Lia said, “I have had no relief from these knots in my shoulder blade. I am now experiencing almost permanent pins & needles in my right arm and have trouble finding any relief!  Any ideas?”

Well, yes, I do have ideas.  It’s hard knowing what might be going on long distance but I do have ideas.  In this case, I suspect that muscles in the neck are causing both the knots and the arm sensation.

The pins and needles sensation and the knots in her shoulder blades could be caused by separate issues or they could have the same cause.

I told Lia that I am pretty sure (my best long distance guess) that the problem is caused by muscles in her neck pressing on a nerve.  Those muscles are called scalenes.  There is a set of scalene muscles on the left side and the right side of your neck.

Nerves run from your neck to your hand.  If the scalene muscles are “too tight” they can press on these nerves and cause symptoms such as knots in your back and uncomfortable hand and arm sensations.

If your shoulders are “bunched up” that can cause the muscles to get tight and press on the nerves.  Also, if you have “forward head” posture (your head is in front of your body instead of over and your shoulders are rolled forward) that can cause these symptoms.

If you can find a massage therapist who knows how to “release” the scalenes that person can probably help a lot.  Yes, there is a cost involved and it may take several sessions.  But you will be able to feel a difference pretty quickly.

Please don’t just ask, “Do you know how to release scalene muscles?” Some practitioners will say yes, even if they don’t.

Ask whether the therapist has had any experience doing this release?  Have they worked successfully with people who have had your symptoms?  What type of training have they had?

It usually requires advanced training to do scalene release.

If the scalenes are not the problem, then it’s (long distance guess) possibly the muscles of your upper body on that side being so tight that they are pressing on a nerve.  Those muscles could be in the front of the chest.

I’m leaning to the scalenes because they cause BOTH pain in the hand and knots in the back.

In my program I have self-help videos about this problem.  They help you to release the scalene muscles and so take pressure off the nerves.  If you’d like the free report about the causes of those miserable knots in your back, it’s here:  Miserable Knots

And here are some articles that may help.

Look at the Video Category and the Self Help Category (Categories are listed on the right hand side) while you are at Carpal Tunnel Pain Relief, too.

Also, if you go to you will see a replay called “Carpal Tunnel Syndrome–Is It All In Your Head? Or In Your Neck?” and that is about the scalene muscles.

Remember, the scalenes cause knots in your back, too, not just symptoms in your hand and arm.

There is also the outside chance that spinal bones in the neck are causing Lia’s symptoms.  I’m not a doctor but (except in emergencies) my first suggestion is always to try the least invasive, most natural therapies.  In this case, that would be to release the scalene muscles manually (by hand.)

If that doesn’t work, a visit to an orthopedic doctor would be the next step.  Tests could probably tell whether pressure on the nerves is coming from something like a bone spur and whether surgery might help.

If Lia were to consider surgery, I would suggest that she ask lots of questions about the surgery and the outcome.

Muscle therapy doesn’t make permanent changes to your skeleton but surgery of this sort does.  That is why I always suggest conservative manual muscle therapy first for nervy hand and arm pain.


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28 Comments on Knots In Shoulder Blade With Nerve Pain In Arm

  1. Ted Williams says:

    Fantastic post, there is a small grammar error at the end however, otherwise was great!

  2. Hi Ted,

    Thank you for your comment. Will check the grammar–it could happen!


  3. May says:

    Hi, I have a sharp pain between my left shoulder blade and my left arm when I turn my head to the left and when I life my left arm in certain angles and use my right arm to carry things at certain angles. Is this nerve related? My General Practioner seems to think it is. But I’m not convinced. If it is, How to I eliminate it naturally? I’ve just had spine surgery on T6,which means it is at the same level as the shoulder blade about 2 weeks age ago.

  4. Hello May,

    A couple of thoughts come to mind. If it is nerve related, you may find relief from cold therapy (ice.)

    I am unsure exactly what your last sentence means and you didn’t say why you had the surgery. Is this something that has only happened since your surgery?

    Or was this the reason for your surgery and it’s still bothering you?

