Shoulder Blade Pain: Causes, Symptoms, Treatment

Shoulder Blade Pain: Causes, Symptoms, Treatment
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Pain shooting between the shoulder blades signals a variety of diseases of the organs of the chest or abdomen. The most common culprit is in the spine.

Pain shooting between the shoulder blades is a symptom of diseases that are related to the chest and abdominal cavity. Thus, it involves multiple organ systems such as cardiovascular, respiratory (breathing) or digestive.

What is more...

Most commonly, pain originating in the musculoskeletal system and from the spine is projected into this area.

Pain between the shoulder blades as a result of spinal and musculoskeletal issues

One of the most common causes is pain, which arises from musculoskeletal and spinal problems. It can come from muscles, muscle attachments, tendons, ligaments, joints. 

The thoracic region consists of the rib cage, the sternum and ribs, the shoulder joint, the scapula, the clavicle, i.e. the brachial plexus of the upper limb, the vertebrae, the intervertebral discs and the other soft structures already mentioned. 

And the pain can come from any area.

Often the problem in a given area is caused by poor posture or by the spinal curvature and curvature of the spine. 

An example of a morbid curvature of the spine is:

The problem is very often rooted in today's lifestyle and sedentary lifestyle. Lack of exercise, working at an office desk, computer or working in a fixed position and standing, causes weakening of the interscapular muscles. Which leads to pain in the area between the shoulder blades.

Overloading of the spine also has a negative effect, and overloading on one side of the body is even worse. Abrupt movements, spinal snapping and block (lumbago), and a pinched nerve in the section below the scapula are common functional problems.

On the other hand, there is a problem with a slipped intervertebral disc. A worse situation is a disc herniation. This is a condition where part of the disc bulges out of the vertebral space and presses on its surroundings. If there is nerve compression, radicular syndrome occurs.

With nerve compression, there are other discomforts such as tingling, tingling in the upper limb, other sensory disturbances; in addition, there may be weakening of the muscles and pain radiating into the chest, difficulty breathing, especially deeper breathing. 

The pain is intense, prickly, stabbing, and radiates to the chest.
It mimics heart disease.
However, it varies depending on the movement.

Pain from the spine is typically aggravated by movement, change of position, coughing or sneezing. The intensity of the discomfort can also be exacerbated by deep breathing.

The root of the problem:

a bad movement, a sudden bending or stretching out of the bend and an improper technique of lifting the load. The spine is unevenly loaded, which is the basis of overload.

Another example is a back pain in cold weather. A draft, a blowout, windy weather, a sweaty back and an acute block is in the world. The pain aggravates every movement and breath.

Sedentary work and lack of exercise, along with other factors, contribute to and lead to long-term, not just acute, problems.

Most of the world's population will experience spinal pain at least once in their lifetime. 

Sedentary work and computer work are also associated with cervical spine strain. Pain can spread from the neck to the head, causing both sharp and long-lasting headaches. Another unpleasant symptom is vertigo - cervical vertigo.

Headache from the cervical spine is also referred to as cervico-cranial syndrome (CCJ syndrome).

The pain in cervicobrachial syndrome (CB syndrome) spreads from the neck downwards to the chest, between the shoulder blades and into the upper limbs.

Learn more: Vertebrogenic pain syndrome. Regular exercise or specialist methods and exercises can help are outlined in the article Effective help for back or cervical spine pain.

Examples of diseases closely related to the musculoskeletal system and the spine is:

  • osteochondrosis intervertebral disc disease
  • spondylarthrosis, a chronic, rheumatic disease 
  • spondylosis is a degenerative disc disease, leading to damage to the vertebrae 
  • spondylolisthesis is the displacement of one spinal vertebra
  • Spinal disc herniation, i.e. slipped disc, bulging disc, ruptured disc, herniated disc, prolapsed disc
  • pseudoradiculopathy
  • scoliosis, abnormal kyphosis, kyphoscoliosis is a deformity of the spine
  • congenital defects of the vertebrae
  • osteoporosis
  • frozen shoulder
  • intercostal neuralgia
  • injuries, fractures
  • injuries caused by violent movements, e.g. in golf, football, hockey, are common
  • myositis is inflammation of the muscle
  • tuberculosis of the spine
  • spinal tumour

And what if the underlying cause is stress and psyche?

Stiff neck has a basis in long-term stress and excessive long-term psychological load, work pressure, conflicts in the family and others.

The development of psychosomatic disease is also a risk in this case.

