Sharp Upper Back Pain Between Shoulder Blades: Causes and Treatments

What could be causing the sharp upper back pain between shoulder blades?
What could be causing the sharp upper back pain between shoulder blades?

Pain Between the Shoulder Blades: Should I Worry?

Many who experience upper back pain (between the shoulder blades) think that they’re suffering from a common, harmless problem. They might think that they just slept in the wrong position or they’ve just been working out too much, that the problem is merely muscular and will heal itself.

Even though it is possible that this pain stems from bad posture and/or excessive movement, there’s also a chance that it's a sign of a life-threatening disease so, instead of dismissing the pain, it’s much wiser to spend a little time doing research.

Below, you'll find many other common causes for back pain between the shoulder blades.

Many separate muscles come together at the shoulder blades, making that area prone to strain or injury.
Many separate muscles come together at the shoulder blades, making that area prone to strain or injury.

Upper Back Pain Caused by Spine Issues

Upper back pain between shoulder blades can be due to a number of possible issues. In most cases, muscular irritation is the culprit. Depending on the symptoms it could be a sign of something more serious; particularly, pain in the upper back could be related to spinal issues. These cases, however, are very rare.

Three major parts form the spine; the cervical spine or the neck, the thoracic spine which holds the middle-back portion of the body, and lastly, the lumbar spine which is located from the waist down.

Most of the upper body's mobility is focused on the cervical and lumbar spine -- they can be moved from left to right, and angled to the front and to the back. Motion in the thoracic spine, on the other hand, is limited. Because this part of the spine holds the most vital organs of the body, its main function is to shield and protect. Restricted mobility happens to be a great advantage because this prevents injury and degeneration.

When problems do occur, however, you may encounter one of the following medical conditions:

Swollen Facet Joints

Swollen facet joints can produce aches in the upper back. Facet joints are the small stabilizing joints located between and behind adjacent vertebrae. The spine’s flexibility is provided by these joints: in other words, they’re necessary to carry out many kinds of movement (turns and bends are just a few examples). As with any other part of the body, facet joints aren’t invincible. If used too hard or too often, they end up damaged and swollen and of course, swelling leads to soreness.

Facet joints can get swollen if they are able to rub on each other because the padding between the vertebra has worn down. The gaps of the vertebra are occupied by cartilages, which is lubricated by synovial fluid to protect it from wear and tear.

Imagine a crunchy toast sandwich with a layer of really thick cheese in the middle. Think of the toasts as the vertebra, and the cheese as the intervertebral discs (made of the cartilage and synovial fluid). When the sandwich is pressed on one side, the cheese will prevent the toast from touching each other. The same happens when the spine angles and curves.

Due to a number of possible reasons like aging, injury, and too much pressure, the intervertebral discs lose their thickness and springiness, narrowing the gap between the vertebrae and facet joints. If you repeat the process of pressing the sandwich on one side, the toasts will touch and grind against each other. Imagine the corners of the crunchy slices as the spine's facet joints, and crumbs falling from an abrasion.

The pressure and scraping can develop something called bone spurs. These are the source of the swelling. They can grow larger and more painful if left unattended.

The same thing happens in other joints. In fact, this kind of condition is more common in the knees, since it's the most mobile part of the body, and one that carries the most weight. This is generally known as arthritis. If the swelling happens on your spine, on the other hand, it is more accurately called as osteoarthritis.

If this sounded bad enough, however, the next medical issue will seem like a nightmare. Though many professionals view this second condition as separate from the first, this can actually be the result or the effect of a swollen facet joint.

Herniated Disc

A herniated disc is another problem that can prove to be extremely painful. Spinal discs are rubbery pads between the vertebrae in the spinal column that work like shock absorbers. In childhood, the discs are gel-filled, but they begin to solidify as we get older. By middle age, the disks become as inflexible as hard rubber and more prone to injury. With injury or stress, a disc's inner material may swell outward, pushing through the outer shell, pressing against surrounding nerves, and rendering that area more prone to injury.