    My gut feeling is that (unless you had an accident that caused your problem) this is related to posture. Do you have ‘forward-head posture’? That can cause the muscles in the areas you describe to struggle. They get strained from trying to hold your heavy head up when you have forward head posture.

    Besides ice for every area that you feel discomfort in and your whole neck and upper back, my next suggestion would be to correct your posture and strengthen your back. You can find articles that tell how to do that at

    There is a little video at that might help you loosen the muscles around your shoulders and neck.

    It’s only been 2 weeks since your surgery, though, so best to ask your doctor if it’s okay to move your arms in that way yet. I hope this helps and thank you for writing about the pain between your shoulder blade and arm.

    The Pain Relief Coach

  5. Kevin McGrath says:

    I had knots in my shoulder for years and used a masseuse to get them out of there many times over the past 25 years. The knot was bad enough sometimes that i could not sneeze or take a deep breath. The knot came back this time and started to jump on my nerve down my left arm. I have tried many treatments and nothing seems to work. It has been 4 months now and the pain in my arm and the knot in my shoulder remains as bad as it was at the beginning. Can it be scar tissue closing off the nerve? I will try anything. My EMG test was negative so it is not in my neck.

  6. Hi Kevin, I don’t think it’s scar tissue. I suspect it’s the muscles between your shoulder blade and ribs on the back side of your back. Or the muscles in the front of your chest.

    And there are muscles on either side of your neck that can cause knots (the scalene muscles.) Muscles can press on nerves and cause nervy sensations. If massage isn’t helping it’s because the practitioner is working on the symptoms instead of the cause of the knot. There is a big difference!

    I’m glad your EMG was good. That’s good news! Good tests generally indicate that muscles are to blame. And muscles can be treated.

    Can you find a neuromuscular massage therapist in your area? If so, ask him or her if they know how to treat the scalene muscles or subscapularis muscle and listen hard to their answer.

    I do cover this information in my program, Knots In Your Back, too. And there is a lot of information right here at Simple Back Pain Relief.

    Kevin, I hope this helps you get rid of that nasty knot.

    The Pain Relief Coach

  7. Keith Cummings says:

    I used to do a lot of long distance running during my high school days.I then started getting acute pain in my upper back region,and a knot developed around the shoulder blade. I had no idea what muscle knots are,until recently reading your articles . I live in the country side,far from city life ,which means no massage therapy close by.I started doing ‘self help ‘massage ,where I place a hard ball on the floor and lie on it.With the ball pressing on the knot , I breath slowly and deeply. It has brought great relief ,but will it remove the knot completely?

  8. Hi Keith,

    Thank you for writing. That’s great that you are taking action and are having great relief. 🙂

    IF the cause of your knot is where the discomfort is, using the ball will quite possibly get completely rid of it.

    However, if the cause of your knot is in the muscles of your chest, ribs or at your waist or beneath your armpit, those areas need treatment, too. And you can self-treat the same way–by applying pressure with a hard rolled up piece of carpet or a ball. If you feel tenderness there, that’s a clue that those muscles are tight and in need of release.

    If you can figure out what causes your pain (The way you sit or run? Computer use? Sleeping position?) and stop doing that action or alter the way you do it, that should keep it from coming back.

    The slow, deep breathing acts as massage, too, for all of the muscles around your chest and that’s a good thing.

    Good job getting rid of your muscle knots naturally!

    The Pain Relief Coach

  9. Kristen says:

    My arm is very week and it feel like its atrophied slightly. My neck muscles are so tight. I see a massage therapist, acupuncturist, physical therapist, and chirp. Just saw a nuerologist and seeing an orthopedist today. I’ve been trying to do releases at home but not sure I’m hitting the correct spots. My should on that side has fallen slightly and I have forward head posture. I’ve been doing everything right now I’m afraid my arm and that side of my body will never be the same. Should u run off and get surgery or something? I’ve been trying to open my chest cause I can’t breathe deep. I don’t know who else to see or what to do. Any advice?

  10. Dear Kristen,

    If the doctors are not seeing anything to cause this in their tests then my best long-distance guess is the tight muscles in your neck. I wonder whether the muscles below your armpit in your ribs and back are pulling your shoulder down? I wonder whether you have some curvature in your spine?

