Pain around the middle and upper back is common, the area in between the shoulder blades is referred to as interscapular pain. The shoulder blade is also known as the scapula and is a large flat, triangular bone that you have two of, one on each side of your middle to upper back.
Located around the scapula are many muscle attachments that act to support and maintain the scapula’s position and will be involved in almost every arm movement. When an injury or condition weakens or damages these muscles, the position of the scapula may change, thus changing the motion of the scapula and this is called dyskinesis.
How does it feel?
People with scapular pain typically experience an aching, dull, sore, or shooting pain in the upper part of their back between their two shoulder blades. This pain and dysfunction may limit arm movements and interfere with daily activities. Most of the time, shoulder blade pain isn’t anything to worry about but in some cases, it can be a sign of a more serious condition that needs further attention.
Common Causes:
● Muscle tightness, knots or injury
● Problems with the neck
● Problem with the spine
● Fracture in the area
● Nerve Inflammation in the neck
● Heart or lung Conditions
● Widespread chronic pain (Fibromyalgia)
Desk Work
One major factor when considering shoulder blade pain is what type of job does the individual have. Sitting at a desk, whether it’s working for hours at a time or for shorter periods at home, can cause a lot of pain in general around the neck and shoulders. A very important topic in this situation is poor posture and some changes in balance to the shoulder, resulting in pain.
What Causes Shoulder Pain From Sitting at a Desk?
We are all sitting at desks more than any time in history and unfortunately we are paying the price physically. Extended positions of poor posture will typically cause our shoulder and back muscles to often be weaker than our body muscles on our fronts and will be closely related to:
● Extended sitting
● Prolonged work on computers
● Repeated phone use
● Sedentary lifestyles
Repetitive Strain Injuries (RSI)
In addition, RSI’s can be a cause of chronic shoulder pain. This condition is caused by frequent, extended, repetitive movements that can put pressure on some of the tendons and muscles of the upper body. Some common movements that can cause RSI include using computer-related equipment (typing on keyboard, clicking on mouse) and awkward postures or sitting positions. Overhead work, moving house, or participating in a certain sports are all examples of activities that can put your upper back and shoulders through more work than they’re used to doing. Shoulder pain from sitting at a desk can also be masked or compounded by neck or back pain, increasing the extremely important need to have a proper assessment by a trained professional to find out where the pain is coming from.
Sitting Postures
Prolonged poor sitting postures may cause your spine to undergo structural changes that eventually cause pain underneath the shoulder blade. Hunching your back, tilting your head down, or sitting to one side while working behind a desk or reading from a cell phone, for example can weaken your muscles and place pressure on spinal discs, muscles, and ligaments.
Rearranging Your Workspace
Correct ergonomics at your desk can be an important key to lessening the stress your body experiences while working. The placement of your chair, the height of the desk, and the height of your computer monitor are important facets of practicing the best desk ergonomics.
Consider the following when arranging your workspace:
● Adjust your chair height so that your knees are level with your hips
● Strive to keep your pelvis in a neutral position - not too arched or slouched
● Keep your wrists straight and your hands at elbow level
● Place your computer monitor at about an arm’s length away
● Put the monitor at eye level
● Consider using a footrest or something to raise the feet
● Keep your mouse-arm where your elbows are at roughly a 90-degree angle
● Rest your arms on your desk
● Keep any belongings within easy reach
● When using a phone, consider using loudspeaker or hands-free rather than cradling the phone between your ear and shoulder
Practice Good Posture
Training ourselves to keep good posture will have long-lasting benefits and overall less pain.
Here are some things to think about:
● Feet on the floor or a footrest
● Forearms parallel to the ground and your shoulders relaxed
● Legs uncrossed
● Back supported with your chair with good low back support
● Elbows close to your body
● Supported thighs and hips
Other Potential Causes of Shoulder Blade Pain
Disc Herniation (Slipped Disc)
A herniated disc in the neck occurs when a disc’s outer layer, the annulus fibrosus, tears and the inner layer, the nucleus pulposus, starts to move outward into the spinal canal. A disc herniation can cause pain and may compress or pinch a nearby nerve root, causing inflammation that feels like radiating pain down into the shoulder, arm, and/or hand. A disc herniation in the lower neck is more likely to radiate pain into or near the shoulder blade area. It is also possible for a disc herniation in the upper or middle back to cause pain near the shoulder blades too.
Dislocated rib
While less common, a rib may become stiff and/or misaligned after repetitive strain or reaching for an item overhead for example. Sharp pain near your shoulder blade can result from this activity, and it can sometimes make it difficult to take a full deep breath.
Compression Fracture
Compression fractures occur most often in the middle and lower back sections of the spine and can be caused by traumatic injury or as a result of loss of bone density (osteoporosis). A compression fracture is when a vertebral bone weakens and compresses, causing back pain that feels better with rest or is sensitive to the touch. Compression fractures are most commonly seen in older adults, particularly post-menopausal women.
Improper lifting technique
Lifting weights, particularly overhead without proper technique can leave your upper back and shoulders very susceptible to injury. Lifting anything overhead that is too heavy can strain muscles or sprain ligaments, or potentially injure the shoulder joint or spine, which could refer pain under or near the shoulder blade.
Heart Condition
Some heart conditions can present as pain in the shoulder blade region. For example, aortic dissection is a serious, life-threatening condition that occurs when the heart’s largest artery gets a tear and may cause severe pain that can move under or near the shoulder blade. A heart attack may also present as pain felt in the upper back and/or shoulder, especially in women.
Other Potential Causes
● Degenerative disc disease (DDD)
● Scoliosis
● Arthritis in your joints around our neck, spine or ribs
● Spinal stenosis, or a narrowing of your spinal canal
● Acid reflux
● Shingles
● Lung cancer, lymphomas, liver cancer, oesophageal cancer, mesothelioma, and cancers that spread to bone
● Aortic tear
● Pulmonary embolism
A chiropractor is specially trained to perform a proper and thorough assessment to determine what is causing your pain by looking at your body as a whole, with the goal of treating the source of your pain and not just the location at the time will give you the lasting relief you are longing for.