That Nagging Pain Next To Your Shoulder Blade Could Be Coming From Your Rhomboid Muscles
These muscles attach from the scapula to the spine in your mid and upper back. The rhomboids are important for arm movement and stability of both the shoulder girdle and scapula.
As a chiropractor, it is very common for me to see patients who complain of dull, achy, nagging pain in one of these muscles. Many times, the patient will complain that the pain is always there or keeps coming back. When palpated, these muscles are usually tight, tender, and may even have a trigger point or knot.
Fortunately, with the right approach and some at-home care, these common complaints can be easily resolved.
Causes Of Back Pain Between The Shoulder Blades
Lets start with some of the causes for pain between the shoulder blades, looking at the layers from the outside in.
Acute injuries to the skin in this region usually have an obvious explanation, such as a burn or chemical irritation. These injuries are treated symptomatically, and the pain should resolve.
There are examples of chronic pain that involve the skin in the interscapular region that may require ongoing symptom and pain management. Although relatively uncommon, they may cause distress when present.
One example is shingles, a common condition developed later in life by people who had Chicken Pox when they were younger. Usually, the pain resolves as the shingles rash subsides, but in about 10 percent of people with shingles, there may be chronic burning pain, known as post-herpetic neuralgia. Another example of a chronic sensory complaint that involves the skin in the area between the shoulder blades is notalgia paresthetica, a dermatologic complaint with one-sided itching between the spine and the shoulder blade. Again, this dermatomal distribution indicates involvement of the upper thoracic spinal nerves. This condition may have also prompted the invention of the back scratcher for this hard-to-reach location.
Soft Tissues and Muscles
Infections in the upper thoracic vertebrae or the discs may cause pain between the shoulder blades. These infections are usually treated with antibiotics, although surgery may be required in some situations.
What Conditions Affect Your Back Muscles
Most commonly, injuries affect how the back muscles work. Problems affecting the back include:
- Muscle strains: Muscles in the back can stretch or tear. These common injuries usually result from lifting a heavy object , exercise, overuse or an accident. Back strains can lead to muscle cramps or muscle spasms. In severe injuries, the back muscles can be paralyzed.
- Pain, tightness and stiffness: Chronic pain in the back is extremely common. Pain can lead to stiffness and decreased mobility . Tense muscles and back muscle pain can also result from depression, stress and anxiety. Pain in the neck and upper back can lead to headaches.
Also Check: Fluid On The Elbow Joint
What Is The Cause
A rhomboid muscle strain or spasm is usually caused by overuse of your shoulder and arm. This can happen from:
- Overhead activities, like serving a tennis ball or reaching to put objects on a high shelf
- Carrying a heavy backpack, especially if you carry it over just one shoulder
- Poor posture, especially while you are using a computer for a long time
Endless Nagging Between Your Shoulder Blades
If there was only one movement assessment I had to pick when it comes to evaluating interscapular pain, Im going to look at thoracic rotation mobility. Be sure to watch the full video to learn not just how to assess, but also how to improve thoracic rotation mobility and potentially fix rhomboid pain!
Read Also: The Best Treatment For Tennis Elbow
Possible Causes Of Pain Between The Shoulder Blades
Pain between the shoulder blades can develop from a problem with any body parts located between the shoulder blades, such as:
- The skin between the shoulder blades
- Muscles like the rhomboids, middle trapezius, and lower trapezius, which all help keep your shoulder blades back and down
- The thoracic spine
- The thoracic aorta, which is part of the largest blood vessel that carries blood from the heart to the rest of the body
- Part of the esophagus
- Part of the heart
- A portion of the lungs
You might also have referred pain. When this happens, nerves send signals that cause pain near the shoulder blades, even though the original source of the pain is somewhere else.
Understanding The Shoulder Blades
The shoulder blades, or scapulae, are the large triangular bones located at each side of the upper shoulder.
They are connected to the collarbone and allow a range of motions such as pivoting up or down, side to side, and shoulder rotation. But the flexibility of the blades is what makes them susceptible to injury or trauma.
Read Also: Best Shoulder And Neck Massager
Preventative Tips For Pain Between Shoulder Blades
Dismissing the pain as something incidental is not going to make it go away. If you are experiencing any of the symptoms we have discussed, then know that there could potentially be a more serious problem. But if you are hoping to prevent any back pain, or reduce the chances of severe back problems, then there are two steps that you can take right now to help.
1. Eat better People underestimate just how much diet is related to overall health. Its not just beneficial for managing weight, but it has an impact on your physical functions as well. Practicing good eating habits will strengthen your body, making it more difficult to break down.2. Exercise regularly It doesnt even take strenuous exercise to feel the benefits. Just consistent exercise will help strengthen your back muscles and help you better utilize the nutrients from your diet.
Mohan Garikiparithi got his degree in medicine from Osmania University . He practiced clinical medicine for over a decade before he shifted his focus to the field of health communications. During his active practice he served as the head of the Dept. of Microbiology in a diagnostic centre in India. On a three-year communications program in Germany, Mohan developed a keen interest in German Medicine , and other alternative systems of medicine. He now advocates treating different medical conditions without the use of traditional drugs. An ardent squash player, Mohan believes in the importance of fitness and wellness.
