Your shoulder blade is the triangular bone that forms the back of your shoulder and facilitates movement, making it a critical part of most everyday activities. When you experience pain in the shoulder blade, you may notice an inability to move your arms and complete other tasks. The causes of this pain can range from innocuous to very serious, so it is important to always seek treatment for shoulder pain from a medical professional. You can continue reading to understand more about shoulder blade pain and what it may mean.
What Is a Shoulder Blade?
The human shoulder is a ball-and-socket joint, but it is unique in that it has three distinct components, where most joints have only two. The head of your upper arm bone (the humerus) is the ball, and the scapula or shoulder blade forms the socket where the humerus sits. The front of the scapula is also connected to the collarbone (clavicle) through the acromioclavicular joint. Muscles and ligaments help your arm and scapula stay attached and allow movement. As you move your arm, the scapula must also move in order to maintain the alignment of the joint.
Symptoms of Shoulder Blade Problems
When something is wrong with the shoulder blade, it can alter the normal resting position of the scapula or the normal motion of the scapula during arm movement. This is known as scapula dyskinesis. This is often visible when looking at a person from behind, as the inner border of the impacted shoulder blade appears more prominent than the other side. The prominence may be exaggerated during movement of the arm. Doctors will often refer to this as a “winged” scapula, and it occurs as a result of the muscles that hold the joint in place being damaged or weakened.
Signs of dyskinesis include:
- Pain in the form of a dull ache or sharpness around the shoulder blade.
- Weakness in the impacted arm, especially when attempting overhead motion.
- Limited range of motion that makes it hard to lift the arm above the shoulder.
- Snapping sounds during movement.
- A visible protrusion of the scapula.
- A tilted posture on the affected side.
In some cases, shoulder blade pain can be related to other problems like a heart attack or cancer, so it is important to take all symptoms seriously and have them evaluated by a professional.
Causes of Shoulder Blade Pain
There is a wide range of possible reasons for pain in the shoulder blades, ranging from injuries to underlying conditions. Some emergency health scenarios can also manifest as pain in the shoulder blades.
Musculoskeletal Causes
When the muscles in your shoulders are strained, they can become weak or stop functioning as intended. This can be a result of poor posture, especially while working on a computer or phone, or overuse during heavy lifting and exercise. Certain activities may cause an acute strain on the muscles as well, even sleeping in an odd position.
Muscle strain is likely in people who have recently started a new exercise program, lifted an object heavier than they are used to, or slept in a new bed.
Chronic conditions like fibromyalgia and myofascial pain syndrome impact the musculoskeletal system and can contribute to long-lasting pain in the shoulders. There is also a condition called snapping scapula syndrome, which involves cracking and popping on the inner side of the shoulder blade, resulting in pain and instability.
Injuries such as rotator cuff tears can contribute to shoulder blade pain as well.
Bone and Joint Causes
A number of conditions of the bones and joints can cause scapula pain.
Arthritis, an inflammation of the joints, can directly affect the shoulder joint or cause referred pain from arthritis in the chest, spine, or ribs. Osteoporosis and degenerative disc disease are also common disorders that contribute to this pain.
Acute issues like a compressed nerve, caused by a displaced disc or spinal stenosis, can also occur. While the scapula is one of the hardest bones to break, a rare fall or severe car accident can cause fractures in the shoulder blade.
Cardiac Causes
A number of heart problems can manifest in shoulder blade pain, including the following:
Heart attack
Along with shortness of breath and chest pain, shoulder blade pain has been associated with heart attacks, especially in women.
Aortic tear
The aorta is a large blood vessel that branches off from your heart. Thoracic aorta rupture, also known as aortic dissection, occurs when a tear or rupture appears in the inner layer of the aorta. Symptoms include sharp, severe pain in the upper-middle back near the shoulder blades.
Pericarditis
Inflammation of the lining of the heart.
These are medical emergencies that require immediate treatment.
Lung-Related Causes
Many people with lung cancer or mesothelioma will experience pain in the shoulders and the shoulder blade. A type of tumor known as a Pancoast tumor can also grow on the lungs and cause these symptoms.
Other lung-related conditions that can cause scapula pain are:
Pulmonary embolism
Sharp, sudden pain in the shoulder blades accompanied by shortness of breath is often reported by those suffering from a pulmonary embolism. This can result from blood clots in the legs breaking off and traveling to the lungs.
Pneumothorax
A collapsed lung.
Chest Wall Causes
The chest wall is composed of muscles, bones, fat, skin, and other tissues that surround the vital organs in your chest. A shingles infection in the chest wall can cause pain in the shoulder blades. Shingles is a condition caused by the chickenpox virus that leads to burning and tingling pain, though the first symptoms will be body aches.
Abdominal and Pelvic Causes
The muscles that separate the chest cavity and the abdominal cavity are known as the diaphragm. If nerves along the base of the diaphragm are irritated, it can cause referred pain in the shoulder and shoulder blade. Abdominal surgery is a common cause of this because of the gas used to fill the abdomen.
