Shoulder Blade Pain: Your Guide to Pain Relief

Pain in the shoulder blade area is a common phenomenon. We guide you through the common causes, pain relief techniques and ways to prevent shoulder pain.

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Krista Bugden Human Kinetics & Rehab Exercise Expert
Medically reviewed by 

The area around or under your shoulder blade is achy. It’s sore. It may even get worse when you perform certain activities, such as turning your head or reaching for an object with your arm. Pain, in general, poses an irritating problem.

Yet, shoulder blade pain doesn’t have to take over your life. There are various treatments and methods that can ease your pain. However, your specific way to pain relief may depend on what is causing your discomfort or injury in the first place.

To help you find a solution that works for you, this article describes the most common causes of shoulder blade pain and how to relieve the pain.

Looking for a solution to your shoulder pain problem? Try the Injurymap exercise app now.


Common Causes of Shoulder Blade Pain

  1. Muscle Knots
  2. Muscle Injury
  3. Neck Condition
  4. Shoulder Condition
  5. Spinal Condition
  6. Shoulder Blade Fracture
  7. Nerve Inflammation
  8. Heart or Lung Conditions
  9. Widespread Pain (Fibromyalgia)

Managing Shoulder Blade Pain

Common Causes of Pain Under the Shoulder Blade

There are many reasons you might be experiencing a nagging ache or soreness under the shoulder blades. It may hurt due to inflammation from injury or overuse. This is often noticeable at onset or gradually after you have been active. It may feel painful due to radiating pain from another body part or structure, such as from the neck, spine, or shoulder. Here are some of the most common causes.

1. You Have a Muscle Knot or a Tense Muscle

The most frequent reason for shoulder blade pain is a tense muscle or a muscle knot. The area around the muscle will feel tender to touch or tight. A way of thinking about it is imagining you pull on a loose thread in a sweater. This will create a hard knot in the fabric.

Why do the muscles become tense? It can come from doing too much, too soon, which is often the case in sports or exercise. For example, repetitive throwing may result in a muscle knot or tender spot under the shoulder blade. They may also develop as the result of pain in the neck and the shoulder.

Common areas where muscle knots may occur.

These knots limit your functionality and impact your day-to-day life. You may find it hard to reach for an object on a high shelf or have difficulties twisting your torso.

Luckily, muscle knots are often easily treated with a massage technique known as myofascial release. Myofascial release is where moderate pressure is applied to the spot to release the “stuck” tissues. A popular example of this technique is foam rolling (see How Can You Reduce Your Shoulder Blade Pain?).

2. You’ve Injured a Muscle

A frequent and common reason for shoulder blade pain is a muscle strain, also known as a pulled muscle. This may result from overuse or stress on the arms or upper back.

A muscle may also become strained if you’ve slept in a new bed, a new position, or even recently started a new exercise program. Bad posture may also play a part. When you slouch forward, it places stress on the muscles in the back. As a result, you may feel pain under your shoulder blade.

3. You Have a Condition Affecting Your Neck

Arthritis of the neck may result in local neck pain, as well as shoulder blade pain due to tense muscles. Spinal stenosis, a narrowing of the spinal cord, a pinched nerve in the neck spine, due to a slipped disc, or arthritis, and problems with the discs in between the bones of the spine may also cause radiating pain in the shoulder blades.

4. You Have a Condition Affecting Your Shoulder

A rotator cuff tear or a frozen shoulder may lead to pain around the shoulder blade. If you’ve recently experienced a shoulder injury, it may also be causing your shoulder blade pain.

A rotator cuff injury.

5. You Have a Condition Affecting Your Thoracic Spine

The thoracic spine is the part of the spine that sits between the shoulder blades (see the illustration below). Arthritis in the thoracic spine may cause pain around your shoulder blades, either because of radiating pain, or tense muscles.

In these cases, and many others, exercise, including stretching and strengthening, may help alleviate your pain and provide adequate support to the areas of the body that need it.

The thoracic spine

6. You’ve Fractured Your Shoulder Blade

A fractured shoulder blade is usually obvious. You’ll experience severe pain at the onset of the injury. It is often caused by a direct blow or trauma, such as a car accident. When this happens, it’s critical to seek out immediate medical attention. Avoid using the affected side. A sling may help until you can get the treatment you need.

Shoulder blade fracture (scapula fracture)

One condition that increases the risk of shoulder blade fractures is osteoporosis. This is when the body loses bone tissue, resulting in lower bone density. This makes the bones brittle and easy to break or injure. However, if you have osteoporosis, strength training goes a long way when it comes to strengthening the body and its joints.

7. A Nerve in the Shoulder Blade Region has Become Inflamed

Such inflammation may result from carrying a heavy load on your shoulder, for example, a heavy backpack, or from infections. It can lead to widespread pain around the shoulder blade, as well as impaired muscle function. This can create a condition where the shoulder blade is sticking out from the back, instead of being pulled close to the chest.

