What Causes Pain Between The Shoulders And How To Fix It

Pain Between Shoulders

It’s not uncommon to experience pain between the shoulders: According to a study that was published in the journal Occupational Medicine in 2015,[1] around one in ten men and one in five women feel pain in the upper back. Although the resulting discomfort can range from mildly uncomfortable to severe and debilitating, the root cause can often be corrected with a combination of rest, stretching, and exercise. The most common cause of upper back pain between the shoulders is a muscle strain caused by overuse, injury, or poor posture.

Less frequently, this pain, which may also be referred to as interscapular pain, may be an indication of other disorders that require the attention of a doctor, such as a bulging or herniated disc, acid reflux, a gallbladder infection, or shingles. These conditions require immediate medical attention. Shoulder blade pain can be a symptom of something more serious, such as a heart attack or a tumor, but this only occurs in extremely unusual circumstances.

Continue reading to find out how to treat some of the more frequent causes of pain between the shoulders, as well as how to recognize warning signs that indicate you should visit a doctor about your condition.

A Look at the Anatomy of the Shoulders and Upper Back

It is useful to have an understanding of the anatomy of the area in order to gain a better understanding of the various sorts of injuries and medical conditions that can cause discomfort in the upper back between the shoulders.

According to Dean Padavan, M.D., associate program director of the primary care sports medicine fellowship at Atlantic Health System in New Jersey, pain in the upper back and shoulders can typically be attributed to muscles and nerves connecting to the thoracic or cervical spine. This statement was made by Dr. Padavan. There are seven vertebrae in the neck that make up the cervical spine. These vertebrae are connected to the twelve vertebrae that make up the thoracic spine, which is the largest segment of the spinal column. The thoracic spine is responsible for the protection of the spinal cord and is attached to all 12 ribs.

A number of muscles, including the trapezius, rhomboids (both major and minor), serratus anterior, levator scapula, and latissimus dorsi, are all connected to your shoulder or shoulder blade along the thoracic spine. The thoracic area is positioned in the middle of the back, just behind the rib cage. In addition, the pectoralis major and pectoralis minor attach to the upper back, moving from the front of the body to the back.

Patients are provided with an alternative, less professional approach to image the region by Dr. Padavan. “When describing the numerous structures of the back, many medical professionals like to use the analogy of a freeway. He explains that your brain and spinal cord are like the major highway in your body, while the smaller highways that branch off of it are like the nerves that run throughout your body, and the landscape that surrounds these roads is made up of your muscles and tendons.

The Pain Between the Shoulders Can Be Caused by Musculoskeletal Issues

It is important to keep in mind that the term “musculoskeletal” refers to the way in which the muscles and skeleton work together, which is the most common cause of back pain between the shoulders. However, it is also important to realize that this term is a broad umbrella under which several more specific causes lie. According to Dave Ochsendorf, a physical therapist at Siesta Key Sports and Physical Therapy in Sarasota, Florida, some musculoskeletal injuries are acute and the result of an accident or injury, while others develop gradually as a result of improper movement or alignment or the progression of certain diseases.

Poor Posture

According to Ochsendorf, poor posture is at the top of the list of potential causes of pain between the shoulders. In a world where so many of us spend a significant portion of our day seated in front of a computer or staring at a device with our shoulders rolled forward and back rounded, poor posture is one of the most common factors. Slouching and “forward head posture,” in which a person’s head juts forward while walking or standing rather than being aligned with the spine, are two examples of poor posture. Slouching is also an example of poor posture.

According to Ochsendorf, “We see a lot of pain syndromes connected to posture and the fact that those muscles [between the shoulder blades] are in tension all day long.” “We see a lot of pain syndromes related to posture and the fact that those muscles are in stress all day long.” We don’t do enough to counteract it by opening up our chest and upper back in the other direction and building up those muscles in between our shoulder blades, which is a common problem.

To arrive at a diagnosis as to whether or not incorrect posture is solely to blame for pain between the shoulders, a physical therapist or another qualified medical practitioner may use one of many diagnostic approaches, the first of which is observation. According to Oschsendorf, “From the moment a patient enters into the room, we’re monitoring them to determine how rounded their shoulders are.” [Citation needed] “We’re observing them to see how rounded their shoulders are.” “How severe of an issue is our posture going to be here?”

