Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 28 September 2026.

Individuals experience neck, shoulder, and low-back pain in their lifetime, with various factors predisposing them to and aggravating this condition. Factors that can significantly affect the severity of pain include an increase in age, higher BMI, and gender.

In this article, we will explore the various causes of pain between the shoulder blades, along with the accompanying symptoms and treatment options.

How Does Pain Between Shoulder Blades Feel Like?

Pain between the shoulder blades (or interscapular pain) can vary in intensity and sensation. For some individuals, it may feel like a dull, constant ache, while for others, it may be a stabbing, sharp pain. The discomfort can also radiate to the neck, arms, or chest, making it difficult to pinpoint the exact location of the pain.

In some cases, the pain may worsen with movement or certain positions, such as sitting for extended periods or hunching over a desk. It’s important to note that the severity and character of the pain can differ from person to person, so it’s essential to pay attention to your own unique symptoms.

It’s worth mentioning that shoulder blade pain can also be accompanied by other sensations, such as stiffness, tightness, or a burning sensation. Some individuals may experience difficulty in moving their necks or shoulders, which can further contribute to their discomfort.

Understanding how the pain feels and any additional sensations you may be experiencing can provide valuable information for diagnosing the underlying cause.

Other Symptoms Accompanying Upper Back Pain Between the Shoulder Blades

In addition to the pain itself, there are several other symptoms that may accompany upper back pain between the shoulder blades. These symptoms can provide clues about the underlying cause and help healthcare professionals determine the most appropriate course of treatment. Some common accompanying symptoms include:

Muscle spasms: You may notice involuntary contractions or tightening of the shoulder muscles, which can worsen the pain and restrict movement.
Headaches: Pain between the shoulder blades can sometimes trigger headaches, especially if the underlying cause involves tension or poor posture.
Numbness or tingling: If the pain radiates down your arm or causes numbness or tingling sensations, it could indicate nerve compression or irritation.
Limited range of motion: You may find it challenging to move your neck, shoulders, or arms freely due to the discomfort and stiffness between your shoulder blades.
Fatigue: Chronic pain can take a toll on your overall energy levels, leading to feelings of fatigue and exhaustion.

It’s important to keep track of any additional symptoms you experience along with the pain between your shoulder blades, as they can aid in diagnosing the underlying cause and guiding your treatment plan.

Possible Causes of Interscapular Pain

There are several potential causes of pain between the shoulder blades. These causes can be broadly categorised into musculoskeletal causes, referred pain from other medical conditions, and causes signalling the need for immediate medical attention.

Musculoskeletal Causes

Pain between the shoulder blades can be caused by various musculoskeletal issues. Here are some common musculoskeletal causes of this type of pain:

Muscle Strain

One of the most common causes of shoulder blade pain is shoulder muscle strain. This can occur due to poor posture, overuse of the muscles, or sudden movements. Activities that involve repetitive motions, such as lifting heavy objects or working at a computer for long periods, can strain the muscles in the upper back and lead to pain.

Injury

An injury to the muscles, ligaments, or tendons in the upper back can also cause pain between the shoulder blades. This can happen as a result of a fall, accident, or sports-related trauma. It is important to seek medical attention if you suspect an injury, as proper diagnosis and treatment are crucial for recovery.

Thoracic Herniated Disc

Herniated discs, also known as slipped discs or ruptured discs, can cause pain between the shoulder blades if they occur in the thoracic spine. The discs act as cushions between the vertebrae in the spine, and when they become damaged or displaced, they can press on nerves and cause pain. Herniated discs can occur due to age-related degeneration, injury, or improper lifting techniques.

Pinched Nerve

A pinched nerve in the thoracic spine (upper back) can cause radiating pain that manifests between the shoulder blades. This could occur due to conditions such as a herniated disc, spinal stenosis, or muscle tightness, which can exert pressure on the nerves in the thoracic region, leading to pain and discomfort in the area between the shoulder blades.