Psychological stress, stress, neurotic personality, genetic predisposition, physical stress are common factors in the development of difficulties such as acute spinal blockage.

How are back pain between the shoulder blades and pregnancy related?

The body of a woman, a future mother, is subject to constant changes. Gaining pounds changes the centre of gravity, the spine and the support apparatus are more loaded.

The optimal weight gain is from 7 to 16 kilograms.

Approximate weight gain in kilograms:

  • fetus - 3 - 4 up to 5 kg
  • uterus - 1 to 1,5 kg
  • amniotic sac and amniotic fluid - 1,5 kg
  • blood volume - 1,5 kg
  • enlargement of the mammary glands - 0,5 kg
  • water retention in the body - 2 kg
  • body fat - 2 - 3 kg

Organ diseases as a cause of pain between the shoulder blades

The organs of the cardiovascular, respiratory and digestive systems are located in the thoracic cavity. It follows that the cause may have a diverse basis.

Colicky pain in the gallbladder is projected to the scapular area.
Severe pains arise in the lower back and between the shoulder blades.

Gallstones irritate the bile ducts or clog the outlet from the gallbladder. Colic occurs. The latter has a typical wave-like course and is very often provoked by bad dietary choices.

Gallbladder pain is characterized by localization in the upper abdomen (stomach area - epigastrium), below the right rib arch or below the right shoulder blade.

The period of pregnancy predisposes to the formation of gallbladder stones.

Similarly, it becomes a tract in gallbladder inflammation. However, 90% of it is due to stones.

In the same area, but on the left side, pain is caused by pancreatic disease. An example is inflammation of the pancreas, which can be acute (sudden) or chronic (long-term).

Find out more in these articles:

 Other symptoms may also occur with these problems, such as:

  • indigestion
  • abdominal pain and radiating to the shoulder blade area
  • flatulence, bloating
  • nausea, upset stomach
  • nausea, vomiting
  • sweating
  • skin pallor
  • jaundice - icterus
  • stool discoloration
  • lack of appetite, malnutrition and weight loss
  • dehydration
  • diarrhoea or constipation 

Other diseases of the digestive system include, for example, gastric and duodenal ulcer disease, GERD - gastroesophageal reflux disease and others, or oncological diseases.

Other causes of pain between the shoulder blades, in the chest and difficulty breathing

What else signals pain between the shoulder blades or under the shoulder blades?

Among the more serious causes may be cardiovascular diseases such as ischaemic heart disease and angina pectoris, heart attack, aortic dissection or pulmonary embolism

Respiratory diseases that may be involved in this type of pain are acute inflammation of the airways, pneumonia, pleurisy and chronic diseases (COPD). 

Examples of associated symptoms:

  • shortness of breath, sudden resting shortness of breath, wheezing to grunting when breathing
  • chest pain
    • may radiate between the shoulder blades, into the neck, face, upper limbs, stomach area
    • may be pressing, stinging, stabbing, in the form of an unpleasant sensation - chest discomfort
  • pallor
  • sweating
  • nausea, vomiting
  • upset stomach
  • dizziness
  • anxiety and fear of death
  • fainting, loss of consciousness to unconsciousness and unconsciousness
  • heart rhythm disturbances and palpitations
  • coughing up blood
  • swelling of the lower limbs
  • in massive embolisation and cardiac infarction and sudden death
  • movement and position has no significant effect on the intensity and change in discomfort

From neurological diseases, it can be shingles. And a number of other diseases. Therefore, with persistence and unclear origin of the discomfort, a professional examination is necessary. The same with sudden, sharp and intense pain.

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Interesting resources

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  2. Marik TL, Roll SC (2017). "Effectiveness of Occupational Therapy Interventions for Musculoskeletal Shoulder Conditions: A Systematic Review". The American Journal of Occupational Therapy71 (1)
  3. "The Unique Role of Occupational Therapy in Rehabilitation of the Hand".
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  11. Cho CH, Bae KC, Kim DH (September 2019). "Treatment Strategy for Frozen Shoulder". Clinics in Orthopedic Surgery11 (3): 249–257.
  12. Physiomobility (30 September 2017). "Frozen shoulder exercises to improve range of motion and pain". Physiomobility
  13. Denegar CR, Ciriani GM (November 2010). "Self-Management of Idiopathic Adhesive Capsulitis: A Case Report". Athletic Therapy and Training. Therapeutic Modalities. 15 (6): 19–22. 
  14. Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP (25 September 2020). "The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis". Evidence-Based Complementary and Alternative Medicine2020: 9790470. 
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