Swollen joints and herniated disks cause pain. However, the pain caused by the latter tends to spread discomfort along the arms as well and may be accompanied by numbness.

Depending on where a herniated disc occurs along the spine, different symptoms and numbness will be felt.

Should the affected intervertebral disc be somewhere in the lumbar region, the nerves connecting the spine to the lower body will be pressed and pressured by the leaking or swelling. This, in turn, will cause the numbness, tingling, or pain on the legs.

On the other hand, should this condition happen along the cervical region, pain and numbness will crawl from the shoulders down to the arms. In the worst cases, the patient will show neurological symptoms.

When it comes to thoracic herniated discs, however, there will be upper back pain between shoulder blades, which can radiate to the upper chest and belly. Luckily, this herniation is rare because of the thoracic spine's restricted mobility.

The last and worst is the herniation towards the spinal cord. When this vital part of the spine is pressed, it causes myelopoathy or spinal dysfunction. Should this form of herniation be at its worst, the patient's entire lower body will not function entirely. Milder effects include loss of balance, weakness in the lower extremities, and bladder control loss.

Disc problems that may cause back pain.
Disc problems that may cause back pain.

Pain Caused by Bile Problems

The human body moves in mysterious ways, especially to non-experts. Since you're experiencing pain in your back, it's only logical to assume the problem is within the area. There are instances, however, when the issue is rooted deeper within the body.

Biliary colic is another medical issue that might cause back pain and shouldn't be taken lightly. This is a type of pain that occurs when a gallstone blocks a bile duct and causes a sharp upper back or rib pain that radiates to the right shoulder. It may manifest after ingesting a fatty meal in an episode of sharp, intense soreness that starts near the abdomen and branches out to the upper-back region and may be accompanied by nausea and vomiting.

Bile is made in the liver then stored in the gallbladder. Its primary purpose is to digest and break down fats entering the body. Therefore, when food enters the body, bile will automatically travel from the gallbladder via the cystic duct to the small intestine to continue the food's digestion.

This simple process can be interrupted by gallstones. These small but highly irritating nuisances block the cystic duct, making it difficult, if not impossible, for the bile to pass through. The body will respond to this problem by continuously contracting the muscle cells of the duct to remove the gallstone. This vigorous contraction can cause pain between your shoulder blades. Other conditions may also cause biliary colic, such as tumors and strictures along the bile duct.

How to Treat the Pain

Initially, you need to make sure your back pain is not caused by simple conditions like muscle strains due to poor standing and sitting positions, faulty executions of physical activities, or excessive weight lifting. Of course, other causes include aging and constricted ligaments. These issues can be alleviated by simple massages or a change of habits. If the pain persists, however, then it may be time to consider the more serious conditions mentioned above as the main problem.

Here's how to distinguish facet joint issues, spinal disc troubles, and bile-related problem from one another and what to do next.

Is it a brief, mild ache?

If so, this could indicate mere muscle strain, but it could also be either swollen facet joints or herniated discs. Experiencing this kind of soreness is a nuisance at best. Doing chores and completing office work should still be possible, but even the mildest pains could turn into more serious issues if proper actions aren’t taken. That’s why these steps are important to remember:

  • Rest for a while and see whether the pain subsides.
  • If the aching stops, consider these suggestions:
  • Do some stretches before engaging in any more physical activity. This may seem ridiculous for some, because the thought of moving their aching backs will only cause more discomfort, thus preventing them from performing their tasks. Understand, however, that the spine along with the ligaments and muscles around it are designed to move. Keeping it idle will only prolong the back pain. You need to warm the body up before doing anything extensive, and slow and simple stretches will do the trick:
    • Back Flexion Exercise. With your back laying flat on a yoga mat, or anything that will prevent you from touching the cold floor, slowly pull your knees to the chest, as you flex your head forward at the same time. There’s no need to force yourself into this balled-up position. Keeping a comfortable stretch is more important. Go back to your starting position in a slow release of the stretch.
    • Knee to Chest Stretch. Again, lie on the floor. Bend your knee while keeping the heels rooted. Hold the back of one knee with both hands, then slowly bring it toward the chest. As previously stated, it’s more important to keep the stretch comfortable. There’s no need to push yourself to complete the extent of the exercise.
  • Consider exercising, opting for routines that benefit the upper back. If lifting heavy objects is a regular part of your day, then keeping a strong back is essential, and there’s no other way to build it but through regular exercise. Not only will this relieve pain between shoulder blades, but it will also prevent it from coming back. There are several back--strengthening calisthenics, and these can be classified to the three major parts of the back; upper, mid, and lower back.
    • Upper Back Exercises: Push-ups and dips — These will benefit your arms more, but it will also indirectly strengthen your shoulders and the muscles between.
    • Mid-back Exercises: Pull-ups and chin-ups — These two especially build the lateral muscles.
    • Lower-back Exercises: Sit-ups, lying leg raises, pilates bridge, floor hyper extensions, and back hyper extensions.
  • Avoid additional strain by avoiding sudden movement.
  • Exert effort to correct common posture problems. There’s no other way to achieve this than by being mindful of your posture. If you don't know what a correct posture is, put a book on your head and keep it from falling off when you stand and walk. A perfectly straight back and angled head will prevent it from sliding off. If is slides off, you need to keep working on your posture.
  • Follow the above suggestions for two weeks to a month and observe if the pain between shoulder blades subsides. If your problem is a simple muscle strain, your back's condition should greatly improve. Otherwise, keep observing your pain and ask yourself the following questions.

Would you describe the pain as long and moderate?

If so, this could indicate the presence of swollen facet joints or herniated discs. In this case, medical attention might be necessary. Moderate pain that stays for half an hour (or more) sometimes means that the problem has worsened. If the pain gets worse, doctors will have to use certain imaging technologies (such as X-Ray for facet joints and MRI for herniated discs) to determine the extent of the damage.

Is the pain intense and accompanied by numbness?

If the episodes of soreness are almost unbearable and there are instances in which certain parts of your body feel numb (or in some cases, tingling), then it’s definitely time to pay a visit to your physician. Together, such symptoms are considered a telltale sign of serious spinal disc dilemmas. If left unchecked, a severely herniated disc could even cause paralysis or permanent nerve damage.

Is your noticeable pain accompanied by nausea?

Periods of upper back pain between the shoulder blades that are accompanied by nausea are indicative of biliary colic. In fact, some medical experts suggest that it’s best to immediately call for an ambulance if this combination of symptoms manifest. Also, those who’ve been suffering from aches after they’ve eaten (another warning sign) should be especially wary of these simultaneous symptoms.

Sharp Upper Back Pain between Shoulder Blades - A Must Read Primer
Sharp Upper Back Pain between Shoulder Blades - A Must Read Primer | Source

Solutions and Treatments

Each of these issues is solved or managed in very different ways.

Swollen Facet Joints

As discussed above, the mildest joint troubles could be prevented from becoming worse through fairly simple techniques, such as maintaining proper posture and avoiding sudden movement. If more severe, the condition might require the aid of a physical therapist to help with strength and flexibility. Individuals suffering from more serious cases of facet joint concerns are given these options:

  • Undergo a procedure called "nerve blocking" so that the soreness would immediately subside. This would involve steroid injections to block the pain.
  • If surgery is not a preferred method, a number of other treatments can still be opted for by patients.
    • Proper exercise -- This, of course, should be according to a physical therapist’s instructions. The results from this method will, however, take longer to surface. Pain between shoulder blades will remain for a couple of weeks, but if the patient is mindful enough of his body, he will notice the slight decrease of aches after every session.
    • Warm or cold presses (heat wraps and cold pad applications, for example) –This can alleviate episodes pain.
    • Alteration of daily activities– You need to reduce physically exhausting routines like long commutes, or increase times of rest breaks.
  • Take painkillers and muscle relaxants on a regular basis. While minor cases of the spinal problem can be effectively handled using over-the-counter medication, the condition’s more alarming variants require powerful prescription drugs.