    All massage therapists are not the same; we have different training, personalities, etc. Some do great relaxation massages but don’t know how to release neck muscles or help ‘straighten people out.’ If your massage therapist is not addressing your tight neck muscles and forward posture (and she’s not, right?) then it’s time to find one with more advanced training.

    Massage can truly be therapeutic and is non-invasive. I don’t know where you are located but there are therapists around the country who are very skilled. Not a lot but some. And they are worth seeking out. You could ask friends for referrals if they have had good pain relief or look for neuromuscular massage therapists. Check with the Paul St. John clinic in FL and ask for referrals to therapists in your area. Also look at this website and you will discover more about the power of massage. (Carpal Tunnel Syndrome is also caused by tight neck muscles.)

    Also there is a diaphragm muscle below your lungs that can be released if it is tight and causing your shallow breathing. That’s the same muscle that makes up hiccup.

    I hope this helps you get rid of your symptoms and get rid of your tight neck muscles naturally.

    The Pain Relief Coach

  11. Errol says:

    Hi Kathryn, I have this pain, almost constant in my left upper back. There is no shoulder or neck pain. I do get pain down the back of the upper arm. I have had xrays and CT scan of neck and xrays of upper spine and doctor says there is nothing there. The original pain came when I was stretching during a yawn! I have had physio and chiro with minimal pain relief. Please help.

  12. Hi Errol,

    It sounds like the scalene muscle in your neck on the same side as your back pain. When the tests show ‘nothing’ that generally means muscles. Start exploring the muscles on the side of your neck and see if you find any tender areas and if they refer to your back pain.

    Or, find a skilled massage therapist who can release (relax) your scalenes. Just ask them if they know how (too many don’t) before you make your appointment.

    I hope this helps you get rid of the constant pain in your left side upper back quickly!

    The Pain Relief Coach

  13. jimmy says:

    I keep having shoulder blad pain on both sides in sharp and sometimes sore knots. I rub tjhem and they make me feel so numb in my upper body. I sat at the computer alot and have had sciatica diagnosis in the past. been leaning up against a door frame and letting thew edge hit those places and it brings relief but it seems the pain is moving to my neck to. How long does it usually take to get relief from these things. I am sure there are alot of stress and tension in these areas and I have had a heart xray and they said its fine. These feelings of tightness set off panic attacks in the past but now I somewhat understand why I feel almost out of body from the numbness and soreness, just looking to get rid of them all together. I started yoga today. Just thougth I woudl see if anyone had a suggesstion on other methods to get those knots out.

  14. Hi Jimmy, A couple of things come to my mind based on your description of your discomfort.

    1. The muscle that is sandwiched between your ribs and shoulder blade is ‘tight’ and needs to be more moveable. Yoga will help and I’m glad you are taking it. Walking like a lion, on all fours, trying to roll your shoulder blades as a lion does when it walks can also help.

    2. I really feel that the muscles in your chest and the front/sides of your neck are a big cause of your discomfort. If you go to you will find articles that can help you strengthen the muscles in your back (important) and stretch the muscles of your chest and the fronts of your arms (also important.) I hope this helps you get rid of the shoulder blade pain.

    By the way, the shoulder blade pain and knots are just symptoms. The causes are the muscles I mention above and maybe a few more, too. Good luck and have fun with the yoga classes!

    The Pain Relief Coach

  15. Buddy Smith says:

    I have a knot/lump in my rib cage under my arm by the left shoulder. The knot/lump is bad enough sometimes that I can not sneeze or take a deep breath or cough. I can’t sleep with the pain either. I take Goody powers and that helps a little but not much. Tried muscle relaxers, pain meds, heating pad (heat increases the pain), and my wife massages it (gives a little relief till she stops). I can not lift things cause I don’t have the strength and it makes the pain worse. If I hold my arm up over my head I can breath, cough or sneeze (still tender but not as sore). The pain hurts all in my shoulder, the area where the knot/lump is and goes down my arm as far as the elbow like electricity. What could it be and what can I do for it?

  16. Hi Buddy, I believe I responded to you by email previously, but here is more.

    When heat increases the pain, that means switch to cold packs instead.

