Shoulder blade pain is a very common experience, with causes ranging from simple strains to serious conditions, such as heart attacks or liver problems.

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

In this article, we examine a variety of different causes of pain around the shoulder blades, along with what can be done to treat each problem.

woman with shoulder pain - skeleton showing
There can be various reasons for pain in the shoulder blades.

The shoulder blades are the triangular bones on the back of the shoulders, medically known as the scapulae.

Each shoulder blade connects the upper arm bone to the collarbone and has three groups of muscles attached to it. These muscles help move the shoulder joint.

The shoulder has a wide range of motion. The muscles that connect the shoulder blade allow the shoulder to rotate, move in a circle, move up and down, and side to side.

As the shoulder can move in so many ways, it is easy to injure, which can cause shoulder blade pain.

Unfortunately, shoulder blade pain is not often as simple as injury-related pain. In some cases, shoulder blade pain is caused by pain from a nearby organ in distress.

There are many potential causes of shoulder blade pain. In some cases, a person may be able to figure out what is causing their pain.

A few examples of causes that may be obvious to a person include:

  • trauma from a hit, fall, or accident
  • sleeping in an uncomfortable or odd position
  • strain from lifting a heavy object

Sometimes, however, the cause of the pain may be more difficult to determine.

Some conditions can cause what is called referred pain, which occurs in the shoulder blades but is due to a problem in another part of the body.

Some potential causes of referred pain in the shoulder blades include:

Some causes are more likely to cause pain in one shoulder over the other. For example, a heart attack is more likely to cause pain in the left shoulder blade. Gallbladder disease is more likely to cause pain in the right shoulder blade.

By contrast, a strain may occur in either shoulder blade depending on where the injury occurred.

Causes may fit into several categories. Some of the causes are listed below:

Bone and joint issues

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

As the shoulder blade is a bone, it is possible for a person to experience a fracture. This is an unlikely occurrence in most cases, as it requires a fall, an accident, or a similar direct injury to the shoulder blade.

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. It is a form of arthritis that primarily affects the spine, but it can cause pain and inflammation to surrounding areas.

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

Musculoskeletal causes

It is very common for a person to experience a musculoskeletal issue that causes shoulder blade pain. Overuse, strains, sleeping akwardly, and rotator cuff issues all fall into this category.

These problems are often related to pain in the muscle groups surrounding the shoulders, including some of the arm muscles.

Cardiac causes

One of the more serious causes of shoulder blade pain is heart-related problems. Healthcare professionals note that localized pain in the left shoulder may be a sign of a heart attack, particularly in women.

Women experiencing pain in the shoulder blade that cannot be explained by a musculoskeletal problem should seek immediate medical attention.

Other heart conditions that may cause shoulder blade pain include:

  • a tear in the aorta
  • inflammation of the lining of the heart

Pulmonary causes

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

  • cancer that grows on the top part of the lungs
  • clots that travel from the legs to the lungs
  • collapsed lung

Abdominal causes

There are some conditions that occur in the abdomen that may cause shoulder blade pain. Issues with the abdomen area that may cause shoulder blade pain include:

  • surgery
  • nerve pain
  • peptic ulcer disease
  • pancreatitis
  • liver disease

man stretching arms and shoulders
Stretching may help to ease shoulder blade pain.

Isolated pain in the right or left side of the neck is most commonly the result of muscle strain or injury.

The following activities could contribute to pain in one side of the neck:

  • Bad posture. Poor posture can strain the muscles in and around the neck and may also lead to an uneven spreading of weight, which could cause pain on one particular side.
  • Poor sleeping position. Sleeping in an awkward position can cause neck pain, and this is more likely for people who sleep on their stomach. Using too many pillows or an unsupportive mattress can also lead to problems.
  • Whiplash. Pain from neck sprains are the result of ligament or muscle damage. While whiplash is most commonly associated with being in a vehicle accident, other common causes include doing vigorous sporting activity and riding a rollercoaster.

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

Once the doctor has ruled out simple causes, they may perform some different assessments.

These tests may include:

  • heart tests, such as an electrocardiogram (EKG or ECG) or stress test
  • abdominal tests, such as endoscopy
  • blood work that tests for liver function
  • radiological studies of the chest and back using an MRI or CAT scan

Treatment depends largely on the exact cause of the pain.

For simple cases of overuse, strain, or sleeping poorly, a person may be able to try a range of treatments from home. These may include:

  • rest
  • ice
  • pain relief medications such as ibuprofen
  • medicated rubs and ointments
  • stretching
  • massages

Where there is an underlying disorder, treatment relies on treating the underlying cause. For example, cancer may require radiation, chemotherapy, or other therapies. Heart conditions may need medications that target heart problems.

When a person knows the cause of the shoulder blade pain, treatment is likely to be more effective.

If treatment is not working, however, people must talk to their doctor to see whether their treatment needs changing or adjusting.

woman holding chest
Immediate medical attention should be sought for unexplained pain in the left shoulder blade accompanied by shortness of breath or chest pain.

In many cases, a person 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 for too long or having recently switched mattresses.

People who are unable to explain a pain in their shoulder blade should see their doctor.

Women should be particularly wary of any pain in the left shoulder blade as it could be a sign of a heart attack, and they should seek out immediate attention from a doctor.

A person may also wish to see 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:

  • chest pain
  • shortness of breath
  • rapid or irregular heartbeat
  • sudden difficulty speaking
  • lightheadedness
  • pain, swelling, or redness in the legs
  • coughing up blood
  • fever
  • vision problems
  • paralysis on one side of the body
  • excessive sweating
  • loss of consciousness

Preventable shoulder blade pain is typically associated with trauma and overuse. 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:

  • eating a balanced diet that is rich in nutrients
  • getting moderate exercise
  • stretching

For simple causes, it is very likely a person will 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 so that an effective treatment plan can be created to address the underlying issues.

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