Herniated Discs

Treatments for this medical issue are similar to the ones developed for swollen facet joints. Doing spine-enhancing exercises and being mindful of the body’s position are more than enough to solve the concerns faced by people with minor disk hernia. Sometimes, anti-inflammatory injections and pain medications are added into the mix. Surgery is only reserved for very severe cases. After all, it’s the solution that comes with the most risks.

Know, however, that a single combination of conservative treatments does not work for all. Patients will have to undergo a process of trial and error to know what will be effective for their condition. For instance, physical therapy may not work as good as pain relief for some.

Should the person undergo surgery, the process will not exempt him from undergoing physical therapy and learning proper lifting techniques and such. This is a part of recovery that will help prevent the development of another herniated disc.

Biliary Colic

People who develop this disease undergo a treatment process that takes advantage of four different types of medication. In particular, they’re asked to take NSAIDs, antibiotics, spasm fighters, and anti-nausea pills. Aside from that, they’re also told to pick among the many ways of cleansing the gallbladder and the bile duct. Well, only one of those methods isn’t surgical in nature – oral dissolution therapy (unlike surgery-type solutions, it doesn’t work fast).

If a health professional confirms that gallstones are the cause of your biliary colic, then you can opt for natural remedies to alleviate the pain and dissolve the stones altogether. Like with oral dissolution therapy, however, it won’t work as fast, and this means, the sharp upper back pain between shoulder blades will stay for a while. These remedies involve the ingestion or herbs such as ginger, cascara sagrada, and homeopathic cheledonium. Before proceeding with these treatments, however, you should still consult with a professional.

Furthermore, there is no better pain relief and prevention than to avoid fatty meals. As explained earlier, bile is essential in digesting fats. If no fat is entering the body, then there wouldn’t be a need for the liquid to pass through the bile duct, thus saving you from the pain that comes with biliary colic.

Preventive Measures

Soreness in the upper-back region shouldn't always be dismissed as a minor problem. In some instances, the aching sensation is a sign of spinal degradation. In others, it indicates the emergence of a dangerous digestive system disease.

People who’ve been experiencing it shouldn't wait until their health worsens before consulting their doctor.

Serious medical issues concerning upper back pain between shoulder blades have been enumerated and explained above, along with symptoms and treatments. If your back pain happens to be caused by simple muscle strains, this does not exempt you from the possibility of acquiring the more serious ones.

Do not wait for these issues to develop. Prevention remains better than cure, thus you need to establish habits that will save you from these pains.

Tip 1: Correct Diet
The food you eat has a lot to do with your overall health. But what’s important in the preventive stages is to moderate your food intake. You can still eat whatever food you like -- nothing is prohibited — but avoid eating too much of one thing.

Tip 2: Regular Exercise
Exercise will not only develop back strength, it will also 1) reinforce the joints of your spine, keeping your intervertebral discs healthy, and 2) help your body utilize the fats and protein that comes along with the food you eat, which prevents the development of osteoarthritis.

This sums up everything you need to know about upper back pain between shoulder blades. Proper evaluation is necessary to provide the exact set of treatments. What’s important to remember is that when it comes to back pains, it is essential to not take the problem lightly, because it could be a sign of something serious that can later on cause irreversible damages on the body.

Before making assumptions, it is still best to seek the opinion of a health professional. They can give a better evaluation of your condition and provide the proper treatments for your back pain.

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A k Jenkins 2 years ago

I just tried to place an order for this Accupressure mat and pillow set, I stay in New Zealand, once I had filled out all my details a note come up saying that, I am unable to deliver to my address!!!