8. You Have a Specific Heart or Lung Condition

If your left shoulder blade is hurting, it could be a sign of certain heart conditions, such as pericarditis or aortic dissection. Lung cancer may further manifest as shoulder blade pain. If you have any other symptoms, such as shortness of breath, dizziness, or chest pain, seek emergency medical attention. These are not symptoms you want to ignore. Such conditions could lead to a life-threatening situation. Go to the nearest emergency room.

9. You Have Widespread Pain (Fibromyalgia)

If it isn’t a new pain and the pain comes and goes, you may have a more chronic condition, such as fibromyalgia, which is a common condition affecting 3-6% of people. It is categorized by widespread pain and fatigue. It may pose similar symptoms to that of a muscle strain. If you suspect you may have fibromyalgia, book a consultation with your doctor.

How Can You Reduce Your Shoulder Blade Pain?

For most forms of shoulder blade pain, you can use the following guidelines to help relieve your pain and get back to your regular activities.

1. Exercise

It should be noted that in most conditions, exercise is the treatment of choice, for alleviating your pain. Exercise builds strength to help support the injured area. Stretch exercises help relieve tension in the muscles. However, exercise should not be continued if pain worsens. Err on the side of caution. Go slow. The preventative exercises in the following section offer examples of exercises you may try to bounce back after shoulder pain.

Don’t know where to start? Injurymap’s app gives you the right exercises at the right time. Try the app for a speedy recovery.

2. Slow down

Does your pain get much worse when you perform certain movements or activities? It’s likely a good idea to give yourself a break. Avoid the activities causing pain for 24 - 48 hours. Give your body time to heal and rest - especially if the pain may be the result of overuse.

Surprisingly, your body is fairly capable when it comes to healing itself. It may just need the time to do so. For instance, if the pain has occurred after a particularly intense workout, your body may need time to adapt. Likely, micro-tears have occurred in the muscle tissue.

The body will heal tears, as well as adapt the muscle tissue to withstand similar future loads. After a couple of days, try to ease back into your regular activities, but reduce the weight and pressure on the muscles, and the length of your activity. If the pain continues, it may be a good idea to seek out some professional advice, such as that of a sports medicine specialist or a rheumatologist.

3. Try out cold or heat therapy

Ice is a quick way to relieve pain. Wrap the ice or cooling device in a wet cloth before applying it to your skin. Apply the cold device for 15-20 minutes. Leave about 45 minutes between applications. Ice or cold reduces blood flow to the affected area. By doing so, inflammation and swelling may be reduced. As a result, you feel less pain.

Some individuals prefer heat over cold. Go with what feels best for you, or alternate between them. Heat, in particular, may offer relief, if your muscles feel tense. Heat promotes blood flow in the applied area and also causes the local muscles to relax.

4. Take over-the-counter pain relievers

Over-the-counter pain relievers are a quick route to reduce inflammation and pain. Aspirin, ibuprofen, naproxen (in the US), and paracetamol (acetaminophen in the US) are all viable options.

Make sure not to use these medications for longer than 10-14 days. Long-term use is associated with gastrointestinal issues and other adverse effects. Most of these medications are intended for short-term use.

If your pain or condition doesn’t improve in due time, get it checked out by your doctor or a physical therapist. Further, if you’re continuing heavy exercising during this time, be careful! It may dull your perception of your pain since exercise stimulates your body’s natural pain relievers.

5. Give yourself a massage

Or better yet, book a massage. If this isn’t an option, there are easy home remedies you can try. A foam roller or massage ball is your best bet. Roll the foam roller or ball under your shoulder blade until you find a tender spot. Once you find the spot, slowly roll side-to-side, up-and-down, or in a circular pattern. Do this for a minute or more. It should feel like a good pain - as if you’re releasing something. Feel free to use this method once or even twice a day.

6. Acupuncture May Help

Acupuncture has been used for centuries. It works by inducing a reflex that makes muscles relax. This release of tension may lead to pain relief. Some people are very responsive to this technique.

7. Do none of these work for you? It’s time to consult with the pros.

If none of these offer pain relief, book an appointment with your doctor or physical therapist. They will assess your condition, diagnose it and guide you through a treatment plan unique to you and your situation.

Preventing Shoulder Blade Pain

After you’ve found an efficient way to relieve your pain, the next step is prevention. How can you prevent this pain from happening again? The main route to prevention is exercise. Strengthening and stretching the vulnerable area or the previously injured area will help you avoid pain down the road. Make sure you slowly ease into exercise.

Exercise regularly, and keep in mind, that the key to long term relief, is to keep training, which you often will have to do for many months. Strengthening exercises ought to be done two to three times a week, with one – two days pause. Stretching exercises can be done daily.

