What causes the pain between your shoulder blades?

Could it be stress? Overwork? Old age? Arthritis? Or maybe your nerves or bones?

Would you be surprised if I told you that the cause was most likely…in most cases…muscles?

But not any old muscles.

Overstretched muscles cause most back pain, especially pain between the shoulder blades.

Pain between your shoulder blades and spine can be on both sides or just one side, depending on how you use your body. Some people only get pain on the dominant side, which means if they are right-handed, the right side of their back will hurt.

When your muscles are continually overstretched, like your back muscles are if you have “forward head” posture, they have to react. If they did not react, the muscles would tear and we would be unable to function.

So, instead of tearing, the muscles “splint” themselves.

They become taut and protect themselves from being damaged or ripping off the bone. (Although that can happen in extreme cases.)

When your muscles become taut (taut:  a rope being pulled from both ends that can’t relax because no one will let go) they become less able to function fully.

They also become crabby.

The overstretched muscles are working way too hard. They are not working the way they were designed to work. Muscles are supposed to help us move. They let us flex and bend and stretch.  That’s their job.

Bones are supposed to support us. That’s the job of bones.  We are not supposed to use our muscles as bones.

Here’s good news:  You can stop your muscles from being overstretched!

You can get your muscles back to being the way they used to be, but it will take some time and effort and you’re the only one who can do it. Well, you could get some help to loosen up from a knowledgeable massage therapist, but basically you are in charge.

The reason I said a knowledgeable massage therapist is because many of them only work where it hurts–your back, in this situation–and your back pain is the symptom, not the cause.

There is a big difference between a symptom and the cause of the symptom.  He or she will also need to loosen the muscles in front of your body.

  • You need to eliminate your forward head or forward arm posture to stop overstretching your back muscles.
  • You need to strengthen your back.
  • You will have to practice lifting your shoulder blades and rolling them backward, so they will become more movable.
  • Practice squeezing your shoulder blades toward your spine.
  • Read the rest of the articles here.

The purpose of this article and this site is to help you get rid of the miserable knots in your upper back.  You will find lots of additional articles about natural ways to get rid of the pain between your shoulder blades here and there is a free report waiting for you at http://KnotsInYourBack.com that will help you understand WHY you have muscle knots and WHAT you can do to get rid of them.


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27 Comments on What Causes Muscle Pain Between Your Shoulder Blades?

  1. Justin says:

    I have had terrible rhombiod pain.. a muscle knot in my back for years.. It cme from playing vdeo games day after day.. now whenever I sit in a chair they doesn’t have good back support the pain is horrible.. I’m a college baseball player and never have time for extra workouts for my back nor the time to go to therapy.. IM STUCK BUT I JUST WANT THE PAIN GONE 🙁

  2. Hi Justin, Please see the answer to your other comment. I want your upper back pain to be gone, too!

    The Pain Relief Coach

  3. Zachary says:

    This pain makes my neck hurt (down the sides). Feels like there is something sticking in them causing them to be extremely stiff.

  4. Hi Zachary, There are muscles on the sides of your neck that can be very tight. There are two, one on each side. They go from the notch between your collar bones to your skull behind your ears.

    Do you remember The Hulk television character? When he would flex his muscles those muscles on his neck would pop out.

    These are fairly large muscles and are called the sternocleidomastoid muscles. Does this sound like these could be the muscles that make your neck hurt?

    The Pain Relief Coach

  5. Gina says:

    My upper back spasms that I have are due to breast enlargement.. My implants are 1.5 years old but the pain has gotten much worse in the last few months. Can you recommend strengthening excersises for my upper back, please. The chronic pain is effecting every aspect of my life.

  6. Hi Gina, If you are feeling a little self-conscious about your breasts now that might be causing you to slump or slouch and that strains back muscles.

    And depending on the weight of the implants, they can pull you forward and down, too. There are easy ways to strengthen your back and you can do it at home and even in bed! There are a lot of simple strengthening movements at http://SimpleStrengthening.com

    http://www.simplestrengthening.....free-body/ is one article that can help.

    Here’s another: http://www.simplestrengthening.....lade-pain/

    That article has back strengthening ideas. It’s no fun having pain like yours and there are simple ways to start getting a strong back.

    I hope this will help you start getting rid of your chronic back pain quickly!

    The Pain Relief Coach

  7. Gina, Did you see this article here? http://www.simplebackpainrelie.....back-pain/

    The Pain Relief Coach

  8. Pamela says:


    I have had pain between my shoulder blade and spine for about four months now on my dominant side. Sometimes, it burns when I sit at the computer too long, but most days it just aches in the romboid area. I have done 3 months of physical therapy, but the pain doesn’t go away. My PT thinks it stems from my neck (which doesn’t hurt!) I have purchased a foam roller, neck ease and special pillow for my neck and do the PT exercises daily, I workout once per week with a trainer to strengthen muscles and pay for some massage therapy – all to no avail. My pain is still there. In 2009, I had this same pain and PT helped after 2 months. This time, I have made an appointment with a sports medicine docter but it isn’t for two more weeks. Any advice would be greatly appreciated – should I keep doing the exercises and massage therapy even though they haven’t worked yet? Should it take this long to go away?

    Thanks so much!

  9. Hello Pamela,

    The burning in your rhomboid area is caused by that area being over-stretched. The burning is a symptom.

    The neck could be involved if the scalene muscles on the side of your neck are causing you to have a ‘knot’ in your back. That may be what the PT was thinking. The scalene muscles can have trigger points that cause knots in your back but they can also be caused by mechanical over-stretch.

    Are you working the the trainer to strengthen the muscles in the back of your neck, back and thighs? And to stretch and lengthen the muscles in the front of your body from knees to chin?
    If so, you are working to re-balance your body.

    Since there is an excellent chance that the muscles in the front of your body are too strong-tight-short already, they don’t need strengthening. They need lengthening.

    There are ways to sit more comfortably at the computer. Using a mouse? Try this:

    1. Switch hands. It really can be done. 🙂
    2. Bring your elbow closer to your waist when you work–no stretching. Stretching aggravates muscle in the rhomboid area–it gets overstretched and complains.
    3. No slouching. A strong back will help prevent slouching.

    The foam roller is excellent for laying on to allow you to stretch and lengthen the muscles in the front of your chest and arm. If it’s narrow enough for you to lay on long-ways (with the full length of your spine and head on it) you can also use it as a tool to squeeze your shoulder blades against. That will help strengthen the muscles between your shoulder blade and spine. Then those muscles can better hold their own against being over-stretched.

    Pamela, I hope this helps you feel better quickly! You are doing lots of right things but you may have to make some tweaks to get rid of this nasty ache in your rhomboid.

    The Pain Relief Coach

  10. Chirag Patel says:

    Hello, I am having pain between spine and right rhomboid for a month.It is caused by my gym exercises. I joined gym last month. I used to do push-ups and lifted some weight. I am a skinny boy of 23. I am taking ultrasound therapy,doing some back strengthening exercises and quit gym. But it isn’t helping me. Every time the exact point of pain changed in that area. What should I do? Is it require serious attention? Please help I want to join gym again.

  11. Hi Chirag, It sounds like you are telling me the location of the pain is moving around?

    For the time being, it is probably best to concentrate on the back strengthening movements rather than for the chest or biceps. The first step is usually to get rid of any areas of muscle restriction but you also have to start using the best posture. That’s why strengthening your back will help.

    If you are able to have massage therapy, a skilled therapist could probably locate areas of muscle that need attention. The best way to rehabilitate an area is to first remove any trigger points or restrictions in the muscles and soft tissues.

    Stretching the muscles in your chest and upper arms will help balance your body. Stretch the front–strengthen the back.

    Make sure your head is not in front of your body. If your ears are over the midline of your shoulders (or close) it will help prevent neck muscles from triggering pain in the area of your rhomboid. Also, your rib muscles on your sides are probably short or tight or strong and may be pulling you forward so it’s good to stretch them, too.

    Rotating your shoulder blades will help relax all of the muscles that attach to them. Up and back, up and back. Try to roll them like a lion.

    I cannot say whether you temporarily damaged a muscle but if you correct your posture and take care of your muscles the discomfort should start to go away within a few weeks.

    Please read more articles here for more ideas about how to get rid of this pain in your upper back naturally.

    The Pain Relief Coach

  12. Lori says:


    I have always had problems with my left shoulder. I had very large breast when I was in my teens and my left shoulder used to pop out of socket. I had a reduction when I was 17 and it got better. I am now 29 and have had two babies and my breast are a little bigger again. I am a petite woman and I am not overweight or anything. I do cardio five times a week such as Zumba workouts and do not lift any weights. I do feed my baby on the left side always and I carry my very heavy purse on the left side. It only hurts if I move my arm a certain way, like when I squeeze my shoulder blades together or if I lean my neck to the left. I am right handed and never have trouble out of my right side. Weird to me, but it has always been this way. I have been to the chiro and had massages and they help for a while, but the pain always comes back. Any suggestions? I would be soooo appreciative!!!

  13. Hi Lori,

    Here are my best long distance thoughts.

    Why do you always feed your baby in the left arm? Why do you carry your purse on that side? Why is your purse very heavy? Could you switch to a lighter bag, back pack or hip pack?

    I’m thinking of a few possibilities: 1. You have scoliosis or curvature of the spine and have had it for a long time. I might guess this because you had the ‘pop out of socket’ issue. 2. You have developed a habit of hiking your left shoulder. I could guess this from the heavy bag and holding baby. 3. Or maybe you had an old injury to your shoulder muscles. If some of the muscles of the shoulder were weakened it would allow the joint to ‘pop’.

    What would I suggest? Switch back and forth from side to side when feeding baby. Place a pillow under baby and your arm so you don’t hike your shoulder and so your arm will be more relaxed.

    Switch the bag to your other shoulder. I know it will feel like it will slide off but it may not. And it will help level your shoulders.

    Stretch your right side by stretching your arm up and away from your body. Yes, I said your right arm. If your left shoulder is hiked that means your right shoulder is lower. The plan is to get them to be level.

    The pain comes back because the cause isn’t being addressed. Someone (perhaps a massage therapist with this training) has to LOOK at your posture and body. Then they can determine whether you have a curvature in your spine and which muscles need to be released or relaxed to help with the curve.

    I hope these ideas help you get rid of your shoulder pain quickly.

    The Pain Relief Coach

  14. Lori says:

    Thank you for your response. I do believe I was told I had a slight curvature of the spine when I was in school. When the chiropractor took x rays of my lower spine he said I was very rotated to the left. He has not x rayed the upper, he just adjusted it. It just feels so odd to feed the baby on the right side and I do need to empty my purse! I will try these things and see if it helps! Massage tomorrow! Thanks!

  15. Dear Lori,

    Thank you for your update and you are welcome! The question now is: Why are you rotated to the left?

    It could be a leg length difference or it may be caused by one flat arch or by habitually using the same position, i.e., always sleeping on the same side or crossing the same leg over the other leg.

    Take care,
    The Pain Relief Coach

  16. Shelley says:

    Hi Kathryn,

    I’ve read all your responses and am not sure if my problem is in there. I have had a few bad car accidents (last one 7 years ago) and so I’ve had a lifetime of back pain which rotates around from lower to upper to shoulder to neck. Most recently it has affected my lower back and left hip. The pain was so bad I cried. It was right in the hip joint and it wrapped around to the front of my quad. The chiropractor, after about 4 sessions, fixed me right up! Unfortunately, everything has moved up to my neck and upper back. We’re not having too much success now. I actually feel fantastic during the day and I’m able to work out regularly. However, after a good night’s sleep I wake up with terrible pain in my upper back all across the shoulder blades. My right rib was out of alignment and I had him adjust it yesterday. This morning I woke up with about 30% less pain but it was all still there. Any suggestions? I was going to try rolling on my foam roller.


  17. Dear Shelly,

    Thank you for writing. Here are my best long distance thoughts:

    The clues you sent make me think of abdominal muscles or the muscles in your neck on each side (scalenes) or maybe the diaphragm muscle below your ribs.

    Do you sleep curled up in a ball? On your side? With your head tucked way forward and down? Those are things that will over-stretch and aggravate muscles on the back side.

    There may be multiple things going on to cause your pain. And the low back is attached to the neck so what aggravates on one end can easily aggravate on the other.

    Rolling on the foam roller is probably a great idea. Do you stretch the front of your body? Or is most of your treatment geared to the back side?

    When ribs are out of alignment it is because muscles are moving the ribs. Figuring out why the muscles are getting tight and pulling on bones is a first step. That’s why I asked about how you sleep.

    It’s good that you can work out but do you focus on all the sides of your body? Right now, my gut feeling is that doing things to strengthen your abdominal muscles may not be a good idea. Rather, lengthen them.

    I hope this gives you some help getting rid of the pain that is rotating around your back.

    The Pain Relief Coach

  18. Kushal says:

    I have had pain between my shoulder blade and spine for about 10 years now. It’s on my right (dominant) side. I also have pain in right side of neck (might be just next to c6 or c7). I am feeling very tight or spasm between shoulder blade & spine and also in neck. Whenever I roll my shoulder (front to back or back to front), I hear some popping sound from my upper back. I am 26 year old. I had X-ray and MRI for my back and there is no sign of anything that looks obvious. I had lots of PT sessions to understand good posture and back stretching exercise at work so, I am regularly following that. I already tried TENS unit but no sign of improvement. I also had acupuncture therapy but no sign of improvement. Last week my doctor tried Trigger point injection and I still having pain. Would you please let me know what might be root cause of this pain?

  19. Hi Dave,

    My best long-distance assessment based on what you told me is that there are tight muscles under your right armpit/shoulder blade and/or that you use a phone or cell phone a lot. Are you hiking your right shoulder when you use the phone? Or are you propping the phone between your ear and shoulder?

    The popping just means something is tight. It could be tendons slipping over bones or it might be vertebrae (spine bones) ‘cracking their knuckles.’

    When tests come out fine that almost always means muscles are the culprits.

    Since this has been so long-standing, I wonder whether you might have a curvature of the spine or a rotation. But that should have been readable in an x-ray.

    The treatments that aren’t working are not working because they are only shooting at symptoms and are missing the cause.

    The point about trigger point therapy or injections is they are supposed to address the areas that are causing the pain rather than the painful areas. A hyperirritable area of muscle or other soft tissue (not bones) will ‘fire’ pain or symptoms elsewhere. A trigger point may be completely unnoticed by you, but the area the TP fires into will be very obvious. If you treat the painful areas, they cannot go away–you have to find the cause and relax it, weaken it, get rid of it.

    I would suggest that you go to http://CarpalTunnelPainReliefNow.com and scroll down on the right hand side and find the blue book about self-treating Trigger Points. Excellent book! You might just end up being your own therapist as Claire had to do. Easy to read and do.

    I hope this helps and thank you for writing. I believe you will be getting rid of the root of your shoulder blade and spine pain soon.

    The Pain Relief Coach

  20. Ogechi says:

    Hi, im a 15 year old basketball player, and ive had pain between my shoulders,and in the middle of my backs for months. The pain starts as ache then the pain increases and spreads. I had either torn or severely strained my rhomboid?(between shoulder blades) muscle about 7-9 months ago? Its really distracting me from the game and im on varsity so practices and games are rough. Help I dont think i can handle the pain much longer.

  21. Hi Ogechi,

    1. When you get the ache, it is probably indicating that area is being stretched too much and doesn’t like it. The ache and spreading pain is a complaint. It’s also called a symptom. It’s possible that you injured the muscle and that it needs some manual therapy (massage or tennis ball rolling) to settle down but I’m thinking (long distance) that it’s more likely related to rounded back posture. Could that be?

    2. Rhomboids get blamed all the time when it’s hardly ever their fault. But there are other muscles in the same area and they could be complaining or to blame, too. But blaming the rhomboid tells me exactly the area you mean.

    3. Try this: Squeeze your shoulder blades toward your spine. What kind of sensation does that cause? Can you tell that’s what’s needed? Or, does it feel inappropriate? If it feels good or like “good pain” that’s what is needed. If it feels “wrong” massaging the area might help the most. The idea behind massage is to warm the muscles and cause them to be healthy and supple. If someone presses on your rhomboid area and it doesn’t feel appropriate or like “good pain” then that is NOT where the problem is.

    4. Your chest and arm muscles may be much stronger than your back muscles. If that’s why your back is complaining then your back needs to be strengthened and your chest muscles stretched or lengthened. Also, include strengthening for the back of your neck. That will help your posture and take the strain off the rhomboid area.

    I hope this helps. Please write again if you need or want more info or have more comments or clues for me. Also, there are lots of helpful self-help articles here at Simple Back Pain Relief including how to use tennis ball therapy.

    The Pain Relief Coach

  22. Rebecca says:

    Hi Kathryn, the past week I’ve been seeing a doctor for numbness in both hands and feet. That they haven’t found an answer for yet. But with that I’ve also had muscle pain between my shoulder blades. It is worse at night and almost unbearable. It keeps me awake half the night and often I have to
    get up and walk around hoping that it will ease some. I had also recently recovered from bronchitis in the last month were I had a continuous cough, unsure if that could be assiciated. Hope you have some idea or info that could help. Tired of hurting. Thanks Rebecca

  23. Hi Rebecca, Here’s the link to an article I wrote that may help http://simplepainrelief.com/20.....-and-feet/

    Where is your head at night? Do you have it propped up high with pillows? If so, that can strain the muscles in your neck and that, in turn, can cause numbness and tingling sensations in your hands.

    Does your pain start as soon as you lay down? Or in an hour? Is the numbness and back pain new since the bronchitis?

    The more clues I have, the better my long-distance ‘guesses’ get. 🙂

    Thank you for writing,
    The Pain Relief Coach

  24. Deanna Gillis says:

    I have Gerd. I have heartburn and pain between my shoulder blades. Is this related? Also, I do have muscle damage in my neck. Could this be a factor?

  25. Hi Rebecca, Thank you for your question. Yes, the pain between your shoulder blades can come from the heartburn/Gerd. It’s a referral–that means the problem is in one area but it refers to another area. The problem is in your esophagus but you feel the symptom between your shoulder blades.

    Is the muscle damage in your neck caused by the Gerd or by something else? Did you know that your muscles–inside and outside–can heal when the cause of the damage or pain goes away?

    The muscles on the outside of your neck can cause pain elsewhere around the neck, like in the head or shoulder area or upper arms and chest. IF the pain wraps around the side of the shoulder blade that is closest to the spine, it could be from your neck muscles, depending on which muscles in your neck are damaged.

    Please let me know if this isn’t clear. You are welcome to send me more information.

    Take care,
    Kathryn Merrow
    The Pain Relief Coach

  26. Renee says:

    I have a tiredness between my shoulder blades. It really is not painful, but I get it often when I’m doing things like sweeping the floor or sitting too long. Even though it is not really painful, I do have to sit for a few minutes after doing a chore until it eases up. There is no other discomfort in my back or neck. Only right between my should blades???

  27. Hi Renee,

    I am so sorry for my delay in responding! The tiredness between your shoulder blades now will become pain in your back in the future but you can stop it!

    What’s happening is the muscles in that area are being stretched more than they like when your arms and shoulders are in front of your body. The solution is to strengthen those muscles! And it’s easy!

    You can do this in any position and any time of day or night. My favorite way to do this is to lay flat on my back. That way, gravity helps with the movement. Just roll your shoulders back a little and let them lower and relax. And then, squeeze your shoulder blades together.

    Only squeeze them toward your spine two or three times the first few days, two times a day, so you don’t get sore muscles. After 3 or 4 days you can start to increase to more times. I do this many times a day.

    When I show that movement to most people, they say, “Oh, that feels good!” But sometimes, a body just isn’t used to moving those muscles yet and they feel stiffer. Something in your question makes me feel that you will be one who says it feels good!

    When your muscles in your back are strong, they won’t be overwhelmed with tiredness when you work or sit. They will be more in balance and will be able to hold their own when you work instead of getting strained.

    I hope this helps you get rid of that tired feeling between your shoulder blades, Renee. In fact, I know it will. 🙂

    Kathryn Merrow
    The Pain Relief Coach