If you are suffering from regular pain between your shoulder blades then it is important to try and address this rather than letting it linger, or possibly doing things that will aggravate the pain. There are often many simple causes to regular upper back pain, however there are also a few more serious ones. Whilst it is highly likely the shoulder pain you are experiencing has a simple explanation (eg: poor posture), you should always get an experienced health professional’s opinion before self-diagnosing and treating.
Symptoms You May Be Experiencing
- Pain in and around your shoulder blades (or scapulae) can be either acute whereby you experience sharp but relatively short bursts of pain, or more chronic – meaning that the pain doesn’t really go away on a day to day basis and has lasted for weeks or months.
- You can experience pain locally at specific points, or the pain can spread to the arms or other areas of the back. You may be experiencing sharp stabbing pains, or your symptoms may be a dull achy pain which lingers on a daily basis.
Try and grade your pain at it’s best and worst, on a scale from 1 to 10; 1 being very mild and 10 being severe and unforgiving. Keep a diary of when you suffer with the pain and any activity you have been doing which could be contributing to the pain.
Some Possible Causes of Pain In or Between Your Shoulder Blades
Muscle Imbalance in and around your shoulders and scapulae
- Many aspects of modern life can contribute to your upper back pain, probably the most common of these being poor posture. Sitting for long periods with poor posture can quickly lead to muscle imbalances in the back, causing some muscles to work harder to compensate for the muscles which aren’t working as hard, to maintain a good posture (See Treatment 1). If any part of your back or spine becomes weaker, this can have a knock on effect on the rest of your back / spine.
- Along with poor posture, a new activity or exercise which strains the back muscles could also be the cause or a contributing factor, especially sports which involve twisting the trunk / spine suddenly, such a golf or tennis (See Treatment 2 – 5).
- Sudden or prolongued heavy lifting could also be a cause of pain between the shoulder blades, for example if you are moving house or have started a new job which involves a lot of lifting / heavy manual labour (See Treatment 2 – 5).
Cervical spine / nerve root problems
As well as muscle imbalances caused from the above, your pain could be a consequence of neck or cervical spine problems. Have you had a car accident in the past or any injury that could have given you whiplash or any other neck / shoulder problems? If there has been any disturbance within the cervical spine itself this can have consequential effects on the rest of the spine and the muscles between the shoulder blades, especially the trapezius muscle and the deeper rhomboid muscles, as well as the levator scapulae surrounding the neck itself.
Treatments to Help Alleviate Your Pain
1. Ideally you or your employer should consider the ergononomics of your workspace, ensuring that everything lines up properly. You can request an occupational health assessment if you suspect that your workplace could be contirbuting to your pain.
- Your posture in sitting: Your chair should be at the correct height, arms angled slightly downards, wrists not raised too much, and your monitor should be just slightly below the level of your eyes. Your chair should be the correct height, so that your hips and kness are at 90°, your feet comfortably touch the floor and your lower back maintains it’s natural curve with a good lumbar support. When sitting for long periods of time always ensure that you are maintaining an upright back and not hunching your shoulders over or letting your neck hang forwards. Remember, if one part of your spine has poor posture, this will have an effect on the rest of your spine! You should aim to be taking a break roughly every 45 minutes where you move around a bit and / or stretch for at least a few minutes (See below for advised stretches).
- Your posture in standing: Look in the mirror particularly at the posture of your head, neck and shoulders. Ensure that your head is not protruded forwards and your shoudlers are not protracted (hunched forwards) or retracted, try and relax your shoudlers so that the muscles between your scapulae (shoulder blades) and in and around your shoulders are not tense. If you are unsure of whether you have any tension in and around your shoulders / shoulder blades, try actively pushing your shoulders forwards and backwards a few times, then relax in a neutral position. You should feel the difference between the tense muscles and a relaxed position.
- Your posture when lying down: When lying on your back, make sure your neck is well supported as well as your head; you may need a small rolled up towel between your head and shoulders to support your neck. You may also find that a pillow underneath your knees helps as this encourages the natural arch in your lower spine and hence helps it relax. If you prefer lying on your side, again ensure your neck is well supported with a rolled up towel, then place a pillow in front of you to allow your upper arm to rest on it, preventing rotation of your trunk in lying. Place a pillow in between your kneesso that you could balance a cup on your thigh and there is no angle between your hips and knees.
A Few Exercise And Stretching Ideas
2. If you have started a new sport or exercise, stretching and loosening up is the key to maintaining good muscle tone and balance throughtout the exercise, thus preventing muscle strains and consequential pain.
- Starting with the lower back, simply placing your hands on your hips and leaning backwards is a great stretch for your lumbar spine. To push this further, try lying on your tummy and whilst keeping your hips on the ground, push your upper body up with your arms, eventually aiming to have your arms straight during the stretch. There are also a number of shoulder pain exercises that you can do to help alleviate things.
- A great stretch for the whole of your back is called ‘The Cat Stretch’, starting on your hands and knees, arch your lower back allowing your abdomen to lower to the floor and lift your head to look at the ceiling. Then stretch the opposite way, arch your back upwards towards the ceiling, pulling your tummy in tightly as you do so, and tuck your chin into your chest, hold each stretch for a couple of seconds, breathing in as you arch your back towards the floor and breathing out as you pull your tummy in and arch your back towards the ceiling.
- A nice stretch for your upper back involves standing up or sitting with a very good posture, straightening your arms out in front of you, placing one hand in the other and pushing your arms forwards, feeling the stretch between your shoulder blades. Shoulder shrugs upwards,forwards and backwards are a great way to loosen up the shoulders and upper back before and after the stretches.
- Stretches for your neck are equally as important, taking your chin towards your chest then taking your head from side to side so that your ear nearly touches your shoulder, then diagonally looking down to either side to stretch the deeper neck muscles. Particularly concentrate on stretches of your back, starting with arching stretches of your lower back, and moving up to stretches for your neck, shoulders and arms.
3. As long as you have normal sensation (i.e can feel the difference between hot and cold / sharp and blunt on the skin), heat is another way of finding relief from pain caused by muscle tension between the shoulders or at any point in the back. Wheat bags are simple to heat up in the microwave, but if you do not have one of these, simply heating up a damp tea towel (ensuring it is not too hot) will be adequate. Apply the heat for 15-20 mins up 4 times a day.
4. TENS (Transcutaneous Electrical Nerve Stimulation) machines are another form of pain relief and can be bought from most highstreet chemists. However, DO NOT buy or use a TENS machine if you have epilepsy, a pacemaker, a malignancy of any kind or if you are pregnant. And only use if you have normal skin sensation (can feel the difference between hot / cold and sharp / blunt) and no skin lesions / conditions in the area you are using it. TENS works by blocking pain signals from the brain to the part of the body that is affected, and increases the circulation to the area acting as a form of natural pain relief. It can only be used up to an hour and a half at a time up to four times a day. Some people find the pain relief lasts for a while after using the TENS machine, and others only find relief whilst using it. However, if it means pain relief without taking tablets, most people would give it a go!
Please remember that the above is only my opinion, and you should always seek the advice of a health professional from a hospital or doctor experienced in shoulder and back conditions.
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