Start with once every two days. In a week or so, bump it up to twice every two days. In about 4-6 weeks, try doing these exercises 2-3 times a day every other day. The following exercises you can find in Injurymap. The app takes the guesswork out of exercising. It helps you ease into it and guides you through every step.

Exercises for Shoulder Blade Pain?

So, what exercises should you be doing? We outline the best ones to start with below. Make sure you go slow. If any pain occurs, back off and adjust. Try again and if it happens again, avoid the pain-causing exercise for now.

  1. Trapezius stretch
    30 sec.

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    The trapezius muscle makes up the upper back and shoulders. It’s a common area for individuals to experience tightness, especially if the cause is posture-related. By stretching out this muscle, you can also relieve tension or pain under the shoulder blades.

    • Sit on a chair with your back straight.
    • Place one hand over your head on the back of your neck so that your forehead is resting on your forearm.
    • You should use the other hand to fixate your shoulder by holding onto the edge of the chair.
    • Turn your head towards the same side as the raised arm.
    • Pull the head diagonally forward to the side and feel it stretching down towards the shoulder blade.
    • It should not hurt in the direction that you bend your head.
    • Hold the stretch for 30 seconds and then repeat the stretch with your head bent to the opposite side.
  2. Posterior shoulder capsule stretch
    30 sec. x 3 sets

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    This exercise will help stretch out any tightness in the muscles in the back of the shoulder. If any of these muscles are tight, they may cause radiating pain or problems under the shoulder blade.

    • Stand up.
    • Grasp your elbow with the opposite arm's hand and pull your arm over to the opposite side.
    • Hold the stretch for 30 seconds and perform 3 repetitions with each arm.
  3. Pectoral stretch
    30 sec. x 3 sets

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    Interestingly, pain under the shoulder blades may arise from a tight chest causing bad posture. The pectoral stretch counteracts this by stretching out the chest muscles, preventing them from becoming tight. This further prevents shoulder and upper back issues.

    • Stand by the edge of a wall.
    • Lift your arm up until it is in an approx.
    • 60 degree angle.
    • Rest the elbow against the wall and lean forward until you feel it stretching in the breast muscle.
    • Perform three repetitions with each arm for a duration of 30 seconds with a short break between each repetition.
  4. Shoulder pull
    5 reps

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    The shoulder pull builds strength in the upper and mid-back. If these muscles are weak, overuse or repetitive movements may contribute to a muscle knot or a pulled muscle. The shoulder pull increases the strength of these weak muscles, as well as corrects bad posture associated with many shoulder injuries.

    • Relax your shoulders by letting them fall down.
    • Retract your shoulders so that your shoulder blades are brought together.
    • Hold the position for 10 seconds and then return to the starting position.
    • Perform 5 repetitions.
  5. "Pistol" exercise
    10 sec. x 5 sets

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    This pistol exercise is similar to the shoulder pull. It also works to strengthen the weak postural muscles in the upper back. By correcting your bad posture and strengthening these often weak muscles, you can significantly reduce your chances of re-injury.

    • Relax your shoulders by letting them fall down.
    • Retract your shoulders so that your shoulder blades are brought together.
    • Bend your elbows and raise your arms approx.
    • 45 degrees.
    • Perform 5 repetitions.

Other exercises that may help improve your posture and reduce shoulder blade pain include yoga or pilates. These types of exercise routines focus on posture and core work to help realign the body. In fact, many rehabilitation programs for the shoulder and back involve yoga or pilates poses. The Injurymap appoffers both stretching, range of motion, and strengthening exercises.That way, you know you’re giving your body exactly what it needs.

Start Living Your Life - Free of Pain!

Find what works best for you and your shoulder blade pain. And remember, what works best for someone else may work differently for you. Everybody is different. Use the above advice to determine what could be causing the pain under your shoulder blade, as well as a guide to determine what the next step for you and your pain should be.

Prehab is just as important as rehab. If you’ve experienced shoulder blade pain in the past, make sure you get those exercises and methods down pat to prevent pain in your future.

If you’re still unsure when it comes to preventing future shoulder blade pain incidences, check out Injurymap app. Injurymap app provides personalized training and rehabilitation plans, so that you can get back to your normal. Track your progress. Find out what exercises are suited for you and your condition. Then, get back to your life - without pain standing in your way.

Treat your pain with Injurymap

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About the author

Krista Bugden has worked as a Rehab Exercise Expert at a physiotherapist clinic in Ottawa, Canada for the past 4 years. She has an Honours Bachelor Degree in Human Kinetics from the University of Ottawa. She uses her extensive knowledge in this area to educate others through well-researched and informative articles. Her passions include helping others and inspiring each person she meets to get the most out of their life.