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Understanding Pain Between the Shoulder Blades: Causes and Solutions

A woman stretching her arms behind her head outdoors, surrounded by autumn trees and a scenic landscape.

If you’re experiencing pain between your shoulders, the source of discomfort may not be as straightforward as you think. While irritated joints or muscles are common culprits, other factors—including referred pain from the neck or even underlying organ issues—can contribute to the problem.

Potential Causes of Pain between the Shoulder Blades

1. Joint Dysfunction

The mid-back (thoracic spine) contains two key joints that can become irritated and painful:

Facet Joints – These small sliding joints connect the vertebrae and can become stiff or inflamed.

Costovertebral Joints – Located where the ribs meet the spine, these joints can also contribute to discomfort if irritated.

An anatomical illustration of the human upper back and ribcage, highlighting the facet joint and costovertebral joint. Red arrows point to these specific joints, with labels indicating their locations. The image shows the spine, ribs, and muscles in detail to illustrate the connection between these structures.

2. Muscular Strain & Postural Fatigue

A man in a light blue dress shirt sits at a desk, resting his chin on his hand while looking at a computer screen. He has dark hair and a thoughtful expression. The background features a modern office setting with glass partitions and soft lighting.

Prolonged sedentary postures, particularly those caused by desk work and excessive screen time, strain postural muscles. Over time, fatigue and waste buildup in these muscles can cause aching and tension between the shoulder blades.

3. Referred Pain from the Neck

The neck (cervical spine) is often overlooked as a source of pain in the upper back. Irritated cervical spine nerves can refer to pain between the shoulder blades, sometimes mimicking muscle tension or joint irritation.

The color-coded areas on the image to the right, upper back, indicate potential sources of referred pain from cervical spine nerve roots. The red area near the shoulder suggests C5 or C6 nerve involvement, the green area on the mid-back suggests C7 or C8, and the blue area near the scapula suggests C8.

Back view of a muscular man with color-coded areas on his upper back, indicating potential sources of referred pain from cervical spine nerve roots. The red area near the shoulder suggests C5 or C6 nerve involvement, the green area on the mid-back suggests C7 or C8, and the blue area near the scapula suggests C8. Labels correspond to possible cervical nerve root contributions to scapular pain

4. Underlying Health Conditions

A detailed 3D-rendered anatomical model of a human heart with a gallbladder positioned next to it. The heart is highly realistic, displaying arteries, veins, and a glossy texture. The gallbladder, depicted in its natural greenish hue, is shown alongside the liver’s textured surface. The background is softly lit, highlighting both organs.

Before assuming the pain is musculoskeletal, it’s crucial to rule out issues related to internal organs:

Heart Problems – Cardiac issues, including angina, can sometimes present as upper back pain.

Gallbladder Dysfunction – Conditions like gallstones can cause referred pain to the right shoulder blade.

Effective Treatment Starts with Proper Diagnosis

Pinpointing the cause of your discomfort is essential for effective treatment. As chiropractors, we assess and treat a wide range of musculoskeletal conditions daily. By conducting a thorough evaluation, we can determine whether your pain stems from joint dysfunction, muscular strain, or another underlying issue—and guide you toward the most effective treatment plan.

 

A chiropractor in a light blue dress shirt examines a female patient’s shoulder in a well-lit medical office. The patient, wearing a white t-shirt, sits on an examination table while the chiropractor gently assesses her arm. The setting features natural light coming through the windows, creating a professional and calming atmosphere

Conclusion

If you’re struggling with persistent pain between your shoulder blades, don’t ignore it. Seeking professional evaluation can help address the root cause and prevent the discomfort from becoming a long-term issue.