Upper back pain between shoulder blades: Causes and treatment

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There are several muscles of different shapes and sizes in the upper back, which help with neck, shoulder, and arm movements.

Injuries to these muscles can cause upper back pain. The feeling can be a dull ache or a sharp pain.

Exercise

Some forms of exercise increase the risk of injuring the upper back.

Throwing a ball overhead, lifting weights, and performing some swimming strokes can strain muscles between the shoulder blades. The repetition of these movements over time is a common cause of muscle strain.

Other symptoms of muscle strain include a feeling of weakness in the area, swelling, and muscle cramps.

People can treat a mild strain with ice, rest, and pain relievers. Most mild strains should heal within a couple of weeks.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling. It is important to try to avoid activities that strain the back muscles.

Applying an ice pack for up to 20 minutes every few hours can also reduce pain and swelling. Gently moving the shoulders at regular intervals can help reduce any stiffness.

Posture

How someone sits or stands can cause pain between the shoulder blades. Some positions that may put a strain on muscles in the upper back include:

• sitting at a desk for much of the day
• using an uncomfortable chair
• leaning over a laptop for long periods
• crossing the legs when sitting down

These postures can cause a dull ache between the shoulder blades.

Gently stretching the muscles in the upper back can help ease the pain. People can try rolling the shoulders forward and backward to reduce stiffness. Linking the hands behind the back and gently pulling the arms downward might also help.

Stress

Stress causes muscles in the body to become tense. The neck and shoulders are a common area of tension, which can cause pain between the shoulder blades.

Stress can also cause headaches if the shoulder muscles are tense for a long time.

Addressing the causes of stress, having a good support network, getting enough sleep, and exercising regularly can all reduce stress.

Lifting or carrying

Carrying or lifting something heavy can strain the upper back. People should take care to use safe lifting practices when pushing, pulling, or lifting items.

Carrying a shoulder bag puts weight on the shoulders, pulling on the muscles between the shoulder blades. Holding heavy shopping bags can also strain the arms and the muscles in the upper back.

People can avoid carrying too much weight on the shoulders by choosing backpacks with two straps to spread weight evenly and only carrying essential items. If necessary, a person can make more than one trip to avoid carrying several heavy bags at once.

Muscle injury

Injury to muscles in the upper back can cause pain between the shoulder blades.

Injuries might occur as a result of exercising, lifting something heavy, or falling. A tear can cause severe pain.

The rotator cuff muscles attach the arm to the shoulder blade. Injuring one or more of these muscles can cause pain in the upper back and shoulder. Such injuries can also cause difficulty in moving the arm or shoulder.

Treatment for mild or moderate muscle tears includes resting, applying an ice pack, and doing strengthening exercises. In some cases, a doctor may prescribe steroid injections to reduce swelling.

For about 20% of rotator cuff injuries, surgery is necessary to reattach a tendon.

Scoliosis

Scoliosis is a condition in which the spine has a sideways curve. A person’s shoulders or hips may look slightly uneven, or one shoulder might stick out.

Scoliosis does not always cause symptoms, but some people with this condition may experience back pain. Exercise will help strengthen muscles in the upper back and shoulders, which can reduce muscle strain and pain.

Myofascial pain syndrome

Myofascial pain syndrome is a long-term health condition that causes pain in specific muscle groups. Unlike with other chronic pain conditions, pain does not occur throughout the body.

A trigger point in a muscle will cause pain in the area. In the upper back, it may cause pain across the group of muscles around the spine, neck, and shoulders.

Treatment can include laser therapy, steroid injections, lifestyle changes, and massage.

Osteoarthritis

Gradual wear and tear of the joints over time can cause osteoarthritis. The symptoms include stiffness, pain, and swelling, which can cause difficulty in moving the joints.

Injuring or overusing the joints can increase the risk of osteoarthritis.

Some people have a job that requires frequent reaching overhead or heavy lifting. This work can lead to osteoarthritis in the shoulder joints and upper back pain later in life.