-inflammatory etc… I hope you get help managing your health soon to give you relief.

  • Barbara McLullich

    i had a second C3/4 fusion in 1996 and in 2006 an mri showed an osteophyte arisingfrom the anterior end plate of t3 vertebral body which has given me a lot of problems. This has now become extremely bad with pain down both arms and loss of use in my left hand. If I stretch or bend I feel like a disc is popping out and get terrible pain come through to my chest when I breath. Do you think I should get this reviewed? What is your opinion on this? Thanks

  • A simple answer might be with an upset stomach episode if you were vomiting lots you could be sore from that, but it shouldn’t last long if that is the case. Get it checked out by you doc if you don’t feel better soon.

  • jude

    i have pain down the middle off spine near sholder it start couple of days ago when i has a stomach bug what do u think could be there reason for this

  • nick518

    thankyou. : )

  • Nick well if you have had the pain for 41 years then it is a compensation pain. It could be postural fatigue syndrome like upper crossed syndrome originally discussed by Dr Janda. There could be such major compensation throughout your body. That is why you can influence the pain with the heel wedges. From a manual medicine point of view I would be looking at the dynamic neuromuscular stabilization exercises (DNS) and maybe even Vojta therapy. The Vojta stuff is weird to see, but amazing how it relaxes people and helps them “unlock” a poor movement pattern. There are UK chiro’s trained in DNS which also uses the Vojta reflex locomotion points. If you get a treatment let me know how it goes.

  • nick518

    I have severe pain in the thoracic spine. I had a slight compression fracture of T7. But the pain is either all down the left side, or all down the right side. The pain hurts my stomach gives me IBS and bladder problems, hip buttock arm chest pain etc.
    It just feels like there is some kind of spinal cord irratation, that gets sorer the longer it goes on. I can change it from the opposite side by putting a small heel raise in my shoe. If I raise the left leg, the pain is on the right, and vice versa. I have had this for 41 years. A recent mri just showed the slight fracture. Any ideas please.

  • Tommo

    I love the Internet!! Lying on my floor I’ve managed to obtain professional help. Thankyou so much. Time for a hot bath, some gentle streches, then i’ll show the misses the video and she can give me a back rub for a change. 🙂 thanks

  • Vancouver Chiropractic

    No problems Gary, anything to help a chiropractor also. Perhaps, a bit off topic but what’s your viewpoint on the relationship between rest and weight loss? I know its way off topic again, but i am just curious.

  • I'm glad to help a fellow chiropractor make their patient education easier.Thanks for referring to the article I hope your patients enjoy reading it.

  • Vancouver Chiropractic

    On average, i get asked that around 5 times a day, now, I can refer this article to them beforehand, perhaps on the phone. This is a highly informative article Gary and will help a huge amount of people and save chiropractors a lot of time.

  • Thanks for the kind words James.

  • Thanks for the kind words James.

  • James

    Great info.. thanks for sharing. Very nice illustration with the images. Keep up the good work