    It sounds as though the muscles at the outside of your back, under your armpit is ‘too tight.’ Does that sound like the area you are describing?

    Ask your wife to pinch those muscles–under your armpit, on the side of your back. Not just the skin, but the muscle. If she is in the right place, you will most likely really FEEL it! It will cause discomfort. But if she can hold that ‘pinch’ for a minute or so, in about 20 minutes you will notice less of your symptoms.

    Also, there is a muscle that is sandwiched between your shoulder blade and ribs that may be involved. (It’s rarely just one muscle; all of the surrounding–and even distant–muscles can join the party.) You can mobilize and help stretch that muscle by rolling your shoulder blades, as a lion does when it walks.

    Hope this helps you get rid of that knot in your rib cage under your shoulder.

    The Pain Relief Coach

  17. patricia kirwin says:

    Hi, I was in car accident 4 months ago. 2 weeks later was having severe spasm in upper rt. Of back between shoulder, and spine. Went to 2 different hospitals er. Was told had strained synthetic mucle. It took about 4 weeks not being able to do anything because
    spasms ,pain were so intense. When finally got better, didn’t last long. Now I continue having spasams but have expanded to under arm and muscles around rt.around the whole rt side of torso, down whole rt. arm. Fingers, have intense pain in elbow.cant hardly sleep on my left side. In pain everydafyy. Please help me. I’m miserable.
    Thank You

  18. Hi Patricia. At this time, I’m thinking that the muscles that are involved have changed. They may have been in your upper back at the time of injury, but now, it sounds like they have moved to the area under your right arm and on that side of your torso. The muscles in the underarm/side of shoulder blade area are referring pain into your arm.

    What to do? Have someone grab and pinch the muscles under your armpit/next to your shoulder blade and also slightly lower on the same side. It will not feel good. They want to grab the muscle, not the skin. If they can hold for about a minute, the muscles will start to relax after a while (maybe 20 minutes later.)

    Ideally, if you can go to a massage therapist, you would ask him or her to work on your latissimus (lats) as well as the whole area around your shoulder blade and even your rib muscles on your right side and your pectoral muscles on your upper chest.

    You can also use cold packs to help relax those areas. You can also stretch those areas when they are warmed.

    These muscles may have been involved in the first place but now they are hollering at you.

    I hope this will help you get rid of the muscle spasms around the right side of your chest. I’d love to know how you are doing.

    The Pain Relief Coach

  19. Cody Padgett says:

    Hi, So last July I was grappling, training MMA. We had a good 2 hour session. In that time I would like to add I did land on my head, hard enough for blood to come out of my nose, but we did continue. After that I developed Tendonitis in both of my arms. I have had this before, so I thought no big deal it will just heal as it did before. But I did not let it rest. I continued to push through the pain and kept working my physically strenuous employment. It started with the basic discomforting pain, and my right arm eventually healed fairly quirky. But my left persisted, and developed into a twitch behind my left eye, and small twitches down my entire left side. All while keeping the same symptoms of stained muscles/tendons in my bicep. I would like to add I continued working through all of this pain and discomfort. Eventually the bicep pain went away entirely, but the twitching did not! I developed into what feels like a knot under my shoulder blade, causes small irritation toward my chest, and the feeling of having a rotten tooth on my left side, which I do not. Finally I got so sick of the pain I tapped/gave in, I first went to see an acupuncturist. Which seemed to only make the pain worse, I mean it felt like it helped. But it was sort of like waking up a sleeping giant, and made my pushing through a days work more difficult. I did that a couple of times and then sought the help of a Chiropractor. Which again seemed to help, relieving the pain significantly, no more twitching, but made work more difficult. During this time I finally told my employer and was put on light duty, which is very hard for me considering I am so physically active. So I was wondering to myself was the Chiropractor actually helping? Or is it the fact that I am not lifting heavy objects any more? So one day I did lift heavy for a bit, and by the end of the day it was like my shoulder would not sit down and relax. It brought back the pain in my back and the pain over my collarbone going up to my jaw. Which had diminished a lot, but had not gone away completely. I would like to add I have developed some inflammation in my armpit, which has subsided a bit with all of this treatment. I am wondering if it is a pinched nerve or tendon and the Chiropractor is helping, or is the simple fact that I am actually resting it the result of my relief? My theory is that the fact that I did not rest my Tendonitis my body reacted and made an internal splint tightening up the muscles, which resulted in my pinching of the nerves or tendon.s The fact that I let this continue for seven plus months is the cause of my long recovery time. The fact that I am right handed and in return my right side is stronger, was the fact it was not affected so. It has been two weeks since the start of my rest and I am getting better. I would just like to know your thoughts on my condition, any information will help.

