Why Does It Hurt Between Your Shoulder Blades?

Pain between your shoulder blades can be frustrating, especially when you can’t identify what caused it. You may feel a dull ache after sitting at your desk, a sharp sensation when turning your upper body, or a burning discomfort that seems to sit directly between your shoulders.

Sometimes the pain disappears after moving around. Other times, it keeps returning or begins interfering with work, sleep, or everyday activities.

So what actually causes pain between the shoulder blades?

Pain between the shoulder blades can originate from muscles, joints in the upper back, structures in the neck, or irritated nerves. In some cases, pain in this region can also be referred from a medical condition outside the spine.

The location of your pain provides useful information, but it doesn’t always identify the source.

At Venn Chiropractic and Wellness Center in Frisco, TX, Dr. Jason Venn evaluates spinal and musculoskeletal conditions with an emphasis on identifying the structures that may be contributing to a patient’s symptoms.

Where Exactly Is Pain Between the Shoulder Blades?

The area between your shoulder blades is part of the upper back, commonly called the thoracic region.

Your thoracic spine consists of 12 vertebrae that connect with the rib cage. Surrounding this region are muscles, ligaments, joints, and nerves that help support movement and everyday activities.

Important structures in this area include:

• Thoracic spinal joints: Joints that contribute to movement and stability in the upper back.
• Rhomboid muscles: Muscles that help control shoulder blade movement.
• Trapezius muscles: Muscles involved in moving and stabilizing the shoulders and neck.
• Rib joints: Connections between the ribs and thoracic spine that can sometimes become painful.
• Spinal nerves: Nerves that may contribute to pain or altered sensation when irritated.

Because several structures occupy a relatively small area, different problems can produce symptoms that feel remarkably similar.

1. Muscle Strain or Tension Between the Shoulder Blades

Muscular discomfort is one possible explanation for pain between the shoulder blades.

The muscles of the upper back help position and move the shoulder blades while supporting activities involving the arms, neck, and trunk.

They can become uncomfortable after unfamiliar exercise, repetitive activity, prolonged positions, or muscular strain.

For example, someone who spends several hours working at a computer may notice aching between the shoulder blades by the end of the day.

Another person may develop soreness after lifting, pulling, or completing a demanding upper-body workout.

Muscle-related symptoms may include:

• A dull or aching sensation
• Localized tenderness
• Tightness around one or both shoulder blades
• Discomfort during certain arm or shoulder movements
• Symptoms that change with activity or position

However, muscular tenderness doesn’t prove that the muscle is the original source of the problem. Muscles can also become sensitive or guarded in response to irritation elsewhere.

2. Thoracic Spinal Joint Pain

The thoracic spine is designed to provide stability while allowing movement through the upper back.

Its joints participate in rotation, extension, and other movements of the trunk.

When a thoracic joint becomes painful or movement is restricted, discomfort may be felt near the spine or between the shoulder blades.

Some people notice pain when:

• Turning their upper body
• Reaching across the body
• Extending the upper back
• Changing positions after sitting
• Taking certain movements through their full range

These patterns can help guide an examination, but they are not sufficient to diagnose a particular spinal joint problem.

At Venn Chiropractic, Dr. Venn uses the Gonstead System to assess spinal findings and determine whether specific chiropractic treatment may be appropriate.

3. Pain Referred From the Neck

One of the more easily overlooked possibilities is that discomfort felt between the shoulder blades may originate higher in the spine.

Certain cervical spine conditions can produce pain that extends toward the upper back or shoulder blade region.

This is called referred pain when discomfort is perceived away from its source.

For example, someone may experience upper back discomfort alongside neck stiffness or pain when turning the head.

Other patients may have relatively little neck pain even when cervical structures are contributing to their symptoms.

Clues that the neck may be involved include:

• Shoulder blade discomfort that changes when moving the neck
• Neck stiffness accompanying upper back pain
• Pain extending from the neck toward the shoulder blade
• Symptoms that change with head position
• Associated arm symptoms in some cases

These findings warrant assessment rather than an assumption that the problem is simply a tight muscle.

Learn more about neck pain and cervical spine conditions.

4. Irritated Nerves and Burning Pain Between the Shoulder Blades

Some patients describe their upper back pain as burning, tingling, electric, or unusually sensitive.

These sensations can sometimes occur with nerve irritation, although burning pain isn’t specific to a pinched nerve.

Depending on the structures involved, nerve-related symptoms may occur alongside:

• Pain extending into an arm
• Numbness or tingling
• Altered sensation
• Weakness in particular muscles
• Symptoms affected by certain neck positions

A cervical nerve root problem is one possible explanation when shoulder blade discomfort accompanies arm symptoms.

However, other neurological and non-neurological conditions can cause similar sensations.