Scoliosis

Scoliosis is a medical condition where the spine deviates laterally from the midline. Instead of a straight line down the middle of the back, a person with scoliosis may have a spine that looks more like an “S” or a “C” shape when viewed from behind.

In some cases, scoliosis can cause pain between the shoulder blades. The curvature of the spine can put pressure on the muscles and nerves in the upper back, leading to discomfort and pain.

Referred Pain from Other Medical Conditions

Pain between the shoulder blades can also be a symptom of other medical conditions that may not be directly related to the back. These conditions include:

Gallbladder disease: Inflammation or stones in the gallbladder can cause referred pain to the upper back.
Acid reflux: Acid reflux is a condition in which the stomach acid flows back up into the oesophagus. The resulting irritation of the oesophagus can cause referred pain between the shoulder blades.
Peptic ulcer disease: Stomach ulcers can cause pain that radiates to the back.
Pancreatitis: Inflammation of the pancreas can cause upper back pain.
Lung conditions: Certain lung conditions, such as pneumonia or a collapsed lung, can cause referred pain to the upper back.

If you suspect that your upper back pain is related to a medical condition other than a musculoskeletal issue, it is important to consult a healthcare professional for a proper diagnosis.

Causes Signalling the Need for Immediate Medical Attention

While most cases of pain between the shoulder blades are not life-threatening, there are some causes that require immediate medical attention. These causes include:

Heart Attack

A heart attack, also known as a myocardial infarction, occurs when the blood flow to a part of the heart is blocked, leading to damage or death of the heart muscle. Severe pain between the shoulder blades can occur during a heart attack due to the referral of pain from the heart to the back.

This happens because the nerves that supply the heart also supply the upper back, so when the heart is in distress, the brain can interpret the pain signals as originating from between the shoulder blades.

Other accompanying symptoms may include chest pain, shortness of breath, nausea, and lightheadedness. If you experience these symptoms, call emergency services immediately.

Thoracic Aorta Rupture

Thoracic aortic rupture, also known as aortic dissection, is a serious condition where there is a tear in the inner layer of the aorta, the main artery carrying blood from the heart. This tear allows blood to flow between the layers of the aortic wall, making it a potentially life-threatening condition.

The pain between the shoulder blades can occur as a result of the dissection affecting the descending aorta, leading to the sensation of severe, sharp, and tearing pain that radiates to the back, including between the shoulder blades. This pain is often described as sudden and excruciating, and it requires immediate medical attention.

Cancer

In rare cases, pain between the shoulder blades can be a symptom of certain types of cancer, such as lung cancer or oesophagal cancer. If you have a history of cancer or are experiencing other concerning symptoms, it is crucial to seek medical attention for further evaluation.

Diagnosing the Pain Between the Shoulder Blades

To diagnose the cause of pain between the shoulder blades, a healthcare professional will typically ask for your medical history, perform a thorough physical examination, and may order additional tests. These tests may include:

X-rays: X-rays can help identify any abnormalities in the bones or joints of the upper back.
MRI or CT scan: These imaging tests provide more detailed images of the structures in the upper back, such as the discs, muscles, and nerves.
Blood tests: Blood tests can help identify any underlying medical conditions that may be causing the pain.
Electromyography (EMG): EMG measures the electrical activity of the muscles and can help determine if there is any nerve damage or muscle weakness.

A proper diagnosis is essential for determining the most appropriate treatment plan for your specific condition.

Pain Management Tips for the Pain Between the Shoulder Blades

Once the underlying cause of your pain between the shoulder blades has been identified, your healthcare provider will recommend suitable treatment options. The treatment plan will depend on the specific cause, severity of your symptoms, and your overall health. Here are some common treatment options that may be suggested:

Over-the-Counter Medication

Pain relief and anti-inflammatory medication are a decision for your doctor or pharmacist. These medications can help reduce pain by blocking pain signals or reducing inflammation, providing temporary relief.

