Why Do I Always Hurt Between My Shoulder Blades?
It’s happened again. You were minding your own business, packing for your much needed getaway to the mountains (or beach, or city…whatever you like) and suddenly you felt this aching pain in between your shoulder blades! It feels like a muscle is just really tight back there, so you try to massage it out in a really awkward position, and it just doesn’t seem to get any better! What the heck is going on??
It could be a lot of different things, but the one that I want to talk about- that you may not expect- is related to the discs in your neck. We see people all the time who have been massaging their upper backs and strengthening their rhomboids (the muscles in between your shoulder blades) for months, and their pain hasn’t gotten any better. But then they come to see us, we have them move their necks in a few different directions, and all of a sudden they realize that the between-the-shoulder-blades-pain is changing when all they’re doing is moving their neck!
Way back in 1959, a guy named Dr. Ralph Cloward published a study describing an experiment where he surgically stimulated the discs of the cervical spine (the neck), and found that his subjects in the study felt pain around the inside edge of their shoulder blade when he was stimulating those discs! Here is a great graphic from that paper that demonstrates what he found:
The gray dots on the right are representing the discs in the neck, and the gray dots and dotted areas on the left (in between the shoulder blades) are showing where a person feels pain when the areas in the neck are irritated. That’s right, the pain may not actually be coming from the muscles in your upper back at all! These discs can get irritated from all sorts of different things. Lifting weight overhead with poor form, repetitive stress to the neck from looking down at your phone or laptop for a long time, sleeping in an awkward position, and the list goes on and on. The great news is, this type of irritation is super common, and not at all something to get worried about as long as you know what to do to calm it down! One helpful strategy can be to get your neck moving repeatedly in a certain direction. I’ve demonstrated that movement below:
Try repeating this movement 10 times, making sure not to tilt your nose up or down. Your head should just move straight backward. If it’s too uncomfortable to do this is a sitting position, you can do it with a pillow behind your head while leaning back in a recliner or even lying on your back. In these positions, you would be pushing your head straight back into the pillow that is supporting you. As this gets more comfortable you can try moving into an upright sitting position again.
Often, when you start this exercise, you’ll feel the pain wake up a little more, but if you keep repeating it the pain can fade away. If this movement helps the pain, keep doing it repeatedly throughout the day! Often, if our patients can do this exercise 6-10 times throughout the day, along with avoiding a few positions that can put stress on the irritated tissue, that annoying pain between the shoulder blades clears up relatively quickly. Just remember, if you deal with this pain on a pretty regular basis, there may be some more strengthening that we need to do to keep the pain gone for good. If you’d like some help, we can look into all of the things that can cause you to hurt in between your shoulder blades, find the root cause of what’s going on, help you get out of pain, and keep it gone. Let us know if we can help!
Cloward RB. Cervical diskography. A contribution to the etiology and mechanism of neck, shoulder and arm pain: Annals of Surgery. 1959;150(6):1052-1064.
