Shoulder pain and pain behind the shoulder blade are quite different. Most of the time, shoulder blade pain does not originate in the shoulder. Read on, to know about the causes of pain behind the shoulder....

Study reports and statistics reveal the fact that more than 4 million Americans seek medical attention for painful shoulder conditions, every year. It has been noticed that pain behind the shoulder is a very common complaint. Sometimes, it is referred to as back pain between the shoulder blades or upper back pain.

Shoulder blade or scapula is a triangular bone which has ridges on its ventral surfaces. The tendons at these ridges provide for the attachment of scapula to the muscles. Inflammation of these tendons can lead to back pain between shoulder blades. The pain can be one of the early symptoms of heart attack, if it is a pain radiating from the chest towards shoulder, arm or face.

Due to upper back pain, one may not be able to lift one or both the arms properly. There can be restricted 'upper body movement' too. One may not be able to carry objects with ease. Severe discomfort can be noticed while standing, bending, sitting or even while sleeping. If you experience mild to severe pain in the shoulder blades while working or resting, and if the pain persists beyond a few days, you should consult your physician. There exist several causes of pain behind shoulder blade. So, an accurate diagnosis is very crucial. Correct and prompt diagnosis helps design proper treatment.

Causes of Shoulder Blade Pain

• Injuries: Structural injuries to the bones, ligaments, tendons etc. or injuries causing shoulder dislocation or shoulder separation can lead to shoulder pain. A rotator cuff (structure consisting of muscles and tendons, supporting the shoulder and promoting arm movement) injury can result in upper back pain. Rotator cuff exercises, under the guidance of an expert may help relieve the pain gradually.
• Diseases/Disorders: Pain behind right shoulder blade can be experienced even in case of inflammation of gallbladder or occurrence of gallstones. Inflammation of pancreas, pleura or pericardium, stomach or intestine ulcers, pulmonary embolus, pneumonia and aortic dissection can also lead to upper back pain. Certain diseases like multiple sclerosis or bone cancer can be the cause of shoulder pain.
• Heart Diseases: Some underlying heart diseases like angina, can result in pain behind the left shoulder blade. The pain may radiate upwards to the face or down to the left arm. Any kind of pain, whether dull or severe, from the left shoulder radiating to the arm can be an early symptom of heart attack.
• Frozen Shoulder: Inflammation in the ball-and-socket joint of the upper arm bone and shoulder, may lead to adhesions (i.e. unnatural connections) within the joint and also to contraction of its 'capsule'. This condition can lead to frozen shoulder and pain.
• Bursitis and Tendonitis: Pain behind the shoulder can occur in case of bursitis (inflammation of the bursae) or tendonitis (inflammation of the tendons) of rotator cuff; or calcific tendonitis of rotator cuff (calcium deposition within the tendon).
• Pinched Nerve: Pain between the shoulder blades can be caused by a trapped nerve in the arm or a pinched nerve in the neck. The pain would be accompanied by neck pain and restricted movement of the neck and shoulder.
• Wear and Tear: Rotator cuff tears may occur due to long-term wear and degeneration of the soft tissues of the shoulder during the process of aging. Untreated tendonitis can lead to rotator cuff tear, resulting in shoulder pain.
• Bad posture: Improper body mechanics can lead to upper back pain. The spinal cord should always be upright while sitting, standing, working or walking. Excessive bending of shoulders or back can lead to shoulder pain.
• Cancer: Metastasized breast cancer in the shoulder or breast cancer surgery can lead to pain behind the shoulder blades. Cancer of the upper end of the humerus (bone in the upper arm) can result in such pain.
• Respiratory Problems: Lung problems or cervical spine problems or strained muscles during muscle cramps can cause pain behind the shoulder during deep breathing.
• Pulled Muscle: A pulled shoulder muscle due to over-stretching, flexing, extending or rotating of the arm or shoulder joint can lead to upper back pain.
• Other Problems: Bad habits like imbalanced diet or insufficient sleep can increase the risk of developing pain in the shoulder.
• Excessive Stress: Constant physical or mental stress can also lead to shoulder or back pain.
• Common Bone Diseases: Arthritis (inflammation of joints) and osteoporosis (diminished bone density) can lead to pain behind shoulder blade.

To treat the back pain between shoulder blades, anti-inflammatory pain medications are prescribed by the doctor. You can use ice packs or heat pads which help relieve the pain. Sufficient rest promotes for fast recovery. Shoulder exercises should be performed under the guidance of a physical trainer. Physical therapy and massage work great for lower and upper back pain. In some severe cases, doctors may recommend cortisone injections. Correct diagnosis and prompt treatment can offer you quick relief from pain and can help you move freely.