Ochsendorf performs an exam in which he observes movements that cause or relieve pain, and he presses on muscles, ribs, and joints to rule in or rule out additional muscular problems based on how tight or tender a patient is in various areas. This allows him to further evaluate how a patient’s poor posture is contributing to their pain.

When evaluating pain between the shoulders, for instance, a physical therapist can check for a specific posture-related condition known as upper crossed syndrome. This ailment manifests itself when there is an imbalance between the strength and weakness in particular muscles of the upper back, shoulders, and chest. The problem may typically be remedied with physical therapy or exercises that are specifically targeted at the affected muscles.

How to put a stop to it: The first thing you need to do is figure out what’s causing your bad posture. Although “tech neck,” which is a strain on the spine produced by constantly gazing down at a cell phone, is very frequent, the configuration of our workstations can also be a key contributing factor to poor posture. [Case in point:] [Case in point:] [Case in point:] [Case in point:] There are, fortunately, adjustments that may be made to guarantee that the hours you spend working do not contribute to back pain. Adjust your chair, for instance, so that your feet are planted firmly on the ground, your hips and knees are at right angles to one another, and your back is supported. In addition, make sure that your keyboard is articulating and that it is placed directly in front of you. Additionally, make sure that you follow the most recent ergonomic standards for the placement of your monitor, documents, and telephone to ensure that the hours you spend working do not contribute to the pain in your back. Oschsendorf recommends asking a coworker or a close friend to take a picture of you while you are working on your computer. “Many of these postural disorders are things we’ve been doing for so long that we aren’t aware that we’re doing them,” he says. “We’ve been doing them for generations.”

To treat poor posture, it is necessary to first strengthen the muscles that are located between the shoulder blades, and then stretch the chest and rib cage in order to allow the shoulder blades to remain in the correct position, which is rolled back. The three stretches and exercises listed below are ones that Dr. Ochsendorf commonly advises to his patients.

  • Doorway stretch: While standing in a doorway or corner, reach one hand across the room while simultaneously rotating your body away from the wall. This will stretch the pectoral muscles.
  • Foam roller stretch: Position a foam roller so that it runs vertically along the spine. Lie down on top of the roller and relax so that your chest and shoulders may expand. You might also lay back on the foam roller in a position that creates extension by placing it across the shoulder blades in a direction that is perpendicular to the spine. (People who are able to get up and down from the floor in a secure manner should perform this stretch.)
  • Individualized exercises: These exercises may include rows, reverse flys, or others that are particular to the source of an individual’s pain. Other individualized exercises may also be used.

When it comes to developing a personalized treatment plan, consulting with a physical therapist might be helpful. “We massage the location, aid [the patient] with stretching, or help manually mobilize the vertebrae or ribs,” explains Ochsendorf. “We have a lot of different techniques.” “There are other modalities we have, too, like ultrasound or laser [technology] to attempt to soothe some of the inflammation,” the doctor explained. “These are some of the options we have.” Alternating between heat and ice, in addition to taking anti-inflammatory medication, may also be recommended.

According to Ochsendorf, there are a variety of treatments that can be useful for releasing pain. Some of these techniques include chiropractic care and massage therapy. However, Ochsendorf finds that combining these treatments with physical therapy is most effective. “If you’re trying to go to the heart of the problem so that it doesn’t come back, you don’t want a Band-Aid,” he adds. “You want a solution that addresses the root of the issue.” You need to figure out what went wrong, why it occurred, and what you can do to prevent it from happening again in the future.

Strain on the Muscles

When a muscle is injured as a result of overuse or a sudden injury, this can lead to the muscle tugging, twisting, or even ripping. This injury is referred to as a muscle strain.

An overuse injury can occur as a result of a move that you perform repeatedly on a regular basis, and it is often strongly tied to postural difficulties (having your shoulders rolled forward or your head tilted down while working or using a device is an extremely common way to put excess tension on the muscles between your shoulders). On the other hand, overuse injuries in the upper back can be caused by a wide variety of repeated motions, some of which are relatively common in certain occupations (like dentistry) or hobbies (like archery) (like certain sports, such as volleyball).

