Written by the Phoenix Rehab physiotherapy team.Clinically reviewed by Louise Yow, Principal Physiotherapist and Director, AHPC A1300363H.Last reviewed 2 October 2026.
Rhomboid pain is an ache or burning spot between the spine and the inner edge of the shoulder blade, usually on one side, and it is most often a tired, overworked muscle or a stiff joint in the neck or upper back referring pain there. It builds over hours at a desk or behind the wheel, and feels like a knot you cannot reach.
Left-sided upper back pain that comes with chest pain, breathlessness, sweating, or pain into the arm or jaw is not a rhomboid problem. Nor is a sudden, severe, tearing pain between the shoulder blades. Call 995.
What are the rhomboids?
The rhomboids are two flat muscles, rhomboid major and rhomboid minor, that run from the spine at the base of the neck and top of the upper back to the inner edge of the shoulder blade. They pull the shoulder blades together and help hold them steady against the ribs when you use your arms.
What does rhomboid pain feel like?
A burning or aching patch between the spine and the shoulder blade, usually one side, often with a tender knot you can press. It is typically worse late in the day, after a long stretch at the desk or a long drive, and better when you move around. Some people feel a catch when they take a deep breath or roll the shoulder.
A strain from a lift or twist is sharper and starts at a moment you can name. The desk ache builds slowly and returns each afternoon.
Is it really the rhomboid?
Often not. Pain felt in the rhomboid area very often comes from the joints and discs of the lower neck or the upper back. They refer pain to the inner edge of the shoulder blade, and the muscle tightens in response. If turning or tilting your head changes the pain, the neck is involved. See our guide to working out neck pain.
The second point surprises people. A rhomboid that feels tight is often not short. When you sit with rounded shoulders, the blades drift forward and the rhomboids are held long and working all day. A muscle held long and tired feels tight and sore. Stretching it further can feel good for a minute and then the ache returns. What it usually needs is strength and a change of position.
What causes a rhomboid strain?
- Long hours at a desk or laptop with the shoulders rounded forward
- Carrying a heavy bag or child on one side
- Rowing, pulling or heavy back work in the gym, especially a jump in load
- A sudden twist or reach, such as lifting a suitcase into an overhead bin
- Sleeping awkwardly; see upper back pain after waking up
What helps rhomboid pain
Movement breaks first. Get up every 30 to 45 minutes, roll the shoulders, and reach both arms overhead. Then work on the upper back and the muscles that hold the blades.
- Stage 1, Calm & Protect: keep moving. Heat for 15 minutes can ease the ache. Cut back the lifting or rowing that set it off.
- Stage 2, Move & Mobilize: thoracic rotation lying on your side (open-book), and extension over a rolled towel or the back of a chair, 10 slow repetitions, two or three times a day.
- Stage 3, Rebuild & Strengthen: band rows, then prone Y and T raises lying face down, thumbs up, lifting the arms just off the floor. These train the rhomboids with the middle and lower trapezius. Start with two sets of 10 and build to three sets of 15.
- Stage 4, Return & Perform: back to full gym rows, pulling and carrying, and a desk set-up you can hold through the afternoon.
Rhomboid stretch
Hug yourself, or hold a door frame with both hands and sit back, rounding the upper back so the blades spread apart. Hold about 30 seconds. Use it only if the area feels better afterward and stays better. If the ache is back within the hour, spend that time on the strengthening instead.
How long does a rhomboid strain take to heal?
A mild strain usually settles in a few days to two weeks. A larger one typically takes three to six weeks. Desk pain lasts as long as the habit does. If it is not clearly better after a few weeks, it is worth an assessment, often of the neck as much as the muscle. Our pain between the shoulder blades guide covers the other causes.
When to see a doctor first
- Call 995 for left-sided upper back pain with chest pain, breathlessness or sweating, or sudden severe tearing pain between the shoulder blades.
- See a doctor soon for pain between the shoulder blades with fever or unexplained weight loss, or pain that is worse lying still at night whatever position you are in.
- See a doctor soon for pins and needles or numbness down the arm, or weakness in the hand.
Where are you with this right now?
1. It is settling on its own
If it came on after a long drive or a heavy gym day and is better each morning, keep moving, take the breaks, and add the rows and Y and T raises. You do not need us for this, and we would rather say so.
2. It has stopped improving
You press a tennis ball into it against the wall every evening. You have moved the laptop, bought a new chair and swapped your bag to the other shoulder. By three in the afternoon it burns again, the same spot, the same side, and it has been doing that for six weeks. Every first visit is one 45-minute Assessment & Treatment, $230, nett, no GST. If it has been months, the Stalled Recovery Review is three appointments over three weeks with the same therapist, $690.
3. A doctor has sent you to us
If your GP has checked you and ruled out the heart, lungs and other causes, we assess the neck, upper back and shoulder blade together, then treat and give you a written plan. See physiotherapy for the upper back. All of it runs on the four stages of the Phoenix Recovery Protocol.
Related reading
Sources: Dwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns I: a study in normal volunteers. Spine. 1990.
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