Shoulder blade pain is discomfort felt around the scapula, a flat bone in the upper back that plays an essential role in shoulder stability and arm movement. This pain may involve muscles, tendons, joints, or nearby nerves that support the shoulder and upper spine.

Common causes of shoulder blade pain include poor posture, muscle strain, overuse injuries, bursitis, and lifting heavy objects incorrectly. In some cases, spinal problems, fibromyalgia, or nerve compression can also trigger pain in this area.

Less commonly, shoulder blade pain may be related to internal conditions such as heart, liver, or gallbladder problems, especially when it appears suddenly or with other symptoms. Treatment depends on the underlying cause and may include rest, physical therapy, medication, or urgent medical care when serious conditions are suspected.

Why does my shoulder hurt?

Some conditions or clinical findings that can lead to shoulder blade pain include:

1. Bad posture

Shoulder blade pain may result from poor posture, prolonged computer use, or frequent use of a cell phone or tablet. These habits can cause muscle tension around the shoulders, which is often felt in the scapula.

What to do: Lifestyle changes can help improve posture. Try adjusting your sitting position when working at the computer (keeping your back supported by the chair) and reduce the time you spend on your phone or tablet whenever possible.

You can also include exercises to improve posture recommended by your physical therapist.

2. Trauma

Shoulder blade pain may result from trauma such as a direct blow, a fall, a car accident, or participation in contact sports. These injuries can cause fractures or compress the suprascapular nerve, leading to severe scapular pain.

Nerve compression can also occur without trauma, as seen in rotator cuff syndrome.

What to do: If you experience severe pain after a direct injury, seek urgent medical care. A healthcare provider will likely request imaging tests, such as an X-ray, to check for a fracture.

If a fracture is confirmed, treatment may include pain medication, physical therapy, and immobilization with a sling or splint. In more serious cases, surgery may be necessary.

3. Lifting weights incorrectly

Incorrect weightlifting technique or carrying heavy objects can strain muscles or ligaments, leading to pain around the shoulder blade.

These injuries are more common among people who engage in activities like weight training or CrossFit, as well as in professions that involve frequent lifting, such as construction work, mechanics, or nursing.

What to do: Apply a warm compress to the area for 15 minutes, twice a day, followed by an anti-inflammatory cream.

During this period, avoid lifting weights and make sure to maintain good posture each day. Gentle stretching can also help relieve muscle tension and ease discomfort.

4. Overuse injury

Repetitive movements can cause overuse injuries in the shoulder joint, which may lead to shoulder blade pain. This type of injury is common among people who play sports like volleyball or basketball, as well as those in professions such as painting or dentistry.

Repeated movements can strain the muscles or ligaments, leading to injuries such as sprains or bursitis, which may cause pain around the shoulder blade.

What to do: Avoid excessive use of the shoulder joint when possible and apply cold compresses to the area for the first 48 hours after the injury to relieve discomfort.

If the pain is severe, you should consult an orthopedic surgeon to assess the type of injury and recommend the most appropriate treatment.

5. Back problems

Certain spinal conditions, such as cervical disc herniation, cervical spondylosis, or osteoporosis, can cause pain in the shoulder blade. Other symptoms may include pain that radiates down the arms or to the fingers, arm weakness, and sensations like burning or numbness in the fingers.

What to do: Consult an orthopedic surgeon to determine the cause of the scapular pain and to receive the most appropriate treatment.

6. Bursitis

The shoulder blade has small fluid-filled sacs called bursae, which help reduce friction in the joint during arm movements. When these bursae become irritated or inflamed due to overuse or injury, a condition known as bursitis can develop.

Bursitis causes significant pain, especially with movement or in cold weather, and commonly affects the shoulder area, leading to shoulder blade discomfort.

What to do: Bursitis-related pain can be relieved by applying ice to the area for 20 minutes, 2 to 3 times per day. The doctor may also recommend analgesics, anti-inflammatories, and corticosteroid medications to improve pain and reduce inflammation.

Treatment also involves rest when possible and physical therapy sessions to maintain range of motion.