While lifting anything that is overly heavy or when lifting something with improper form, acute muscle strains commonly occur between the shoulder blades. It is also possible to incur an acute strain from a fall or other accident that pulls or twists the muscles in your upper back. This type of injury is known as a thoracic outlet syndrome.

According to Dr. Padavan, the solution is to perform stretches and exercises in a way that does not make the injury any worse. A number of the solutions presented earlier for poor posture can be helpful in the case of muscular strain.

According to him, many of the musculoskeletal conditions that might cause pain between the shoulders are amenable to non-invasive treatments, such as alternating heat and cold, stretching, gentle range of motion exercises, anti-inflammatory drugs, topical lotions, and other similar remedies.

If, on the other hand, you are in excruciating pain, the discomfort has not subsided over time, or the pain is growing worse in spite of receiving conservative treatment, it is absolutely necessary for you to consult a medical professional in order to obtain an official diagnosis and a treatment plan.

Rib or Vertebrae Impairment Restricted

Have you ever gotten a terrible kink in your neck to the point where it seemed like it was stuck? “The same type of thing can happen with your vertebrae,” adds Ochsendorf. “A rib is attached to each and every one of the vertebrae. For lack of a better way to describe it, those little joints where the rib comes in, or even a connection between two thoracic vertebrae, can become stuck. In this particular scenario, motion is limited, and attempting to go beyond a certain range of motion may result in excruciating discomfort, he notes.

Again, posture can play a significant role in the development of this disorder. Not only can bad posture cause this problem, but this problem can also perpetuate poor posture.

How to repair it: According to Ochsendorf, the key goal here is to obtain more extension, therefore the foam roller comes to the rescue here. Ochsendorf also adds that resting or softly rolling over the foam roller is an easy approach to make that extension happen. “Doing some rotational stretching can also help open things up again,” he says. “Doing some lateral stretching can also help.” However, just as was the case with posture, it is essential to get to the bottom of the issue. If you believe that you might be having a constricted rib or vertebrae, it is highly recommended that you get checked out by a medical professional as soon as possible.


According to Ochsendorf, the discomfort that occurs between the shoulders can also be caused by other kinds of injuries, such as pinched nerves, bulging discs, or spinal compression fractures. These are the kinds of injuries that need to be evaluated by a doctor, and the treatments can vary.

Compression of the Nerves

Ochsendorf encounters numerous patients who suffer from a pinched nerve in the neck, and in many cases, he is even able to screen for this condition over the phone. “I ask them to tilt their head back, especially to the side where they’re getting discomfort at the shoulder blade,” he says. “I ask them to tilt their head back, especially to the side where they’re suffering pain.” “In most cases, it [movement] causes the nerve to get pinched. And vice versa, if they tilt their head down and to the opposite side, that [movement] ought to alleviate the pain that they are experiencing. If you move your head around and notice that this has an influence on the symptoms, then it’s likely that you have a pinched nerve.

How to put a stop to it: According to Ochsendorf, in certain instances, the affected area can be healed by simply stretching the head in certain directions on a constant basis. “It’s a simple solution that we can teach individuals to use in order to manage [the disease], and it can work very rapidly,” the author writes. However, in other circumstances, chronic postural imbalances need to be addressed. In this scenario, the treatment process takes a little bit more time and may require the patient to see a physical therapist, he notes.

Herniated or Bulging Discs: Which Is Worse?

There is a gel-filled shock absorber called a disc that sits in between each of the vertebrae in your spine. This shock absorber allows for movement in your spine. When a disc is injured, it can cause the disc to protrude into the spinal canal, which is referred to as a bulging disc. This injury could result in excruciating pain, numbness, or weakness; on the other hand, you might not feel anything at all. On the other hand, a disc that has totally burst is referred to as having a herniated disc. Although the lumbar and cervical regions of the spine are more prone to be affected by this injury, the thoracic region is not immune to the condition either.

