Pain Between the Shoulder Blades

Published: August 4, 2017
Last reviewed: March 15, 2018

Causes of Pain Between the Shoulder Blades

Pain between the shoulder blades appears in the middle of the upper back.

To find the cause of pain in the shoulder blades read this article.

The pain between the shoulder blades can result from everyday causes, such as bad posture or muscle strain, or from serious conditions, such as a vertebral fracture or heart attack.

NOTE: The pain arising from the muscles and bones is usually aggravated by touch and movements, while the pain from the internal organs (heart, esophagus, stomach, gallbladder) is not.

Chart 1. SUDDEN Pain Between the Shoulder Blades

Muscle strain Sharp pain, tenderness, swelling or bruising
Whiplash [4] Neck tenderness and stiffness, headache, dizziness
Vertebral fracture (in injury, osteoporosis, bone cancer) [5] Sharp, stabbing pain and tenderness between the shoulder blades aggravated by coughing
Heart attack (in women after 55) [14] Severe, squeezing pain lasting >15 min, shortness of breath, nausea
Aortic dissection [6] Mild or severe tearing pain, shortness of breath, lightheadedness

Chart 2. CHRONIC or RECURRENT Pain Between the Shoulder Blades

Myofascial pain syndrome due to poking chin or hunched posture during sitting work, anxiety or excessive exercise [18] Constant discomfort, tension and spasms and dull ache radiating to other parts of the back after applying pressure on muscle knots
Spinal problems:

Dull pain, tenderness, stiffness or muscle spasms in the neck and upper back and pain, tingling or numbness in the arms, hands or fingers
Spinal cord problems: multiple sclerosis, spinal stenosis…[9] Electric shock-like pain down the spine triggered by bending the neck (Lhermitte’s sign)
Gastroesophageal reflux disease (GERD) [8] Heartburn, worse when lying down, indigestion, metallic taste, dry cough, hoarseness
Stomach ulcer [10] Burning, gnawing pain in the upper central abdomen, worse after eating or at night, indigestion, nausea
Gallbladder attack due to gallstones [17] Pain in the right upper abdomen, nausea or vomiting lasting from several minutes to hours
Esophageal ulcers due to infections or acid reflux, spasms (nutcracker esophagus) or advanced cancer Severe chest pain during swallowing
Coronary heart disease with angina pectoris (in women after 55) [13] Severe, squeezing pain behind the breastbone, jaw and arms triggered by exercise or stress and lasting <5 minutes

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