Shoulder blade pain is a common condition. You may either experience a dull, aching pain or a shooting, burning sensation in the scapular region. It can be a sign of something as simple as poor posture or something as serious as a heart attack. In this article, we guide you through some possible causes of the pain as well as pain relief techniques.
What Is Shoulder Blade Pain?
To understand what shoulder blade pain is, we must first discuss what shoulder blades are? The shoulder blade, also called scapula, is either of two large triangular-shaped bones that lie on your upper back.
Shoulder blade pain is pain that occurs in the shoulder blade region not to be confused with interscapular pain, which is in between.
Right and left shoulder blade pain
Some conditions can cause referred pain to either the right or left shoulder blade. Referred pain is pain felt at a location distant from the site of the injured or diseased organ or body part.
For example, gallbladder disease may cause referred right shoulder blade pain, while a heart attack is more likely to cause referred left shoulder blade pain.
Shoulder Blade Pain Symptoms
Shoulder blade pain can likely present with the following symptoms:
- Dull, aching, sharp, or burning pain at the shoulder blade
- Difficulty using affected arm(s)
- The feeling of a pulled muscle
- Pain in nearby muscle groups, such as shoulder or
- back pain
- Instability of the shoulder
What Causes Shoulder Blade Pain?
There are many potential causes of shoulder blade pain, including:
Musculoskeletal causes
Shoulder blade pain due to musculoskeletal issues is quite common. These issues may include:
- Muscle strain. The most common cause of shoulder blade pain is a muscle strain resulting from intense workouts, heavy lifting, doing more work than you’re used to (overuse), or sleeping in an odd position.
- Rotator cuff tear. A tear in the tendons around the shoulder joint that often occurs in people who repeatedly perform the same shoulder motions such as baseball players, tennis players, painters, and window washers.
- Snapping scapula syndrome. A condition marked by popping or cracking noises when you raise your arm.
Bone and joint issues
As the shoulder blade is a bone, you can experience a scapular fracture. However, it is an unlikely occurrence as the scapulae are considered among the most difficult bones in the body to fracture. So fracturing the shoulder blades often requires a direct blow or trauma, such as a car accident.
Other potential bone or joint problems that can cause right or left shoulder blade pain include:
- Osteoporosis. A condition in which bones become weak and brittle, making fractures more likely.
- Arthritis. Inflammation of one or more joints, causing pain and stiffness that usually worsens with age. The scapulae may be directly involved, or you may be experiencing referred pain from other regions affected by arthritis, such as your shoulder or spine.
- Fibromyalgia. A chronic condition that causes widespread pain throughout the body.
- Spinal stenosis. A condition in which the spaces within your spine narrow, putting pressure on the spinal nerves or the spinal cord, which may result in referred pain to the shoulder blades.
Cardiac causes
If your left shoulder blade is hurting, it could be a sign of certain heart conditions, such as a heart attack, especially in women. Other heart conditions that could cause shoulder blade pain in back, right or left are pericarditis, which is the inflammation of the thin, sac-like membrane that surrounds your heart and aortic dissection, which is a tear in the inner layer of the aorta.
Note: If you are uncertain about the cause of your pain and have any risk factors for heart disease, seek immediate medical attention.
Pulmonary causes
Certain lung conditions can also cause shoulder blade pain. These include:
- Lung cancer and mesothelioma, which is a type of cancer that develops in the linings of the lungs and other internal organs
- Pulmonary embolism, which mostly occurs when blood clots in the legs break off and travel to your lungs
- Pneumothorax, i.e., a collapsed lung
Abdominal causes
Several issues in the abdomen could result in referred pain to the shoulder blades. These include gallstones, peptic ulcer disease, liver disease, and acid reflux.
With the previously mentioned, the referred pain is more common in the right shoulder blade. You may experience left shoulder blade pain if you have pancreatitis. Surgery may also result in shoulder or shoulder blade pain.
Diagnosis
Usually, diagnosis starts with history taking and physical examination where your doctor tries to work out if there is a simple reason behind your pain. Once any obvious causes, such as muscle strain from heavy lifting or sleeping in an uncomfortable position, have been ruled out, your doctor may perform different tests including:
- Blood tests to test for liver function, or check for inflammation
- Radiological studies of your chest or other regions using an X-ray, a CAT scan, an MRI, or a PET scan
- Heart tests, such as an electrocardiogram (EKG or ECG) or stress test, if your doctor suspects your pain may be originating from your heart.
- Abdominal tests, such as an endoscopy to evaluate your stomach and small intestine or an ultrasound to evaluate your gallbladder.
Treatment
The treatment of shoulder blade pain will depend on the underlying cause of the pain. For shoulder blade pain related to muscle strain, sleeping poorly, overuse, or other simple causes, these at-home treatments can help relieve your pain:
- Rest. Does your pain get worse with specific movements or activities? Consider taking a break to give your body time to heal and rest.
- Ice. Ice or cold reduces blood flow to the shoulder blade, reducing inflammation and swelling, which, in turn, helps ease your pain.
- Heat therapy. If you prefer heat, soaking in a hot bath or using a heating pad may offer pain relief, especially if your muscles feel tight.
- Exercise. Strengthening your back could help alleviate pain. Try pushups, sit-ups, and pullups, and remember to start slow if you don’t exercise regularly. Include light stretches to your routine for your front shoulder muscles and shoulder joint rotation.
- Over-the-counter pain relievers. Medications such as aspirin, ibuprofen, naproxen, and acetaminophen may help reduce inflammation and pain. Make sure not to use these medications for longer than 10-14 days.
- Massage. Do it yourself at home or book a massage session as it can help with shoulder blade pain that comes and goes, especially if due to an injury or compressed nerve.
You can also talk to an Orthopedic Exercise Specialist Anne Asher an award-winning health journalist specializing in spine and holistic pain management and founder of Posturally. She will help you get out of the pain without use of drugs or surgery.
Where there is an underlying disorder, treatment relies on treating the underlying cause, for example, radiation, chemotherapy, or other therapies for cancer-related pain. And if a heart condition is the cause of your left shoulder blade pain, you may require medications that target heart problems or even urgent surgery.
Seek immediate medical attention if you have shoulder blade pain along with symptoms such as shortness of breath, chest pain, dizziness, excessive sweating, sudden difficulty speaking, vision problems, coughing up blood, fever, and loss of consciousness.
Tips for prevention
Shoulder blade pain can be prevented by taking various measures, including:
- Exercising regularly
- Practicing good posture
- Avoiding heavy lifting
- Eating healthy
- Changing sleeping positions
- wearing a seatbelt in a car
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- Rochel M.,Jeffrey M., Shoulder Blade Pain: Muscle Strain, Heart Attacks, Gallstones. August 21, 2020
- Merolla G, Cerciello S, Porcellini G, et al. Snapping Scapula Syndrome: Current Concepts Review in Conservative and Surgical Treatment. Muscles, Ligaments and Tendons Journal. 2013;3(2):80-90. NCBI Link.
- Galland, L. (2010, December). Diet and inflammation. Nutrition in Clinical Practices, 25(6), 634-640