    Sincerely, Cody

  20. Hi Cody, Thank you for writing. You provided me with a lot of information about your neck and shoulder injury. I’ll give you my best long-distance response.

    It sounds like you did some damage to the nerves in your neck and/or shoulder girdle and probably to the muscles, too. Muscles refer pain into all of the areas you mention but the twitching makes me think of nerve impingement (which could be caused by pressure from either bone or muscle.)

    It sounds like your current state of starting to feel better was a combination of both: The chiropractor helped (I’m thinking he distracted/stretched your neck?) AND taking a break from the heavy work which gave your body a chance to heal helped, too.

    So I think you had more than tendonitis. I suspect nerve impingement. Nerves send messages to muscles and muscles can go into spasm from either nerve messages or muscle overuse/overstretch. Muscles will splint to avoid damage. And they are really good at splinting (going into protective contraction) but they aren’t so good about relaxing afterward.

    I suspect it’s more likely that your right side was less affected simply because of the direction of your neck/body during the injury.

    You may know that I am highly biased about massage. It can have tremendous benefits. I don’t know whether your chiropractor is also using soft tissue/massage techniques. I would strongly suggest seeing a massage therapist who specializes in injury rehab. At this point, more muscles have become involved. Muscles work together as a group, so an injury may start in only one area but surrounding muscles get in on the fun, too.

    The muscles in your arm pit, behind your collar bone, in your upper chest, upper back, neck (including the sides and front of your neck) and in the subscapularis muscle (sandwiched between your shoulder blade and ribs) would all benefit from treatment. There may be more than those involved but they would be a good start.

    There is a shoulder-blade-lifting muscle (levator scapularis) that was in spasm and when that muscle became ‘too tight’ it pulled on your shoulder blade and caused the muscles around that bone to start complaining again.

    You are getting better–this is good. I would still suggest massage therapy to seek out and eliminate any muscle issues that linger to prevent future discomfort. And you do NOT want a practitioner who does relaxation massage or who blasts away on your ‘knots.’ Find a therapist who will dance around the knots and find the causes for them. The therapist will then get rid of the causes of the knots. This will help you to recuperate more completely.

    The chiropractor can help realign your bones and take pressure off your nerves but in the end, in my mind, muscles always win. Using both massage and chiropractic can work, too.

    Cody, do not rush the healing. If you resume heavy training before you are completely healed, you are setting yourself up for more injury. Athletes hate to hear that but it’s true.

    I hope this helps you in attaining a complete recovery of your neck and shoulder injury and that miserable knot in your back.

    Take care,
    The Pain Relief Coach

  21. mike says:

    I have a knot in my shoulder and it caused terrible pain in my neck and shooting pain down my arm and loss of strength in my right hand. My doc sent me to PT and it actually got the pain out of my neck and arm. I got all my strength back in my hand as well but I still can feel the knot in my shoulder area. I went to see a specialist and they gave me x-rays. Doc told me everything looked ok and that I have a small muscle beside my shoulder blade that just needs massage therapy. Does this sound right? Can that muscle in my back really cause a herniated disk in my back? If so should I just continue to get massages and stretch daily? It’s gotten a lot better since 5 months ago but I’m worried they might not really know what’s going on.

  22. Hey Mike, Your doctor is exactly right! A muscle ‘knot’ can cause a herniated disk in your back or neck.

    You see, muscles are attached to bones and the disks are between bones. When a muscle becomes too tight–spasm or contraction or ‘knot’–it pulls or pushes the bones or disks in the spine. Bones and disks cannot move on their own. Muscles are the movers!