Causes Of Pain Between Shoulder Blades
The most common cause of pain between the shoulder blades is muscle strain, also known as a pulled muscle. You could have pulled a muscle from engaging in strenuous activity, such as lifting heavy objects or playing a sport. Having poor posture at your desk or while standing for long periods can also cause muscle strain.
However, you can also experience pain due to trauma from injuries, such as a fall or accident. Trauma can also affect the nerves that run through your shoulders, causing symptoms such as numbness, pain, or tingling in your arms.
Finally, evidence suggests that heart attacks in women may result in pain between the shoulder blades rather than in the chest area If you encounter a dull ache in between your shoulder blades accompanied by shortness of breath, dizziness, or lightheadedness, you should go to the emergency room as soon as possible.
You May Like: Pain In Bicep And Shoulder
What Are Your Back Muscles
Your back has many different muscles. Some muscles support your spine and trunk. Others help you move your body, stand up straight and assist with breathing.
Because your back muscles support so much of your weight and are responsible for so many movements, injuries to these muscles are common. These injuries can cause low back pain. To avoid injury and keep your back muscles healthy, you should warm up before physical activity and keep other muscles in your body strong.
You Have A Muscle Knot Or A Tense Muscle
The most frequent reason for shoulder blade pain is a tense muscle or a muscle knot. The area around the muscle will feel tender to touch or tight. A way of thinking about it is imagining you pull on a loose thread in a sweater. This will create a hard knot in the fabric.
Why do the muscles become tense? It can come from doing too much, too soon, which is often the case in sports or exercise. For example, repetitive throwing may result in a muscle knot or tender spot under the shoulder blade. They may also develop as the result of pain in the neck and the shoulder.
These knots limit your functionality and impact your day-to-day life. You may find it hard to reach for an object on a high shelf or have difficulties twisting your torso.
Luckily, muscle knots are often easily treated with a massage technique known as myofascial release. Myofascial release is where moderate pressure is applied to the spot to release the stuck tissues. A popular example of this technique is foam rolling .
Don’t Miss: Pain In Knee Inner Side
Where Are Your Back Muscles
Your back muscles start just under your skull, extend across your shoulders and down to your lower back just above your hips. These muscles attach to your ribs, vertebrae , shoulder blades and neck.
You have three groups of muscles in your back. They are:
Superficial: Healthcare providers also call these the extrinsic back muscles as they are close to the surface of your skin. They make up your upper back muscle anatomy, although some of them also extend to your lower back. The superficial muscles include:
- Latissimus dorsi , the largest muscle in the upper part of your body. It starts below your shoulder blades and extends to your spine in the lower part of your back.
- Levator scapulae, a smaller muscle that starts at the side of your neck and extends to the scapula .
- Rhomboids, two muscles that connect the scapula to the spine.
- Trapezius , which start at your neck, go across your shoulders and extend to a V in your lower back.
Intermediate: The intermediate muscles include the serratus posterior inferior and serratus posterior superior. They sit in the shoulder girdle, which is between your shoulder blades.
Video: Cervical Herniated Disc
A cervical herniated disc occurs when the inner portion of a disc in the cervical spineor neckruptures through the outer wall of the disc.Watch Now
A herniated disc in the cervical spine occurs when a discs outer layer tears and the inner layer starts to leak outward. A disc herniation can cause pain and may inflame a nearby nerve root that radiates pain down into the shoulder, arm, and/or hand. A disc herniation in the lower cervical spine is more likely to radiate pain into or near the shoulder blade area.1 While less common, its also possible for a disc herniation in the thoracic spine to cause pain near the shoulder blade.
See Cervical Herniated Disc Symptoms and Treatment Options
Read Also: How Much Does Shoulder Surgery Cost
Treatment For Rhomboid Muscle Pain
A mild rhomboid strain can heal in as little as a few weeks. A more serious injury, strain, or tear can take longer to heal.â
There are some things you can do at home to help manage your pain:
- Get a massageâ
You can also try stretching out your muscles with different techniques:
Tennis ball. Lay down on the floor and place a tennis ball under your shoulder. Gently roll your shoulder back and forth across the ball. Change positions and repeat.
Foam roller. Lay on the floor and roll your shoulder over a foam roller. This will help loosen and massage the muscles.â
Self-massager tool. You can buy an electric or battery-operated tool to massage your shoulder. Donât use high settings that might make it too painful.â
Warm-up stretches. If you are working out or doing sports, you can help protect your muscles by warming up and stretching before and after exercise. If your muscles are sore from a recent workout, allow them to rest and focus on a different set of muscles.
Taking breaks. If you work at a computer and sit most of the day, take lots of breaks. Stand up, move around, and do some stretches.
Better posture. Find an office chair that has a tall back and sit all the way back with your shoulders against the chair. Keeping your feet on a stool can also help you keep good posture.