Rest, medicine, and physical therapy are the three main components of a treatment plan for both bulging discs and ruptured discs, respectively. Injections of cortisone are another method of reducing the pain that may be considered. Even though these non-operative treatments are successful for the majority of patients, surgery may be an option for more severe instances that show no signs of improvement after approximately six weeks. It is imperative that you be checked out by your health care practitioner if you have any reason to suspect that you may have a herniated or bulging disc.

Vertebral Compression Fractures

According to Ochsendorf, vertebral compression fractures can be the source of pain between the shoulders. These fractures are typically the result of low bone density, but they can also be the result of traumas such as falls or vehicle accidents. According to him, “older persons with bone density difficulties and thoracic kyphosis (a rounded upper back) are especially susceptible, and their vertebrae can shatter [by] just leaning forward sometimes.” thoracic kyphosis refers to an abnormal curvature of the upper back. Everyday activities like turning over in bed can become excruciatingly painful, and the problem needs to be assessed by a health care specialist, he says.

How to put a stop to it: According to Ochsendorf, kyphoplasty is a frequent treatment for spinal compression fractures. In this procedure, a specialized cement is injected into the vertebrae in order to restore the shape and height of the vertebrae while also reducing discomfort. Patients should be informed about postural considerations in everyday life and spinal decompression exercises can be taught in physical therapy, he adds. “Spinal decompression exercises can be taught in physical therapy.”


Scoliosis is a degenerative disorder that causes curvature and rotation in the spine. It affects around 2% to 3% of the population worldwide. Chronic or acute pain between the shoulder blades can be caused by a number of different factors, including muscle spasms, local inflammation, or degeneration of the intervertebral discs or joints owing to scoliosis. Adults diagnosed with scoliosis are more likely to experience the pain that is linked with the condition.

How to put a stop to it: Because the diagnosis of scoliosis at an early stage is so important, many schools now offer screenings for the condition, which are performed by a nurse or another qualified medical professional. Those individuals who are referred for additional evaluation and are determined to have scoliosis have two different categories of treatment goals available to them: morphological (which refers to aesthetics), and functional (pertaining to mobility).

It is possible to explore a number of treatments, which can considerably change from one instance to the next. If scoliosis is identified, a health care expert will discuss treatment options with you and help you choose the one that will work best for you.


According to the Arthritis Foundation, roughly one third of persons over the age of 60 have some degree of shoulder osteoarthritis [2]. Although osteoarthritis (OA) of the shoulder isn’t as frequent as that of the hip or knee, it can still be debilitating. Although osteoarthritis can affect any part of the spine, it most frequently manifests in the lower back or the neck rather than the thoracic region of the spine. You should discuss the likelihood of osteoarthritis (OA) with your primary care physician if you have been experiencing symptoms such as stiffness, soreness, or crepitus (a grinding sensation as you move).

How to treat it: Osteoarthritis (OA) is a degenerative joint condition that cannot be cured but can be managed with a variety of conservative treatments. A reduction in pain may be achieved through the application of heat or ice, massage, physical therapy, stretching and exercise, or braces designed to support the area. In the event that nothing else relieves your discomfort, you might consider surgical intervention.

Additional Common Trigger Points That Cause Pain Between the Shoulders

If you’ve tried stretching, strengthening, and improving your posture but are still experiencing upper back pain, it’s possible that one of the following issues is to blame. Musculoskeletal imbalances or injuries aren’t the only potential causes of upper back pain; there are other potential causes as well.

Acid Reflux

According to Dr. Padavan, “typically, acid reflux… will have an association with the use of particular meals.” When you eat meals that are fried, spicy, or fatty, as well as beverages that contain caffeine or alcohol, you may be more likely to experience soreness between your shoulder blades after eating. If this is the case for you, it may be good to keep track of what you’ve been eating recently.

People who suffer from acid reflux are more prone to also have gastroenterological symptoms, such as feeling nauseous or having abdominal pain. Acid reflux is characterized by a number of symptoms, the most typical of which are a burning sensation that originates in the chest, belching, a lump in the throat or difficulty swallowing, and a taste in the mouth that is either metallic or sour.