    But what is the reason for that knot in your right shoulder? If you are right-handed (I’m suspecting so) the muscles in the front of your chest and right upper arm are probably somewhat shortened (from daily use) and they are basically pulling on your back muscles. This causes the muscles in the back (the ‘knot’) to complain and become tight themselves. It’s a different type of contraction (muscle shortening) than the front muscles have.

    So, to get fully rid of the knot near your shoulder blade, massage to the muscles in your upper chest and front of your upper arm is needed, too.

    When you stretch, be sure to stretch those front muscles and open up the front of your body. You can do this by laying at the edge of your bed on your back and letting your arm stretch gently backward and upward. (Pretend you are a butterfly, flying.) When you do this thoughtfully, you will probably be quite amazed at the various areas that you can feel pull in front.

    And, when tests show that nothing is wrong, that’s good news! It almost always means that muscles are involved and muscles are treatable. 🙂 I am impressed by your doctor’s knowledge.

    Good job getting rid of the shooting pain in your arm and, now, the knot in your back next to your shoulder blade.

    The Pain Relief Coach

  23. TIA says:

    I have pain around my shoulder blade that will radiate down my arm to the inside of my elbow and the outside of my forearm. It is usually after work and when sitting. It’s not bad during the day. Movement doesn’t hurt it more and raising my arm straight up relieves the pain. I had a broken collar bone on that side that didn’t heal straight and my shoulder is a little lower too. Lying down takes all the pain away. Could it be trapped nerves around the collarbone area?

  24. Hi TIA, Yes, it could be trapped nerves around the shoulder blade. It could also be trigger points in the muscle on the bottom 2/3’s of your shoulder blade on that side. Pressing into the back of lower part of your shoulder blade (like with a small, firm ball) will help that area relax. If the muscle there is tight and needs to relax, it will be pretty uncomfortable to press into. About 20 minutes after laying on a ball like that, you may very well notice that the pain is gone.

    Pay attention to the position you are using when sitting. You may be leaning or slouching in a way that causes the area around your shoulder blade to ‘cramp’ or tighten. If so, you can change the position.

    Tight muscles under your armpit and shoulder blade and in your upper chest (pecs) will cause your shoulder to be lower, too. Stretching up is good! Lengthen the short side which is quite possibly your dominant hand side.

    Take care.

    The Pain Relief Coach

  25. Sheeja Jeffry says:

    Hi Kathryn,
    Trust you are doing great.
    This is for my husband who is 48 years old. He keeps having sharp and acute pain just below his left shoulder on the upper arm . He cannot lift or do anything much with his hand.We are not sure if it is a muscle or a nerve catch. He says it is not related to the heart because he does have a heart problem and has a stent on in 2011 as his left artery was 90% blocked. He says that pain that he experienced during the heart problem is totally different than this pain.
    He did have an accident 26 years back and had cut his right shoulder bone and he does not have muscles on his right hand. He is on his medications for the heart. Could you please help on this, should we go and meet a doctor and would like your suggestions on which doc is the right one to meet.

    Thanks & regards,
    Sheeja Jeffry

  26. Sheeja Jeffry says:

    Hi Kathyryn,

    Can you please respond to my questions that I posted at 11.5 am on 28th Aug 2017.

    Sheeja Jeffry

  27. He Sheeja, I apologize for my long delay. I had been having problems receiving notifications but hopefully that has been resolved. Kathryn

  28. Hi Sheeja,
    I’m doing very well, thank you! I’m sorry to hear about your husband’s shoulder. His pain is just below his left shoulder on his upper arm. So it hurts when he lifts his arm and feels like it could be nervy pain? Does this pain run down the back of his arm? Is it below his shoulder blade/arm pit or is it higher on his shoulder? Is there any discomfort at all in his arm? If so, where? Does he sleep on his side or back? My email should be working better now and I hope to see your responses soon. I’m hoping that I will be able to suggest you see a therapist who works with muscles or even suggest do-it-yourself therapy to you rather than a doctor. Again, I apologize for my delay. I knew I was missing emails but they were just gone. 🙁
    Thank you,
    Kathryn Merrow
    The Pain Relief Coach