Common Shoulder Muscle Problems
Injuries to the muscles of the shoulder are common, particularly as we age. Muscle and tendon damage may be caused by:
- Overuse: which leads to inflammation
- Overstretching: where the muscle is stretched beyond its elastic limit and tears
- Wear & Tear: gradual wear and tear over time usually due to friction caused by poor shoulder stability
Common shoulder muscle problems include:
- Tendonitis: inflammation of one of the shoulder tendons e.g. supraspinatus tendonitis, biceps tendonitis, triceps tendonitis
- Impingement Syndrome:Shoulder impingement syndrome causes wear and tear of the shoulder muscles & tendons
- Muscle Tear: Overstretching, overloading or repetitive friction leads to tearing e.g. rotator cuff tear
- Bursitis: Inflammation of the sacs that sit between muscle tendons and bone e.g. shoulder bursitis, scapulothoracic bursitis
Recommended Reading: Elbow Straps For Tennis Elbow
Anatomy Of The Shoulder Blade
Your shoulder blade, or scapula, connects to the clavicle and to the humerus .
This triangular-shaped bone also attaches to several muscles, including those of the rotator cuff. The rotator cuff muscles include four musclesthe teres minor, subscapularis, supraspinatus, and infraspinatus.
These are the muscles that help your shoulder abduct, like when you lift your arm, and internally and externally rotate the shoulder.
Also, around the shoulder blade, youll find muscles that support shoulder stability, including the levator scapulae, trapezius, rhomboids, and serratus anterior .
Rhomboid Muscle Pain Symptoms
Youâll usually feel rhomboid muscle pain as aches or tension in your upper back between your shoulder and your spine. â
Symptoms of rhomboid muscle pain may include:
- Working out your shoulders and back with weights
Some health conditions can also cause rhomboid muscle pain. If you have joint problems in your shoulder, the surrounding muscles might be affected.
Myositis. This condition can cause muscle weakness and inflammation. It usually shows up first in your shoulders and hips.
Polymyalgia rheumatica. This is a disorder that causes shoulder and hip pain and stiffness. It typically affects people over age 50. The pain and stiffness may be worse in the mornings and affect both sides of your body.â
Rheumatoid arthritis. This is an autoimmune disease that causes your immune system to attack your joints. It usually causes a lot of pain and swelling and can lead to joint deformities. Rheumatoid arthritis can affect your shoulders, which might also impact your rhomboid muscles.â
Osteoarthritis. Osteoarthritis is a degenerative bone disease that causes loss of cartilage. This can cause pain and stiffness. You might not have much movement in your shoulder, which can cause discomfort in the surrounding muscles.
Also Check: Women’s Elbow Length T Shirts
Herniated Or Bulging Discs
Degenerative disc disease in the cervical spine or thoracic spine can irritate or press on your nerves or spine. This can lead to pain between your shoulders.
Other symptoms of a herniated disc include:
- Pain in one or both arms
Sometimes pain caused by disc disease in the neck is positional, meaning it can get better or worse when you flex or extend your neck.
Ways To Alleviate Pain In Your Upper Back And Shoulder Blades
There are exercise and stretching techniques that you can practice to deal with the pain in your upper back and shoulder blades. There are techniques that will give you temporary relief via self-massage and stretching for areas that are actually painful. There are also stretches and muscle activation that will help promote better posture. This is more of a long-term strategy.
You May Like: Hand And Wrist Center Of Houston
How To Deal With Painful Shoulder Blade Muscles
Like it has been mentioned before, these muscles are like any other muscles in the body. Their strain contractions can cause the pain which can be relieved with the following home remedies or medical treatments:
1. Home Remedies
- Rest is one of the easiest things to do when in pain. The muscles will automatically go back to their normal state when they are not strained which means there should be plenty of rest involved.
- Hot and cold compresses: In case of an inflammation, a cold compress everyday works wonders on relieving the pain. A cold pack can be placed on the shoulder blade three times a day for 15 minutes each to relax the muscles.
- Yoga and exercise: The best way to relax strained shoulder blade muscles is to stretch them properly. Doing yoga and certain low intensity exercises can diminish the pain.
- Massage has great effect on alleviating muscle pain and relaxing the body by soothing knotted muscles and reducing muscle stress.
2. Medical Treatment
- Medications: If the pain is unbearable, certain medications like liquid relievers and topical ointments can be used.
- Sling: Some people are advised to wear slings to restrict shoulder movements, offer some stability and allow should blade muscles to heal fast.
- Other treatment: If none of the home remedies or the medications work, it is important to know if there is an underlying cause for the pain in the shoulder blade muscles. It is best to get them checked to eliminate any underlying medical conditions.
Pain Between Shoulder Blades Nagging Back Pain
Pain between shoulder blades can produce that nagging type of pain that is difficult to reach. Most often it is related to muscle problems, however, a herniated disc or pinched nerve in the neck can cause pain in this area, along with neck joint irritation. These causes usually respond to neck and/or shoulder movements. This pain can also be referred by the heart, stomach and gallbladder or, if you have osteoporosis, a possible compression fracture.
If there has been a past injury to the area or from years of poor posture, a degenerative condition like arthritis can develop in the area between the shoulders causing upper back pain.
Recommended Reading: Right Side Chest And Shoulder Pain