Should it turn out that acid reflux is what’s causing your discomfort, modifying your lifestyle and taking over-the-counter medications that are developed to treat acid reflux should help alleviate your symptoms. Your primary care physician is in the greatest position to determine whether or not the pain you are feeling between your shoulders is the result of reflux.


Pain in the upper back may be a symptom of shingles, which is caused by a reactivation of the varicella zoster virus (commonly known as chickenpox). According to Dr. Padavan, it is something that happens later in life and is sometimes brought on by stress. “It can manifest as painful vesicles (sores) on your back and requires a clinical diagnosis,” he explains. Because of this, it is essential for a physician to examine a patient’s skin whenever they come in complaining of back discomfort.

Gallbladder Issues

According to Dr. Padavan, illnesses related to the gallbladder, such as gallbladder infections or gallstones, tend to have a connection to the foods that a person eats and are frequently accompanied by nausea and abdominal pain. Acid reflux is another condition that is related to the gallbladder. If this is the case, the pain may not go away when you use the restroom or pass gas, and it may also be located in the middle of your abdomen or just under your ribs on the right side of your body.

You might be able to avoid these problems by adhering to a healthy diet and keeping your weight at a healthy level. According to Dr. Padavan, “Fried, fatty foods and obesity might induce gallbladder illness.” Gallbladder disease typically manifests itself in the form of stones, which can lead to gallbladder dysfunction. “Diagnosis of these disorders is possible by thorough medical history and examination, as well as through blood testing and imaging.”

Causes of Acute Pain in the Chin and Between the Shoulders

Even though the following reasons for pain in the space between the shoulders are not as common as the musculoskeletal problems discussed before, it is nevertheless important to be aware of the warning indications.

Attack of the Heart

According to Joonun Choi M.D., director of non-invasive cardiology at Stamford Health in Stamford, Connecticut, “pain between the shoulder blades is most usually attributable to a musculoskeletal etiology,” but “it can be an uncommon presentation of a heart attack.” It’s important to note that discomfort between the shoulder blades can also be caused by other heart problems, such as aortic dissection and pericarditis, as he explains: “For heart attacks, this pain will often be accompanied by shortness of breath or chest pain. It’s also worth noting that discomfort between the shoulder blades can also be caused by aortic dissection.”

Women in particular should be aware of pain between the shoulders as a potential symptom of a heart attack because there are sex-based differences in how symptoms of acute coronary syndromes—including heart attacks—present, with women being more likely than men to experience pain or discomfort between or under the shoulder blades, as well as in the central high chest, neck, and arms. In addition, women are more likely to experience pain or discomfort in the central high chest, arms, and neck. Because of this, Dr. Choi notes that he recommends to all of his patients, but particularly to women, that they seek quick medical assistance for any kind of torso discomfort for which there is no known cause.

Cancers of a Particular Genre

According to Jonathan Stegall, M.D., an integrative oncologist at the Center for Advanced Medicine in Alpharetta, Georgia, pain between the shoulders that is caused by cancer is unusual. When someone complains of pain in this region, we usually start by looking at the more prevalent potential causes.

Pain in the space between the shoulder blades is a symptom that he claims can be caused by a particular form of lung cancer called a Pancoast tumor. Pain in the region between the shoulder blades may be caused by referred pain from uncommon tumors that have the potential to irritate the lungs in the vicinity of the upper portion of the lungs. If Dr. Stegall had reason to suspect cancer in a patient who complained of upper back pain, he would also inquire about any other symptoms the individual was experiencing, such as a cough, difficulty breathing, or chest pain.

If you are experiencing pain in the space between your shoulders and are concerned that it may be caused by cancer, you should consult a medical professional.

When You Should See a Physician

According to Dr. Padavan, you should get a professional diagnosis whenever you have concerns about the nature or severity of your discomfort. According to him, “Dr. Google” and other online search engines might cause people to feel nervous and agitated. “It is crucial to get evaluated so that you can receive care as quickly as possible if you have pain that is continuing, growing worse, or not getting better despite the use of home remedies,” says the author.