--- title: "Shoulder Blade Pain: Causes and Treatment" description: "Pain around or between the shoulder blades: muscular, postural, neck-related and other causes, and when to seek urgent care." date: 2026-10-24 lastmod: 2026-11-02 canonical: https://drmotiva.com/en/articles/shoulder-blade-pain/ lang: en --- # Shoulder Blade Pain: Causes and Treatment Pain around the shoulder blade (scapula) or between the shoulder blades is common, especially in people who sit for long periods. Most causes are muscular or related to the neck, but some need prompt attention. ## Common causes - **Myofascial pain:** tender, tight bands in the muscles around the shoulder blade [2] - **Posture and scapular dyskinesis:** altered movement of the shoulder blade, which can also contribute to shoulder problems [1] - **Neck problems:** cervical disc or facet problems can refer pain to the shoulder blade - **Notalgia paresthetica:** itching or burning in a patch of skin near the shoulder blade, linked to nerve irritation [3] - Rarely, heart, lung, gallbladder or other internal problems **Seek urgent care** if shoulder-blade pain comes with chest pain, shortness of breath, sweating or fever. Further reading: the [guide “Cervical Disc Herniation”](https://drmotiva.com/en/guides/cervical-disc-herniation/) and the articles [Supraspinatus Tendinitis (Rotator Cuff Tendinopathy)](https://drmotiva.com/en/articles/supraspinatus-tendinitis/) and [Frozen Shoulder (Adhesive Capsulitis)](https://drmotiva.com/en/articles/frozen-shoulder/). ## Treatment - Exercise focusing on scapular control and posture - Physiotherapy, including manual therapy - Workstation adjustments and regular breaks - Pain medicines and, for myofascial pain, trigger-point injections in selected cases ## Anatomy in brief The shoulder blade (scapula) is a flat, triangular bone that glides over the back of the rib cage. Muscles such as the trapezius, rhomboids, levator scapulae and serratus anterior hold it in position and move it. Nerves from the neck supply these muscles and the overlying skin, which is why neck problems commonly cause pain around the shoulder blade. ## Risk factors - Prolonged sitting and screen work with rounded shoulders and the head forward - Repetitive overhead work or carrying heavy bags on one side - Stress and poor sleep, which increase muscle tension - Sudden increases in training such as rowing, swimming or weight training - Age-related changes in the neck ## Assessment The examination covers neck movement, nerve-root tests, shoulder movement and the position and motion of the shoulder blade (whether it lifts away from the rib cage, known as winging). Tender muscle points are checked. Imaging is not routinely needed. X-ray or MRI of the neck may be used if nerve-root symptoms or persistent pain are present, and further tests are arranged if a non-musculoskeletal cause, such as heart, lung or gallbladder disease, is suspected. ## Rehabilitation - Exercises to strengthen the muscles that stabilise the shoulder blade - Mobility exercises for the upper back and neck - Postural awareness and changes to work habits - Gradual increase of activity and fitness The programme is planned by your physical medicine and rehabilitation specialist and the physiotherapist. Whether an injection is suitable is decided after examination. ## Home measures - Set your screen at eye level and keep your arms supported when working - Take short movement breaks and do shoulder rolls regularly - Apply heat to tense muscles if it helps - Carry bags on both sides or use a backpack - Pay attention to sleep and stress, which affect muscle pain ## Red flags Seek urgent care for shoulder-blade pain with chest pain, shortness of breath, sweating, nausea or fainting; fever; pain after significant trauma; pain that is constant and unrelated to movement; or new weakness or numbness in the arm. Unexplained weight loss or a history of cancer also needs prompt assessment. ## When to see your physical medicine and rehabilitation specialist Seek assessment if pain is severe, keeps getting worse, wakes you at night or does not start to improve within a few weeks; if numbness, weakness or any warning sign appears; or if you are unsure what your test results mean. Your physical medicine and rehabilitation (PM&R) specialist, a doctor trained to diagnose and treat musculoskeletal and nerve problems without surgery, examines you, explains the findings and plans treatment together with the physiotherapist. Whether injections or other advanced treatments are suitable for you is decided by a PM&R specialist after examination. Prof. Dr. Engin Çakar works in this field and can be consulted online or in person; otherwise, please consult a PM&R specialist near you. To make the most of the consultation, it helps to bring: - A short timeline of your symptoms and what makes them better or worse - A list of your medicines and other health conditions - Previous imaging (the images themselves, not only the reports), test results and treatment summaries - Your questions and goals, such as returning to work, sport or a particular activity ## Frequently asked questions **Can sleeping position cause shoulder-blade pain?** It can contribute; an appropriate pillow and position may help. **When is imaging needed?** When symptoms persist, there are neurological signs, or a non-muscular cause is suspected. See [Neck pain radiating to the shoulder](https://drmotiva.com/en/articles/neck-pain-radiating-to-shoulder/). **Is a “winging” shoulder blade serious?** It can result from muscle weakness or, less commonly, nerve injury. It should be examined, and EMG may be needed. **Does massage help?** It may provide short-term relief, but active exercise and changes to daily habits usually provide more lasting benefit. ## Assessment and contact You can request an appointment or a second-opinion review of existing reports and imaging: [Contact & second opinion (WhatsApp)](https://drmotiva.com/go/wa?l=en&t=&loc=inline_contact&p=%2Fen%2Farticles%2Fshoulder-blade-pain%2F). This page is general health information. Diagnosis and treatment decisions are made individually after examination. ## Sources 1. Kibler WB, et al. Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg. 2012. [PMID: 22661566](https://pubmed.ncbi.nlm.nih.gov/22661566/) 2. Steen JP, et al. Myofascial Pain Syndrome: An Update on Clinical Characteristics, Etiopathogenesis, Diagnosis, and Treatment. Muscle Nerve. 2025. [PMID: 40110636](https://pubmed.ncbi.nlm.nih.gov/40110636/) 3. Robinson C, et al. Notalgia Paresthetica Review: Update on Presentation, Pathophysiology, and Treatment. Clin Pract. 2023. [PMID: 36826171](https://pubmed.ncbi.nlm.nih.gov/36826171/)