7. Winged scapula

A winged scapula occurs when the shoulder blade sticks out abnormally from the back during movement. This misalignment can make it feel as though the bone is “out of place,” often causing discomfort.

Although it can affect either side, it most commonly appears on the right shoulder blade and may be associated with conditions such as arthrosis, clavicle fracture, muscle paralysis, or damage to the thoracic nerve.

The diagnosis is confirmed by an orthopedic surgeon through a physical examination, followed by an electromyography (EMG) test to assess how well the muscles in the affected area are functioning.

What to do: Once the diagnosis is confirmed, the specialist may prescribe medication to provide short-term pain relief. In most cases, surgery is recommended to repair any nerve damage located behind the chest cavity.

8. Fibromyalgia

Fibromyalgia is a common rheumatic condition characterized by widespread pain that can affect multiple areas of the body, including the shoulder blades. It may also cause fatigue, muscle stiffness, tingling in the hands, depression, and sleep disturbances, all of which can significantly impact quality of life.

These symptoms should be assessed by a rheumatologist, who can establish the diagnosis through a comprehensive review of the patient’s medical history, including the location and duration of pain. The physician may also order imaging tests, such as MRI or EMG, to rule out other possible conditions.

What to do: Fibromyalgia is a chronic disease that does not have a cure. Treatment is aimed at symptom relief and can include muscle relaxants (like cyclobenzaprine) and tricyclic antidepressants (like amitriptyline). TENS machines and ultrasounds, typically used by a physical therapist, can also help to manage pain.

9. Snapping scapula syndrome

Snapping scapula syndrome (SSS) is a condition that causes pain and a cracking or grinding sensation around the shoulder blade during movement. It often results from overuse or direct trauma to the shoulder and is most commonly seen in young adults.

The diagnosis is confirmed through a physical exam and imaging tests, such as X-rays or CT scans, after other conditions have been ruled out.

What to do: Treatment consists of analgesic and anti-inflammatory medications to relieve pain and reduce inflammation. Physical therapy can help to strengthen the scapular muscles and prevent further injury.

10. Gorham’s disease

Gorham’s disease is a rare condition that causes bone loss and is associated with sudden difficulty moving the arm. Diagnosis is usually confirmed by an orthopedic surgeon through CT scans and MRI.

What to do: Treatment is directed by an orthopedic surgeon and depends on the areas of bone most affected. Medications such as bisphosphonates can help regulate bone remodeling, while surgery may be needed to stabilize weakened bones.

11. Heart problems

Certain heart problems, such as a ruptured aortic artery or a heart attack, can cause sudden, intense pain in the area around the shoulder blades.

Heart problems can also cause other symptoms, such as severe chest pain, pain that spreads to the shoulder or arm, shortness of breath, dizziness, general discomfort, nausea, cold sweats, or paleness.

What to do: Seek medical help right away, as these conditions are serious and can become life-threatening without prompt treatment.

12. Liver and gallbladder problems

Gallstones and liver problems, including abscesses, hepatitis, or liver cancer, can cause pain around the shoulder blade, particularly on the right side. This pain may occur along with other symptoms such as jaundice, back pain, nausea, fever, and diarrhea.

Blood work and imaging tests, such as ultrasound, CT, and MRI, can help diagnosis liver or gallbladder conditions that may cause scapular pain.

What to do: If you experience these symptoms, seek medical evaluation as soon as possible. The appropriate treatment will depend on the underlying cause.

When to see a doctor

Pain around the scapula (shoulder blade) can sometimes signal a condition that isn’t related to the bones, muscles, or nerves. It may be caused by a problem with the heart or lungs, such as a heart attack or an aortic aneurysm.

Seek medical attention right away if you notice symptoms such as:

Sharp chest pain;
Shortness of breath;
Paralysis on one side of the body;
Excessive sweating;
Coughing up blood;
Pallor;
Increased heart rate.

It is also important to monitor for fever, as it may signal an infection and indicate the need for further testing.

Shoulder Blade Pain: Common Causes & When to See a Doctor