Can you please explain to me 'why not' for I am more than happy to pay nd most importantly I am in so much pain I would really like to try this

healthbooklet profile image

healthbooklet 2 years ago Author

Hi A k Jenkins,

Not sure about that....But added Accupressure ebay listing details in article which has delivery option to New Zealand :)

Hope it helps... :)

msdielise profile image

msdielise 2 years ago

Me too, I sometimes feel back pain. I make my son sit on my back to relieve it. lol.

healthbooklet profile image

healthbooklet 2 years ago Author

@msdielise : my father use to follow that technique ...... :)

StephanieP profile image

StephanieP 2 years ago from Los Angeles, California

Very useful information regarding back pain. I went thru a period of intense pain and I am glad I have that behind me now. It's important to note the different levels of pain and what can be done. Thank you gain for the article.

Lee Hansen profile image

Lee Hansen 2 years ago from Vermont

I've experienced biliary colic and it is horribly painful if you have a gallbladder full of stones and a blocked bile duct. This past winter I injured the connective tissue between my trapezius and spine; it took 6 months of therapy, rest and painkillers but it's finally feeling normal again. Good information here - and well presented.

Tammy 2 years ago

I have a very strange issue with shoulder area pain. I'm from Illinois but moved to Florida for a year. Upon my arrival back to Illinois the first time the time changed on March 20th, 2009 I get a debilitating pain in my shoulder blade area. I can not get any relief from this!! It lasts 6-12 weeks. And ruins my life. It onsets very year since 2009. But after the 6-12 weeks it goes away & I'm perfectly fine. I've used chiropractic care & medical care. No one can give me an answer!!! I've had nerve study , xrays , narcotics ( they don't even touch it). The only thing is this year I flew to Florida a month after onset & pain was completely gone after I got off plane. Came back when I returned. And then I fly to Georgia in June. Left in pain landed and got off plane. Pain free. And it didn't return when I got home. What's going on here????? Anyone?

sunnykmr123 2 years ago

I am doing sitting job. So that I have to sit in office around 8 hour in single day. And I feel back pain sometimes, Is this because of sitting continues 8 hours?

amazaving profile image

amazaving 21 months ago

I find good exercise helps a lot. It's spending hour after hour at a computer terminal that does for me. Thanks for the post, healthbooklet.

Risa Stewart profile image

Risa Stewart 21 months ago from North Carolina

Had to read this. I've been having this as well. I've noticed stretches help. I figured between being top heavy and back problems from a car accident that this would interest me. Thanks!

Kristen Howe profile image

Kristen Howe 21 months ago from Northeast Ohio

Great information. I've been experiencing low back pain for two years, since my Scoliosis rod had wear and tear at the bottom, and had caused a flare up last year. I had Scoliosis for 26 years thereabouts.

Kelsey Farrell profile image

Kelsey Farrell 17 months ago from Orange County, CA

Great information. I've had upper back pain between my shoulder blades for as long as I can remember. When I started working from home it became worse because of the angle I'm at on the computer (without a desk or proper chair I'm forced to type on my laptop wherever I can). Unfortunately, I don't see this pain going anyway any time soon since I live in an apartment and have no room for a desk. Great hub though--with helpful information!

Jim 11 months ago

Very useful information. Well done.

Lori 7 months ago

I have debilitating pain between my shoulder blades, right side.

eilval profile image

eilval 4 months ago from Western Cape , South Africa

All the insightful information is very useful for pain between shoulders and will certainly look at these .

Mamoon 2 months ago

My father have been invoved in the upper back pain between shoulder & backbone

It happens always at mid night his body temprature always getting higher like fever in the body can not sleep in the night but the good part is he is all right in the day but he can't sleep Dr let me just know what is the solution what is the cause.

I dont have any account plz send ne solution if possible at

Deepal 15 hours ago

Please suggest me the proper medicine for rib pain..

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    Sree has been a nutritionist for over 8 years. She has written many articles educating people suffering from various diseases and ailments.

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