Upper Back Pain Between the Shoulder Blades

Pain between the shoulder blades, called interscapular pain, is most often a strained upper back muscle from posture, lifting or sports. Less often it comes from a herniated disc, arthritis, an injury, gallbladder disease or a heart attack, so new, sudden or severe pain should be checked right away.

4 min read

Pain between the shoulder blades, or interscapular pain, is a common type of upper back pain. The most common cause of this pain is muscle strain. However, several more serious conditions can also cause pain between the shoulder blades. Traumatic injuries, herniated discs, gallbladder disease, and heart attacks are some of the conditions that can cause upper back pain between the shoulders.

What Causes Muscle Strains?

There are several things that can cause muscle strains in the upper back region. Poor posture such as hunching over a computer or at a desk all day can cause muscles to tense up or provide less support for your spine. These muscle strains can also lead to headaches. [1] Lifting heavy objects can also strain muscles in the upper back causing pain. [1] Always use proper lifting technique. Continuous strain on the back can build up over time and cause pain, even without an acute strain. Other causes of muscles strains can be from sleeping on an unsupportive mattress, or it could be sports related especially with sports that involve a lot of twisting such as tennis or golf.

Treating Pain at Home

There are many at-home treatments you can try to relieve interscapular pain from muscle strains. Stretching can help improve poor posture and relieve tension in muscles from the strain. Heat and cold therapies can help reduce swelling and pain, and over-the-counter pain relievers can also help. If you strained a muscle in your upper back it is important to let it rest to heal. Some strains take several weeks to heal. If the pain does not go away with at-home care, or if it gets worse, talk with your doctor. Treatment may include working with your doctor, a physical therapist, a chiropractor, or other specialists. [1]

Back Pain from Traumatic Injuries

Traumatic injuries from sports or car accidents can cause shoulder injuries such as rotator cuff tears and joint separation. [1] These are more severe than a muscle strain and can cause constant upper back pain or pain that worsens with movement. Any traumatic injury should be evaluated by a healthcare professional to help determine the best course of treatment.

Herniated Discs and Back Pain

Herniated discs and arthritis are two other causes of pain between the shoulders. Herniated discs in the neck or upper back can put pressure on the spine or nerves, causing pain in the neck or between the shoulders. [2] Upper back pain caused by a cervical herniated disc can be positional, where the pain worsens when the neck is extended.

Other symptoms you may experience with a herniated disc include numbness, tingling, or pain that radiates down the arms. [2] Pain experienced from a herniated disc may be a burning or stinging sensation rather than an ache as experienced with muscle strain. [2] Arthritis can cause stiffness in the spine that leads to pain and decreased flexibility. There can also be swelling or tenderness over the affected vertebrae.

Serious Conditions Causing Back Pain

Though less common, a few serious medical conditions can cause upper back pain between the shoulders. Some people, especially women, can experience a persistent, dull pain between their shoulders when having a heart attack. Other symptoms you may experience with a heart attack are chest pain, lightheadedness, or feeling short of breath. [3]

A pulmonary embolism is a blood clot that blocks blood flow to your lungs, and it can have the same symptoms as a heart attack. Some types of cancer may also first present with pain between the shoulders, sometimes with no accompanying symptoms.

Finally, gallbladder disease may cause pain that radiates to the space between the shoulders. This pain is experienced after eating meals containing a lot of fat. If you begin experiencing new, sudden, or severe back pain it is important to seek medical attention to rule out any serious medical problems.

It is estimated that 39% of adults live with back pain. [4] If your pain is not relieved by at-home treatment, is getting worse, or came on suddenly, contact your doctor to find the relief you need.

Sources

El Sayed M, Callahan AL. Mechanical Back Strain. [Updated 2022 Jan 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542314/

David DeWitt, MD. (2009, July 28). Upper back pain from a thoracic herniated disc. Spine-health. Retrieved June 17, 2022, from https://www.spine-health.com/conditions/herniated-disc/upper-back-pain-a-thoracic-herniated-disc

Warning signs of a heart attack. www.heart.org. (2022, April 11). Retrieved June 17, 2022, from https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack

Lucas JW, Connor EM, Bose J. Back, lower limb, and upper limb pain among U.S. adults, 2019.

NCHS Data Brief, no. 415. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:107894.

Frequently asked questions about pain between the shoulder blades.

What is interscapular pain?

Interscapular pain is pain in the upper back between the shoulder blades. It is a common type of upper back pain, and the most common cause is a muscle strain. Less often, it comes from a herniated disc or arthritis in the neck or upper back, an injury, or a problem outside the spine such as gallbladder disease or a heart attack.

What causes pain between the shoulder blades?

The most common cause of pain between the shoulder blades is a strained upper back muscle. Strains often come from poor posture, such as hunching over a desk or computer, from lifting heavy objects, from an unsupportive mattress, or from sports with a lot of twisting, like tennis and golf. Herniated discs, arthritis, injuries, gallbladder disease and heart problems are less common causes.

When should I worry about pain between my shoulder blades?

See a doctor promptly for pain between the shoulder blades that is new, sudden or severe, or that follows an injury such as a car accident. Get emergency care if it comes with chest pain, shortness of breath or lightheadedness, which can be signs of a heart attack or a blood clot in the lungs. Pain that doesn’t improve with home care, or keeps getting worse, should also be checked.

Why do women get pain between the shoulder blades?

Women get pain between the shoulder blades for the same reasons as anyone else, most often a strained upper back muscle. One difference matters: some people, especially women, feel a persistent, dull ache between the shoulders during a heart attack. If that ache comes with chest pain, shortness of breath or lightheadedness, get emergency care.

How do you relieve pain between the shoulder blades?

Pain between the shoulder blades from a muscle strain usually improves with home care: rest, gentle stretching, heat or cold, and over-the-counter pain relievers. Stretching also helps correct the poor posture that often causes it. Some strains take several weeks to heal. If the pain doesn’t improve, or gets worse, see a doctor; treatment may include physical therapy.

What does sharp pain between the shoulder blades mean?

Pain between the shoulder blades that feels sharp, burning or stinging, rather than achy, can point to a herniated disc in the neck or upper back pressing on a nerve; a strained muscle usually aches. A disc may also cause numbness, tingling or pain down the arms, and the pain may get worse when you tilt your head back. Sudden, severe pain or pain after an injury needs prompt medical care.

Can gallbladder problems cause pain between the shoulder blades?

Yes. Gallbladder disease can cause pain that spreads to the area between the shoulder blades, typically after a meal high in fat. Because problems inside the body can feel like back pain, new or unexplained pain between the shoulder blades should be checked by a doctor.