Pain Between the Shoulder Blades: Causes and When It Is a Warning Sign

Pain between the shoulder blades is a complaint of discomfort in the middle part of the back, the thoracic region. The article covers what causes back pain, how acute and chronic pain differ, and when a doctor is needed. This is reference material, not a substitute for a consultation.

Why the back hurts between the shoulder blades

Back pain is one of the most common medical problems: 8 out of 10 people encounter it at least once in their lives, and 95% of people experience it at some point. Five out of ten working adults feel back pain every year. Between the shoulder blades is the middle part of the back, the thoracic region; in the classification by localization it is called exactly that: pain in the middle part of the back, thoracic.

The cause is not always obvious. A common variant is an injury such as a muscle strain. Less often, pain is caused by conditions such as a herniated intervertebral disc, nerve entrapment, or ankylosing spondylitis. Quite rarely, a serious problem hides behind the pain: a fracture, tumor, or infection. A separate group is referred pain from internal organs. In 90% of cases, diagnostic tests find no physiological causes, and such pain is called nonspecific.

Pain from muscles and the spine

Nonspecific pain is often associated with strain of the muscles or ligaments of the back — yet many cannot recall the event that caused it. Degenerative and traumatic changes of the intervertebral discs and facet joints produce secondary pain in the muscles and nerves. Chronic pain with normal examination results may be explained by central sensitization: after the initial injury, sensitivity to pain remains increased.

Distinguishing musculoskeletal pain from referred pain is the doctor's task. They assess the complaints, the examination, and, if necessary, prescribe imaging: radiography, myelography, discography. People see a doctor if the pain:

• does not go away within several weeks;
• interferes with everyday activities;
• comes specifically from above, between the shoulder blades, rather than from the lower back;
• does not ease after rest or worsens at night;
• worsens when sneezing, coughing, or going to the toilet.

The same applies to unintentional weight loss, swelling, or a change in the shape of the back.

Aching and acute pain: how they differ

Back pain ranges from dull and constant to sudden and sharp. Acute pain arises suddenly and usually lasts from several days to several weeks — in the classification by duration, this is a period of up to 6 weeks. Subacute lasts from 6 to 12 weeks, chronic — more than 3 months. Back pain is the most common type of chronic pain and one of the main causes of missed workdays and disability.

Local, radiating, and referred pain are distinguished: with radiating pain, it is felt both at the site of the pathology and in healthy organs; with referred pain — only outside the site of the pathological process.

When pain between the shoulder blades requires urgent help

Pain between the shoulder blades is not in itself a reason to call an ambulance; 103/112 — if pain between the shoulder blades or in the back comes together with chest pain; both legs go numb, weaken, or hurt; sensation is lost in the genital or anal area; urination or bowel movements have changed (difficulty urinating or you cannot hold urine and stool); there is no erection or orgasm; the pain began after a serious accident.

An urgent visit to the doctor should not be delayed when the pain is severe and appeared suddenly, is rapidly increasing, and also with chills, fever, or general malaise. Chest pain is among the signs for which help is needed immediately. With pain between the shoulder blades that does not go away for several weeks and interferes with life, the path is the same — to the doctor.

The material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer