Aching, painful pain under the shoulder blades could be a muscle strain or something more serious like a heart condition or cancer. Diagnosis depends on physical exam, review of medical history and blood tests. Imaging studies such as X-ray, CT scan or MRI may be needed.
Treatment varies by the underlying cause. For musculoskeletal injuries it may include rest, ice and over-the-counter nonsteroidal anti-inflammatory medications.
Exercises
In most cases, the best treatment for shoulder blade pain is exercise. This builds strength to support the injured area and relieves tension in stressed muscles. However, it is important to stop exercising if the pain worsens.
One simple exercise is to stand with the back of the neck against a wall. Extend the arms out to the sides, squeezing the shoulder blades together and then bringing them in toward each other. Repeat this exercise a few times per day.
Other exercises that may help include rolling the shoulders forward and backward to reduce stiffness. You can also try linking your hands behind your back and pulling down gently to stretch the shoulders. Another option is to roll a foam roller or massage ball around the shoulder area while lying down, stopping at the spot (or spots) of most intense discomfort and pressing gently with the roller or ball for 30 seconds. Daily self-massage using this technique can be very helpful in reducing discomfort.chiropractor in my area
Massage
Massage is a great way to relax the muscles in your upper back and shoulders. You can use a massage gun or other hand-held device to help break up muscle knots that may be causing shoulder blade pain. A variety of over-the-counter creams and rubs are also available to reduce pain in this area.
A professional therapist can help you identify the muscles and areas that need work, as well as provide manual manipulation to loosen stiff or misaligned joints. They can also teach you stretches and exercises to strengthen your shoulder and back muscles.
If you are self-massing your shoulders, try to work only on the areas that are painful or sensitive. You can use a tennis ball or massage ball and place it between your spine and the inner border of your shoulder blade to target the levator scapula and trapezius muscles. When you find a spot that is tender, massage that area very gently and carefully.
Over-the-Counter (OTC) Medications
Medications can relieve pain in some people with shoulder blade pain. Medications that you swallow can work on pain receptors in the brain and reduce inflammation. Examples include acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB, others), and naproxen sodium (Aleve). You can also try topical creams and gels that contain 10% menthol, such as Icy Hot or BenGay. These products can be used on the skin for about 20 minutes a few times a day.
Tight muscle knots or tense muscles can also cause pain in the area between your shoulder blades. These knots are called trigger points. Trigger points may develop after overuse or injury, and they can also be caused by some health problems, such as a gallbladder problem, like inflammation (cholecystitis). Pain under the shoulder blade that radiates to other areas of the chest and abdomen is a sign of a possible heart attack. If this occurs, seek emergency medical care. You should also see a doctor if you have other symptoms, such as chest pain and shortness of breath.
See a Doctor
It’s important to see your doctor or a physiotherapist if you have persistent shoulder pain or if the pain is getting worse. A number of different conditions can cause pain around the top of the shoulder blade. These include problems with the neck spine, such as a herniated disc or spinal stenosis, and arthritis in the thoracic area of the spine. Other conditions, such as fibromyalgia, can also cause shoulder pain and fatigue.
It’s not always easy to figure out what is causing the pain, but it’s best to get a diagnosis so that you can take steps to treat or manage the condition that is causing the shoulder blade pain. Most shoulder pain responds to rest, activity changes, a physiotherapy program and sometimes to OTC medications like aspirin, ibuprofen or naproxen. Surgery is rarely needed. But any pain that lingers for weeks and interferes with work, sleep or activities should be evaluated by a healthcare provider.