Sharp Upper Back Pain Between the Shoulder Blades: Causes and Treatments
Muscle strain, injury, or overuse is the most common cause of upper back pain.
Pain Between the Shoulder Blades: Should I Worry?
The most common causes of upper back pain are muscle strain, injury, poor posture, and other lifestyle habits. Sometimes, however, upper back pain can result from underlying conditions that are more serious.
In this article, you will learn about a number of possible causes, symptoms, and treatments for this type of pain.
When to See a Doctor or Call 911
You should see a doctor if your back pain has lasted for longer than 2 weeks with home treatment.
See a doctor immediately if you're experiencing:
- New loss of bladder or bowel control
- New numbness in legs or numbness that's getting worse
- New weakness in legs or weakness that's getting worse
- New or increased back pain with fever
- Painful urination, or other symptoms of a urinary tract infection
- Pain that is getting worse or pain you can't manage at home
Call 911 immediately if:
- Your back pain coincides with chest pain or other symptoms of heart attack like sweating; shortness of breath; nausea or vomiting; pain, pressure, or a strange feeling in your back, neck, jaw, upper belly, or one or both shoulders or arms; feeling dizzy or lightheaded; or a fast or uneven heartbeat.
- You are experiencing signs of severe injury to the spine after a fall, such as being unable to move part of the body, severe back or neck pain, weakness or tingling in the arms, legs, chest, or belly.
Possible Causes of Back Pain Between the Shoulder Blades
Muscle Strain, Injury, or Overuse
This is the most common cause of pain between the shoulder blades
Cold and hot compresses, stretching, and back exercises, along with over-the-counter pain killers
Smoking, obesity, poor posture, and stress can all contribute to upper back pain
Osteoarthritis (Swollen Facet Joints)
A common cause of back pain
Weight management, physical activity, stretching, and medications (prescription or over-the-counter)
Though they occur most often in the lower back, herniated disks in the neck can cause pain between the shoulder blades
Most people can treat at home with exercises and over-the-counter pain medications. Medical help may be necessary in some cases.
This is a type of radiated pain — a gallstone blocks a bile duct and causes a sharp upper back or rib pain that is felt in the right shoulder.
See a medical doctor for treatment of gallstone and pain
Home Treatments for the Most Common Upper Back Injuries
Pain between the 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, such as spinal issues. These cases, however, are very rare.
If you are experiencing sudden pain in your upper back between or under your shoulder blades, and you have not been in a sudden injury, you should take steps to treat at home.
HealthLine recommends treating your upper back pain by applying cold compresses for 3 days, then alternating with hot and cold compresses and doing back stretches until the pain goes away. The pain can erupt suddenly, but healing might take a long time, up to one month even.
If your neck or back was injured by something like a car accident or sports injury, you should see a doctor immediately.
According to Everyday Health, some long-term lifestyle changes that could help your pain include:
- Losing weight
- Exercising and stretching — a strong and flexible back is less likely to get injured
- Improving your posture
- Purchasing more supportive shoes, choosing a better desk or chair, or getting a new, firmer mattress
- Buying more supportive bras
- Being careful of carrying too much weight in a shoulder bag
- Quitting smoking
Treatment and Causes of Different Types of 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 a more serious condition as the main problem.
Here's how to troubleshoot your pain and find out what the cause might be.
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 to you, because the thought of moving your aching back will only cause more discomfort, thus preventing you from performing any 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.
- Also see the back exercises from HealthLine, including the I-Pose, the W-Pose, and the Head Tilt.
- Consider exercising, opting for routines that benefit the upper back. If lifting heavy objects is a regular part of your day, 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 your 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 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 it slides off, you need to keep working on your posture.
- Make sure you are maintaining good posture throughout your day. If you work a desk job, get a chair that supports your spine and make sure you're not straining your neck to look at your computer.
- Follow the above suggestions for two weeks to a month and observe if the pain between your 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 (osteoarthritis) 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 may 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 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.
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 could indicate the emergence of something more dangerous.
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.
Other Causes and Treatments for Upper Back Pain
About the Spine
There are three major parts that 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.
Osteoarthritis (Swollen Facet Joints)
Swollen facet joints, or osteoarthritis, 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, such as turns and bends. 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 can 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 cause pain. 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.
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.
- 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. The pain between the 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 of 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 serious variants require powerful prescription drugs.
- Natural remedies (though not extensively studied) may provide some relief. Acupuncture, massage, supplements, and transcutaneous electrical nerve stimulation are all some methods that have worked for others.
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 are 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 (this is the most common), 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 in 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 the 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 loss of bladder control.
Treatments for this medical issue are similar to the ones developed for arthritis. 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.
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 may radiate 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 and 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 — usually in the upper right part of the abdomen, though it can also radiate to the right shoulder. Other conditions may also cause biliary colic, such as tumors and strictures along the bile duct.
One-third to one-half of all people who have a gallstone episode never have it come back again, so your doctor might recommend a wait-and-see option.
People who end up needing treatment have some options — you should consult your doctor to see what they may be. There are some non-surgical ways to attempt to remove gallstones, though surgery may end up bing necessary.
You might be asked to take NSAIDs, antibiotics, spasm fighters, and anti-nausea pills. Aside from that, you may 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 might be able to 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. Though not well-studied, 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.
If You Still Have Concerns, Consult Your Physician
This sums up everything you need to know about upper back pain between the shoulder blades. Proper evaluation is necessary to determine the appropriate treatment. What’s important to remember is that when it comes to back pain, it is essential to take it seriously. It might be a sign of something that could potentially cause irreversible damage to the body.
Before making assumptions, it is best to seek the opinion of a medical professional. Proper diagnosis is the first step toward recovery.
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