Certain conditions can also cause pain specifically on the right shoulder blade: gallstones, peptic ulcer disease, acid reflux, and liver disease. Pancreatitis is more likely to cause pain on the left side.
Cancer
Cancerous tumors that involve the chest are likely to cause shoulder blade pain. This includes lymphomas and cancer of the esophagus, stomach, liver, and pancreas. Cancer that has spread to the bones can also cause this pain.
When to Seek Medical Attention
If your shoulder blade pain is severe, unusual, or does not lessen over time, it is a sign you should see a doctor. Pain indicates that something is wrong, which could be serious. Even if you are not suffering from an emergency, it is important to rule these scenarios out and work towards a reduction of pain.
Certain symptoms that accompany your pain can mean you need to seek emergency care. If you have any of the following symptoms along with your pain, seek immediate help:
- Shortness of breath
- Chest pain
- Lightheadedness
- Excessive sweating
- Pain, swelling, or redness in the legs
- Coughing up blood
- Fever
- Rapid or irregular heart rate
- Sudden difficulty speaking
- Loss of vision
- Paralysis on one side of your body
- Loss of consciousness
If you are not experiencing these symptoms, monitor your pain closely and if it doesn’t resolve or lessen over a few days, make an appointment to seek treatment.
Diagnosis
Because of the range of possible causes, your provider will need to consider many factors when diagnosing your condition. They will usually begin by asking about your symptoms and doing a short physical examination. If you provide thorough details, that may be all they need for an accurate diagnosis. Be sure to share your exact symptoms, any changes to your recent behavior, details on your daily activities, and what makes the pain better or worse.
Your provider may order blood tests to look for inflammation and connective tissue disorders. Imaging studies may also be ordered, such as an x-ray or an MRI, to show the internal workings of your body. Depending on what they want to identify or rule out, a variety of scans could be used.
Treatment for Shoulder Pain
Depending upon the underlying cause of your pain, treatment options can vary and recovery time can range.
Home Remedies
For most minor pain and muscle strain, home remedies can be effective. This includes resting the area, using ice to address pain and swelling, and using over-the-counter pain medication as necessary.
Exercise
While resting an injury is a good initial step to take, it is actually better to slowly introduce movement back to the shoulders. By strengthening the muscles in the back, shoulder pain can decrease over time and occur less often in the future.
It is recommended to work with a physical therapist to create an exercise routine specific to your condition in order to most effectively reduce pain. This will help you to properly address your pain without risking hurting your shoulder further. Common exercises a physical therapist may recommend include pushups, pullups, and situps.
Diet
Certain foods contribute to inflammation in the body, which can worsen symptoms. Processed foods and high sodium foods should be avoided, while fruits and vegetables are always recommended. Foods that are high in omega-3 fatty acids, like salmon, can also be helpful.
Medications
While medication does not address the underlying cause of shoulder pain, it can be used to manage symptoms. This may make it easier to perform activities and exercises that help to heal the shoulder. In most cases, over-the-counter medications with anti-inflammatory properties are sufficient. This includes ibuprofen, commonly sold as Advil or Motrin IB.
For more severe pain, steroids can be prescribed in pill form or given via injection. These corticosteroids are different than anabolic steroids and are meant to reduce pain and inflammation.
Certain conditions can also be helped by the use of muscle relaxers and anti-depressants. Like all medications, these should be taken only when prescribed and in the exact amounts and intervals your doctor recommends.
Surgery
In rare instances, surgery may be necessary to resolve ongoing shoulder conditions. The majority of people are able to resolve their pain with less invasive options, but cases that may require surgery involve:
- Severe shoulder blade pain
- Non-response to more conservative treatment
- Severe arthritis
- Shoulder blade fractures
Surgery may involve removing scar tissue or repairing damaged tendons in the upper back and shoulder. The entire joint can also be replaced with an artificial version through shoulder replacement surgery.
Preventing Shoulder Blade Pain
Some conditions and injuries cannot be avoided, but it is possible to take steps that reduce your risk of experiencing pain.
Tips to prevent shoulder blade pain are:
Maintain good posture
This is one of the most effective prevention measures for shoulder issues. Stand tall, sit upright, and avoid slouching. For those who work at a computer all day, it may be worth investing in making your workplace setup more ergonomic.
Don’t sit for long periods
If you work a sedentary job, stretch frequently and take frequent breaks to walk around. Set a timer if needed. This movement will keep your muscles limber and prevent strain.
Lift properly
Whether you are lifting boxes and other heavy items for practical purposes or you are deadlifting at the gym, it is important to use proper form. Bend your knees first and do not strain when you lift.
Warm-up
Before any workout or exercise, be sure to do some light stretching to help prime your muscles for the activity.
Maintain a healthy lifestyle
Getting enough quality sleep, eating a nutritious and balanced diet, and regularly exercising can all contribute to a healthier body. Managing stress and staying positive can also help you to feel rested and maintain fitness.
If you are experiencing pain in your shoulders, it is important to seek care quickly to address the root cause and eliminate symptoms. At AICA Jonesboro, our team is composed of multiple specialists who can assess and diagnose your condition before creating a personalized plan for recovery. Contact us today to schedule your first consultation!