Hot or Cold Therapy

Applying heat or cold to the affected area can help alleviate pain and reduce muscle tension. You can use a heating pad, warm towel, or hot water bottle for heat therapy or an ice pack or cold compress for cold therapy. It’s important to follow the recommended time and temperature guidelines to avoid any skin damage.

Massage Therapy

Massaging the muscles between your shoulder blades can help relax tense muscles and improve blood circulation, reducing pain and stiffness. Consider seeking the services of a licensed massage therapist who specializes in treating upper back pain.

Physiotherapy

Shoulder pain physiotherapy can be beneficial in relieving pain between the shoulder blades through various methods tailored to the specific cause of the pain.

For example, physiotherapists from Phoenix Rehab can assess and correct poor posture, which is a common contributor to upper back pain. They can provide exercises and guidance to improve posture and reduce strain on the muscles between the shoulder blades.

Various physiotherapy modalities such as heat, ice, ultrasound, or electrical stimulation may also be used to reduce pain and inflammation in the affected area.

When to See a Doctor

While many cases of pain between the shoulder blades can be managed with self-care measures, there are situations where it is essential to seek medical attention promptly. You should consult a healthcare professional if you’re experiencing the following:

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Amazing experience with Phoenix Rehab, was assisted by Mavis. She’s very kind and professional and did thorough check on my wrist. I feel very comfortable during the process.

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Sudden and Severe Pain: If the pain is sudden, severe, and unexplained, it’s important to seek medical attention promptly.
Pain Accompanied by Chest Discomfort: If the pain between the shoulder blades is accompanied by chest pain, pressure, or tightness, especially if it radiates to the arms, neck, jaw, or back, it could be a sign of a heart-related issue and requires immediate medical evaluation.
Shortness of Breath: Difficulty breathing or shortness of breath, along with pain between the shoulder blades, should prompt a visit to a doctor.
Symptoms of Heart Attack: Symptoms such as nausea, lightheadedness, profuse sweating, and palpitations alongside pain between the shoulder blades warrant urgent medical assessment.
History of Heart Disease: Individuals with a history of heart disease or risk factors such as high blood pressure, diabetes, or smoking should promptly seek medical attention if experiencing pain between the shoulder blades.
Persistent Pain: If the pain persists or worsens over time despite rest or over-the-counter medication, it’s advisable to consult a healthcare professional for an evaluation.
Pain Following an Injury: If the pain between the shoulder blades follows an injury or trauma, it’s important to have it assessed by a healthcare provider to rule out any serious underlying issues.

Remember, it is always better to err on the side of caution and consult a healthcare provider to rule out any serious underlying conditions.

Final Words

Experiencing pain between the shoulder blades can be both uncomfortable and concerning. By understanding how it feels, recognizing accompanying symptoms, exploring possible causes, seeking appropriate diagnosis, and following the recommended treatment options, you can effectively manage this condition.

Remember to maintain good posture, take regular breaks during extended periods of sitting, and engage in exercises that strengthen the muscles in your upper back. By taking proactive steps, you can find relief and improve your overall well-being.

A burning spot between the spine and one shoulder blade is often called rhomboid pain. An ache at the top inner corner of the blade, up into the neck, is usually levator scapulae pain.

Where are you with this right now?

1. It is settling on its own

Many shoulder problems settle over weeks to months. Night pain that slowly becomes less frequent, and reach that slowly returns, are the usual pattern. If you are reaching higher this month than last, and sleeping better, it is on the normal course. You do not need us for this, and we would rather say so.

2. It has stopped improving

You put your shirt on that arm first. The top shelf belongs to someone else now. You have stopped reaching behind you without thinking.

Reach comes back before strength does. A shoulder that goes overhead but cannot hold anything there is halfway, not finished. That is the gap worth measuring, and it is not measured by how you feel on the day.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.

3. You have had surgery, or you have a date

Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the Rotator Cuff Repair Recovery Program, or shoulder physiotherapy if you are not sure which applies to you.

All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.

Next step

Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.

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