A neurological examination may assess muscle strength, reflexes, sensation, and other findings to help determine whether a nerve-related problem is likely.

For more detail, see our page on pinched nerves in the neck.

5. Rib Joint Irritation and Upper Back Discomfort

The ribs connect to the thoracic spine through joints that contribute to movement of the chest wall.

Problems involving these joints or nearby tissues may sometimes produce localized upper back discomfort.

Some people notice symptoms during trunk rotation, certain reaching movements, or deep breathing.

However, pain associated with breathing should not automatically be attributed to a rib or spinal joint.

Lung, heart, and other medical conditions can also cause pain related to breathing or discomfort around the upper back.

New or unexplained pain with breathing, particularly when accompanied by shortness of breath, chest discomfort, dizziness, or other concerning symptoms, requires prompt medical assessment.

What Does Burning Pain Between the Shoulder Blades Mean?

Burning pain can have several possible explanations.

Some people use the word “burning” to describe muscular discomfort after prolonged activity. Others experience burning sensations associated with nerve irritation or altered sensation.

Skin conditions, including shingles, may also produce burning discomfort, sometimes before a rash becomes visible.

The character of the pain is useful, but it must be considered alongside other findings.

For example, burning discomfort accompanied by arm numbness may prompt a different evaluation from burning pain associated with a new skin rash.

Persistent, unexplained, or worsening burning pain deserves appropriate medical or clinical evaluation.

Why Does It Hurt Between My Shoulder Blades When I Sit?

Some people notice upper back discomfort after sitting at a desk, driving, or remaining in one position for an extended period.

Prolonged positioning can increase muscular fatigue and may aggravate sensitive joints or tissues.

For example, holding the arms forward while working at a computer requires sustained activity from muscles around the shoulders and upper back.

However, there is no single sitting posture that explains every episode of pain between the shoulder blades.

Symptoms may be influenced by workstation setup, activity tolerance, existing spinal conditions, or the amount of time spent in one position.

Changing positions periodically and remaining comfortably active may help some people manage position-related discomfort.

But if the pain repeatedly returns, a more specific evaluation may be useful.

Why Does It Hurt Between My Shoulder Blades When I Turn or Twist?

Turning the upper body involves coordinated movement through the thoracic spine, ribs, shoulders, and surrounding muscles.

Discomfort during rotation may suggest that one or more of these structures is sensitive to movement.

For example, a person may notice a localized ache near the spine when turning to look behind them.

Another may feel pulling or tension between the shoulder blades during reaching or twisting.

These observations can help a clinician select appropriate examination procedures.

However, pain during twisting does not automatically establish that a spinal joint is misaligned or that an adjustment is required.

Can Pain Between the Shoulder Blades Come From a Herniated Disc?

Sometimes, although not every episode of upper back pain involves a disc problem.

Disc-related conditions in the cervical spine may contribute to symptoms perceived near the shoulder blade, particularly when a nerve root is affected.

Thoracic disc problems are another possibility, but symptomatic thoracic disc herniations are less common than those in the cervical or lumbar spine.

Imaging findings also require careful interpretation.

A disc abnormality visible on an MRI does not necessarily explain a person’s current pain.

Clinical history, neurological examination, and the distribution of symptoms help determine whether a disc-related condition is a reasonable explanation.

Learn more about herniated and bulging disc conditions.

When Is Pain Between the Shoulder Blades a Medical Emergency?

Most upper back discomfort is not caused by a medical emergency. However, pain between the shoulder blades can occasionally be associated with serious conditions involving the heart, major blood vessels, lungs, or other organs.

Call 911 or seek emergency medical care immediately for sudden severe or tearing chest or upper back pain, especially when accompanied by fainting, weakness, or other concerning symptoms.

Emergency evaluation is also important when upper back pain occurs with:

• Chest pressure, tightness, or pain
• Shortness of breath
• Cold sweating, nausea, or faintness suggesting a cardiac problem
• Sudden unexplained severe pain
• New significant neurological weakness
• Symptoms following major trauma

Heart-related symptoms do not always include classic chest pain. Some people experience discomfort in the back, shoulders, jaw, or other areas.

Do not attempt to stretch, massage, or adjust away symptoms that could represent a medical emergency.

For non-emergency but persistent or unexplained symptoms, medical evaluation may still be appropriate.

How Does Dr. Venn Evaluate Pain Between the Shoulder Blades?

At Venn Chiropractic and Wellness Center in Frisco, Dr. Jason Venn has more than 25 years of experience evaluating spinal and musculoskeletal complaints.

His approach begins with identifying the patient’s symptoms and determining which structures may be involved.

