Shoulder blade pain can happen for many reasons, ranging from simple strains to serious conditions, such as a heart attack or liver problems.

Determining the cause of shoulder blade pain can be difficult. People experiencing shoulder blade pain need to know the possible reasons behind the pain and what precautions to take.

Possible causes include sleeping in an uncomfortable or unusual position, a strain from lifting a heavy object, or a physical trauma from a hit, a fall, or an accident.

In this article, we discuss various causes of pain around the shoulder blades, as well as the treatment options and preventive measures available.

The upper back and shoulders of a man lying face down on a bedShare on Pinterest
Dina Marie Giangregorio/Stocksy

The shoulder blades are the triangular bones on the back of the shoulders, which health experts also refer to as the scapulae. The scapulae attach to the top of the arm at the shoulder joint and the clavicle, at the acromioclavicular joint.

A complex series of muscles, tendons, and ligaments surround the scapulae and these joints. Damage in any part of these muscular and skeletal systems can result in pain.

Some conditions can cause referred pain, which occurs in the shoulder blades but is due to an issue in another part of the body.

There are several potential bone or joint issues that can cause shoulder blade pain.

As the shoulder blade is a bone, a person can experience a fracture. This can result from a fall, an accident, or a similar direct injury to the shoulder blade.

Moreover, as a person ages, degenerative conditions may cause shoulder blade pain. Some of these conditions include:

More specifically, a type of arthritis called ankylosing spondylitis is most common among people aged 20–40 years. It is a form of arthritis that primarily affects the spine, but it can cause pain and inflammation in surrounding areas.

Certain cancers may also cause pain in the shoulders and shoulder blades. The most common types of cancer that may cause shoulder blade pain include lung cancer, breast cancer, and colon cancer.

It is common for an individual to experience a muscular issue that causes shoulder blade pain. Muscles and tendons in the rotator cuff, across the scapula, up into the neck, and down into the arm are common pain sites.

A person may damage these tissues due to:

Weak muscles in the shoulder can increase a person’s risk of injury and shoulder blade pain.

Pain throughout the shoulder and shoulder blade can be a sign of heart complications, including:

Shoulder pain as a symptom of a heart attack is more common in women than in men. However, anyone experiencing shoulder pain and other heart attack symptoms, such as shortness of breath, should seek immediate medical attention.

Learn more about heart attack symptoms here.

Certain lung conditions may also cause referred pain in the shoulder blades. Some examples of lung conditions include:

Other causes of direct or referred shoulder blade pain include:

A doctor will need to examine a person to determine what is causing the shoulder blade pain. A typical diagnosis starts with an interview in which the doctor will try to work out whether there is any simple reason for the pain.

Once the doctor has ruled out simple causes, they may perform various assessments, including:

  • heart tests, such as an EKG or a stress test
  • endoscopy to test for any abdominal abnormalities
  • blood work that tests for liver function
  • MRI or CAT scans to check for abnormalities in the lungs and wider chest area

Treatment depends largely on the exact cause and severity of a person’s shoulder blade pain.

Rest

For simple cases of overuse, strain, or sleeping badly, a person may be able to treat their shoulder blade pain with rest.

Learn about the RICE method here.

Exercise and stretching

Stretching and light exercise can often help a person remedy shoulder pain.

A 2020 review found that exercise therapy can be as effective at treating shoulder pain as corticosteroid injections and surgical interventions.

Here, discover 10 of the best shoulder exercises to reduce tightness.

Medication

A person may require medication to manage their shoulder blade pain.

Depending on the cause of the pain, a doctor may recommend several over-the-counter and prescription drugs, including:

  • pain relief medication, such as ibuprofen
  • corticosteroid medications, injections, or ointments
  • muscle relaxers

Surgery

Most people do not require surgery to treat shoulder blade pain. However, in cases of severe damage or injury, surgery may be necessary. These instances include:

  • severe shoulder blade fractures
  • severe arthritis
  • rotator cuff tears
  • severe tendon or ligament damage

Surgeons may perform open surgery on a person’s shoulder and shoulder blade or seek to repair the damage through shoulder arthroscopy. This procedure involves using insertable cameras and small instruments.

Shoulder replacement surgery is also an option.

Other treatments

When shoulder blade pain is due to an underlying condition, treatment aims at addressing that condition.

For example, cancer may require radiation, chemotherapy, or other therapies. Heart conditions may need medications that target heart issues.

Recovery time

Performing shoulder exercises for 6–8 weeks can help a person recover from shoulder blade pain.

In many cases, an individual can trace shoulder blade pain back to a seemingly harmless incident, such as a recent fall or an occasion when they lifted too much weight. It may be less evident to a person who slept badly, but warning signs include sleeping on one side too long or having recently switched mattresses.

People who cannot explain pain in their shoulder blade should contact a doctor, as it may be an indicator of a serious underlying issue. For example, pain in the left shoulder may be a sign of a heart attack.

A person may also wish to seek guidance from a doctor in the case of a strain, as the doctor may be able to recommend additional treatment.

Symptoms that signal a need for immediate attention include:

Preventable shoulder blade pain typically results from trauma and overuse. Preventive steps to take may include:

  • avoiding potential falling risks
  • wearing a seatbelt in a car
  • easing into any new workout routine
  • changing sleeping positions

Other means of prevention include:

For simple cases of shoulder blade pain, an individual will likely experience a full recovery with minimal medical intervention. In most of these situations, it will probably only take a few days to a few weeks for a person to experience complete symptom relief.

Where the pain is due to an underlying cause, the length of treatment and recovery time will vary greatly.

It is important to know the cause of the shoulder blade pain so that a doctor can create an effective treatment plan to address the underlying issues.

Read the article in Spanish.