What is shoulder blade pain?
Shoulder blade pain is pain in the scapular area of the upper back. The scapula (shoulder blade) is one of three bones that make up the shoulder joint. It is a large triangular bone that sits in the upper back. It forms the socket for the ball of the humerus (upper arm bone) to make the ball-and-socket portion of the shoulder joint. It also forms a joint with the clavicle (collarbone) at the top of the shoulder.
There are also muscles, tendons, ligaments and other soft tissues in the shoulder. Ligaments connect the shoulder blade to the other shoulder bones. Tendons connect muscles to the shoulder blade. Shoulder blade pain can occur when problems develop in the bone itself or any of these components. Shoulder blade pain can also include problems with nerves. The pain can feel different depending on the cause. It may be dull and achy, sharp, severe or burning. The pain may also get worse or feel better with movement.
See your doctor if you have shoulder pain or other problems that persist or worsen with time. Seek immediate medical care if you have an injury or trauma that affects the shoulder.
In some cases, shoulder blade pain is referred pain. This means you feel pain in one area, but the cause is in another area. Usually, referred shoulder pain doesn’t change when you move your shoulder. Some of the causes of referred shoulder blade pain are serious and even life threatening, such as heart attack and lung disease. Seek immediate medical care (call 911) if you have shoulder blade pain with other potentially serious symptoms including:
- Chest pain, pressure or squeezing
- Pain that radiates down the arm or up to the neck and jaw
- Rapid heart rate or heart palpitations
What other symptoms might occur with shoulder blade pain?
Depending on the underlying cause, shoulder blade pain can occur with other symptoms.
Musculoskeletal-related symptoms that may occur along with shoulder blade pain
The shoulder blade is part of the musculoskeletal system—the system that consists of bones, cartilage, muscles, tendons, ligaments, and other soft tissues. Shoulder blade pain can accompany other symptoms related to the musculoskeletal system including:
- Clicking, crunching, grinding, popping or snapping sensation in the shoulder
- Looseness or instability in the joint
- Pain, swelling or stiffness in other joints, including the spinal joints
- Shoulder drooping or tilting forward
- Stiffness and limited range of motion, which may prevent overhead movements
- Weakness or numbness in the arm
- Winging of the scapula, meaning the shoulder blade sticks out in the back
Other symptoms that may occur along with shoulder blade pain
When shoulder blade pain is referred pain due to problems outside the shoulder itself, other symptoms can occur along with it. These symptoms may be the result of conditions in the chest or abdomen and include:
- Cough, hoarseness, increased effort to breathe, or wheezing
- Heartburn, bloating, mild nausea, abdominal pain, and changes in bowel habits
- Pain that gets worse when lying down
Symptoms that might indicate a life-threatening or serious condition
In some cases, shoulder blade pain may occur with other symptoms that might indicate a serious or life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have shoulder blade pain with any of these potentially serious symptoms including:
- Chest pain or pain that radiates down the arm or up to the neck and jaw
- Coughing up blood or pain that gets worse with deep breaths
- Heart palpitations, racing heart, or chest discomfort, tightness or pressure
- Severe abdominal pain or severe or persistent nausea and vomiting
- Shortness of breath, rapid breathing, or difficulty breathing
- Vomiting blood or material that looks like coffee grounds
- Yellowing of the skin or eyes
What causes shoulder blade pain?
Musculoskeletal causes of shoulder blade pain
Shoulder blade pain may arise from problems in the shoulder and musculoskeletal system including:
- Arthritis, including osteoarthritis and rheumatoid arthritis
- Dislocated or fractured shoulder
- Nerve damage
- Rotator cuff tear or labrum tear
- Spine problems, such as scoliosis, spinal stenosis, compression fractures, and herniated disc
- Sprains, strains and other soft tissue injuries
Other causes of shoulder blade pain
Shoulder blade pain can also be caused by referred pain due to problems in chest and abdomen including:
- Abdominal problems, including gallbladder disease, liver disease, pancreatitis, peptic ulcer disease, and blood, fluid or gas in the abdominal cavity, such as following laparoscopic surgery
- Heart and vessel problems, including heart attack, pericarditis (inflammation of the sac surrounding the heart), and aortic aneurysm
- Lung problems, including lung cancer, collapsed lung, pneumonia, and PE (pulmonary embolism)
Serious or life-threatening causes of shoulder blade pain
Most musculoskeletal causes of shoulder blade pain aren’t medical emergencies. Of course, shoulder injuries and trauma involving the shoulder require immediate attention. With conditions that cause referred shoulder blade pain, it may be a symptom of a serious or life-threatening condition that requires emergency medical treatment. These include:
- Heart attack
- PE
How is shoulder blade pain treated?
Shoulder blade pain treatment options depend entirely on the underlying condition. For musculoskeletal conditions, treatment usually starts with nonsurgical approaches. This includes rest, anti-inflammatory medicines, and exercises to strengthen, stabilize, and improve range of motion in the shoulder. Your doctor may recommend physical therapy if necessary. In some cases, surgery is the best solution to shoulder blade pain due to musculoskeletal problems.
For conditions that cause referred shoulder blade pain, doctors will need to treat the underlying condition. Treatment varies with the cause and may require emergency medical care in some cases.
What are the potential complications of shoulder blade pain?
Like treatment, shoulder blade pain complications depend on the underlying cause. With musculoskeletal causes, most cases of shoulder blade pain resolve with proper treatment. However, potential complications may include continued pain and limited shoulder function. With referred shoulder blade pain, complications can be serious and even fatal, depending on the cause. Talk with your doctor to understand your risk of complications and how to prevent or treat them.
