Shoulder Blade Pain

Shoulder blades or scapulae are the triangular shaped bones located on your upper back below and behind the shoulders. Right and left shoulder blades serve as the anchor for muscles that contribute to movements of the upper trunk, shoulders, and arms. Its function in everyday movements makes it difficult to ignore the pain felt in, under, behind, below, around, or near the shoulder blades.


Usually, the pain goes away with rest along with other home remedies. If severe pain happens suddenly that is not preceded by any activity or if the pain gets worse as the days go by, it may be necessary for you to visit your doctor.

General Causes of Shoulder Blade Pain

  • Muscle Strain: Any overused and abused muscle causes muscle strain. Sleeping in an uncomfortable position especially at night is one of the most common reasons why a person experiences pain around the shoulder blades when he wakes up. Muscle strain also happens when you carry or lift heavy objects when you are not used to do so. Strenuous exercise or sports such as tennis or golf may develop shoulder blade pain.
  • Rotator Cuff Injury: The rotator cuff consists of four muscles and tendons that stabilize the shoulder. If one of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles is injured, there will be pain of the shoulder blade in the affected side. This injury is common to athletes.
  • Fracture: Scapulae are rarely fractured but it could happen due to vehicular accident, sports injury, or fall.
  • Osteoporosis and Arthritis: Porous bones and inflammation of the joints around the shoulder blades, shoulders, or neck may cause pain around the shoulder blades.

Shoulder Blade Pain

  • Nerve Impingement: Burning pain on the shoulder and/or shoulder blade that radiate to your arm may signify an impinged or damaged nerve. Your fingers may perceive burning sensations as well. It may last for weeks or months. This does not go away on its own. It needs medical attention.
  • Lung Tumor: Tumors in the lung, especially pancoast tumor or the one that lies on superior aspect of the lung, may cause pain behind the shoulder blades. Pneumothorax and pulmonary embolus may also cause shoulder blade pain.
  • Herniated Disk: Presence of slipped disks in the neck region causes referred pain to the shoulder blades.
  • Varicella Zoster Virus: This virus that causes chickenpox and shingles may cause shoulder blade pain. In shingles, one of the early symptoms is burning pain on the right shoulder blade.
  • Cancer: When a cancer, whichever the source is, metastases to the bones, pain may be felt around the shoulder blades [1, 2].

Left Shoulder Blade Pain

Left shoulder blade pain in women may be indicative of myocardial infarction (MI) or heart attack. Along with this, the patient also complains of pain in the chest, jaw, and upper back.

Other signs and symptoms include feelings of indigestion, fatigue, palpitations, impending doom, pallor, cold clammy skin, difficulty of breathing, excessive sweating, hypotension or hypertension, anxiety, restlessness, crackles, heart murmurs, and atrial gallop. Pain in the right shoulder blade seldom occurs with MI [3].

Inflammatory disorders such as pericarditis, pancreatitis, and pleuritis cause referred pain to the left shoulder blade. It can also be a symptom for other health conditions such as aortic dissection, pulmonary embolism, and pneumonia [4].

Right Shoulder Blade Pain

Diseases of the gallbladder are manifested by a referred pain to the right shoulder blade. Fat women in their 40s are at risk in developing problems with the gallbladder.

The gallbladder is an organ located at the right upper quadrant below the liver. It stores bile that is responsible for chemically digesting fats or lipids. Everytime you eat fatty foods, your gallbladder becomes active as it secretes the bile.

If your gallbladder is diseased or has gallstones in it, you will experience severe sharp pain after eating. The pain radiates up to your right shoulder blade.

Different diseases of the liver may also cause pain to the right shoulder blade. An infected liver creates pus. Liver cirrhosis leads to peritonitis or fluid accumulation in the abdomen. Liver tumor or cancer may metastasize to different parts of the body. All of these result to general feelings of illness and pain behind the right shoulder blade [5].

Pain between the Shoulder Blades

Upper back pain between the shoulder blades is connected with the Causes section of this article. Generally, it may be due to muscle strain, rotator cuff injury, fracture, osteoporosis, arthritis, nerve impingement, herniated disk, virus, or cancer.

If you have a problem with your ribs, stabbing pain when breathing may be felt. Sharp pain after eating is felt when you have a problem with your gallbladder.

Severe pain between shoulder blades may be associated with thoracic outlet syndrome, rib problem, lung process, or pathologic diseases of the thoracic spine.

Diagnosis

  • The doctor begins by taking comprehensive history and physical examination. However, this may not be enough to make a reliable diagnosis.
  • Radiography including, chest x-ray, MRI, CT scan, or PET scan may be necessary to aid the diagnosis.
  • If a heart disease is suspected, the doctor will order you to have ECG and stress test.
  • Endoscopy or other abdominal exams is performed to determine if cause of shoulder blade pain is a problem in the gastrointestinal system [1].

Treatment for Shoulder Blade Pain

Shoulder blade pain has many causes. Treatment depends on it [2].

  • If it is as simple as a muscle strain, it’s easy. Do your shoulder blades a favour and take a rest.
  • Maintain proper posture and biomechanics.
  • Heat and cold compress offers relief.
  • Massage provides comfort.
  • At night, sleep in a comfortable position with your head and shoulders aligned so you won’t have to wake up in the morning having a sore shoulder blade. Use pillows.
  • Perform scapular retraction exercises. Position your arms at shoulder level and imagine that someone is standing right in front of you. Wrap our arms around that imaginary person and hold for 8-10 seconds.
  • If the pain is severe, muscle relaxants and even steroids are prescribed by the doctor.
  • If the cause is cancer, the treatment can get as complex as chemotherapy, radiation therapy, and surgery.

References:

  1. Eldridge L, Shoulder Blade Pain, About.com, 06/20/14 accessed on http://lungcancer.about.com/od/Symptoms-Of-Cancer/a/Shoulder-Blade-Pain.htm
  2. http://www.md-health.com/Shoulder-Blade-Pain.html
  3. Interpreting Signs and Symptom, Lippincott Williams & Wilkins, 2007, p 129
  4. http://www.buzzle.com/articles/pain-under-left-shoulder-blade.html
  5. http://www.md-health.com/Right-Shoulder-Blade-Pain.html

Published on May 5th, 2015 by under Pain Management.
Article was last reviewed on May 5th, 2015.



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