Depending on the presentation, an evaluation may include:

• Detailed symptom history: Where the pain is located, when it began, and which activities affect it.
• Cervical spine assessment: Evaluating whether neck movement or other cervical findings are associated with shoulder blade symptoms.
• Thoracic spine assessment: Examining clinically relevant movement restrictions, tenderness, and spinal joint findings.
• Orthopedic testing: Selecting examination procedures based on the suspected source of discomfort.
• Neurological examination: Assessing strength, sensation, reflexes, and other findings when nerve involvement is suspected.
• Imaging when indicated: Using digital X-rays when clinically appropriate or referring for additional diagnostic studies when needed.

The goal is to distinguish possible spinal and musculoskeletal causes from symptoms that require a different type of medical evaluation.

Not every patient with pain between the shoulder blades needs a chiropractic adjustment.

Can Gonstead Chiropractic Help With Pain Between the Shoulder Blades?

Some patients with musculoskeletal upper back pain may be appropriate candidates for chiropractic care.

Dr. Venn uses the Gonstead System to assess clinically relevant spinal dysfunction and determine whether a specific adjustment may be suitable.

When an examination suggests that spinal joint dysfunction is contributing to pain or restricted movement, chiropractic treatment may be considered.

However, symptoms involving the shoulder blade region can have several causes, and an adjustment is not the appropriate treatment for every one of them.

For patients with additional functional limitations, spinal rehabilitation may also be incorporated when indicated.

If the findings suggest a medical or neurological condition outside the appropriate scope of chiropractic treatment, further evaluation or referral may be necessary.

What if Your Shoulder Blade Pain Is Actually Coming From Your Neck?

This distinction can be especially important when symptoms don’t respond as expected to treatment directed only at the shoulder or upper back.

At Venn Chiropractic, one documented patient case involved shoulder pain and arm symptoms for which a cervical nerve-related source was suspected.

The case illustrates why the location where someone feels pain may not identify the structure responsible.

Read the full Frisco cervical nerve and shoulder pain case study to learn how the patient’s symptoms and examination findings influenced the clinical approach.

Individual patient experiences do not predict outcomes for other patients.

Frequently Asked Questions About Pain Between the Shoulder Blades

What Is the Most Common Cause of Pain Between the Shoulder Blades?

Musculoskeletal problems involving muscles, joints, and surrounding tissues are common causes of upper back discomfort. However, the most likely cause for an individual depends on their symptoms, medical history, and examination findings.

Can Neck Problems Cause Pain Between the Shoulder Blades?

Yes. Certain cervical spine conditions can refer pain toward the shoulder blade region. When symptoms also involve neck movement, arm pain, numbness, tingling, or weakness, the cervical spine may warrant evaluation.

Why Do I Have a Burning Sensation Between My Shoulder Blades?

Burning discomfort may occur with muscular sensitivity, nerve irritation, or other conditions, including some skin disorders. The sensation alone cannot identify the cause.

Can Poor Posture Cause Pain Between the Shoulder Blades?

Prolonged positions and sustained muscular activity can contribute to upper back discomfort in some people. However, posture alone does not explain every case, and there is no single perfect posture that prevents all pain.

Is Pain Between the Shoulder Blades a Sign of a Pinched Nerve?

It can be associated with nerve irritation, particularly when symptoms extend into an arm or include numbness, tingling, or weakness. But shoulder blade pain alone does not establish a pinched nerve diagnosis.

Can Pain Between the Shoulder Blades Be Related to the Heart?

Yes. Some cardiac conditions can cause discomfort in the upper back or shoulder blade region, sometimes without prominent chest pain. Sudden or unexplained upper back pain accompanied by chest symptoms, shortness of breath, sweating, faintness, or other concerning symptoms requires emergency evaluation.

Should I See a Chiropractor for Pain Between My Shoulder Blades?

A chiropractor may be an appropriate option for some musculoskeletal causes after suitable evaluation. However, persistent unexplained symptoms, significant neurological changes, or signs of a medical condition may require medical assessment first.

What if the Pain Keeps Coming Back?

Recurring pain may reflect repeated activity-related irritation, an unresolved musculoskeletal problem, or another condition. Rather than assuming the same cause each time, a clinical evaluation can help determine which factors may be contributing.

Get to the Source of Your Upper Back Pain in Frisco, TX

Pain between the shoulder blades isn’t always as straightforward as a tight muscle.

Sometimes the discomfort involves the thoracic spine. Other times, the neck, nerves, or surrounding tissues may contribute. Certain symptoms also require medical evaluation to exclude more serious causes.

At Venn Chiropractic and Wellness Center in Frisco, Dr. Jason Venn focuses on detailed spinal assessment, specific Gonstead chiropractic care, and individualized treatment recommendations when appropriate.

If you’re experiencing persistent or recurring pain between your shoulder blades and have no emergency warning signs, an evaluation may help clarify the possible source and appropriate next steps.

Contact Venn Chiropractic and Wellness Center to schedule an appointment in Frisco, TX.