Medical News Today: What is causing the pain in my shoulder blade?

Shoulder blade pain is a very common experience, with causes ranging from simple strains to serious conditions, such as heart attacks or liver problems.

Determining the cause of shoulder blade pain can be difficult. People experiencing shoulder blade pain need to know the possible reasons for the pain and what precautions to take.

In this article, we examine a variety of different causes of pain around the shoulder blades, along with what can be done to treat each problem.


woman with shoulder pain - skeleton showing
There can be various reasons for pain in the shoulder blades.

The shoulder blades are the triangular bones on the back of the shoulders, medically known as the scapulae.

Each shoulder blade connects the upper arm bone to the collarbone and has three groups of muscles attached to it. These muscles help move the shoulder joint.

The shoulder has a wide range of motion. The muscles that connect the shoulder blade allow the shoulder to rotate, move in a circle, move up and down, and side to side.

As the shoulder can move in so many ways, it is easy to injure, which can cause shoulder blade pain.

Unfortunately, shoulder blade pain is not often as simple as injury-related pain. In some cases, shoulder blade pain is caused by pain from a nearby organ in distress.

Possible causes

There is any number of potential causes of shoulder blade pain. In some cases, a person may be able to figure out what is causing their pain.

A few examples of causes that may be obvious to a person include:

  • trauma from a hit, fall, or car accident

  • sleeping in an uncomfortable or odd position

  • strain from lifting a heavy object

Other times, the cause of the pain may be more difficult to determine.

Some conditions cause what is called referred pain. Referred pain is pain that occurs in the shoulder blades but is due to a problem in another part of the body.

Some potential causes of referred pain in the shoulder blades include:

Some causes are more likely to cause pain in one shoulder over the other. For example, a heart attack will more likely cause pain in the left shoulder blade. Gallbladder disease is more likely to cause pain in the right shoulder blade.

By contrast, a strain may occur in either shoulder blade depending on where the injury occurred.

Causes may fit into several different categories. Some of the causes are listed below.

Bone and joint issues

There are several potential bone or joint problems that can cause shoulder blade pain.

As the shoulder blade is a bone, it is possible for a person to experience a fracture. This is an unlikely occurrence in most cases, as it requires a fall, a car accident, or a similar direct injury to the shoulder blade.

As a person ages, degenerative conditions may cause shoulder blade pain. Some of these conditions include:

Certain cancers may also cause pain in the shoulders and shoulder blades. The most common cancers that cause shoulder blade pain include lung, breast, and colon cancer.

Musculoskeletal causes

It is very common for a person to experience a musculoskeletal issue that causes shoulder blade pain. Overuse, strains, sleeping badly, and rotator cuff issues all fall into this category.

These problems are often linked with pain in the muscle groups surrounding the shoulders, including some of the arm muscles.

Cardiac causes

One of the more serious causes of shoulder blade pain is heart-related problems. Doctors have noted that localized pain in the left shoulder is a sign of a heart attack, particularly in women.

Women experiencing pain in the shoulder blade that cannot be explained by a musculoskeletal problem should seek out medical attention quickly.

Other heart conditions that may cause shoulder blade pain include:

  • a tear in the aorta

  • inflammation of the lining of the heart

Pulmonary causes

Certain lung conditions may also cause referred pain in the shoulder blades. Some examples of lung conditions include:

  • cancer that grows on the top part of the lungs

  • clots that travel from the legs to the lungs

  • collapsed lung

Abdominal causes

There are a few conditions that occur in the abdomen that may cause shoulder blade pain. Issues with the abdomen area that may cause shoulder blade pain include:

  • surgery

  • nerve pain

  • peptic ulcer disease

  • pancreatitis

  • liver disease

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When to see a doctor

woman holding chest
Immediate medical attention should be sought for unexplained pain in the left shoulder blade accompanied by shortness of breath or chest pain.

In many cases, a person can trace shoulder blade pain back to a seemingly harmless incident, such as a recent fall or an occasion when they lifted too much weight.

It may be less evident to a person who slept badly, but warning signs include sleeping on one side for too long or having recently switched mattresses.

People who are unable to explain a pain in their shoulder blade should see their doctor.

Women should be particularly wary of any pain in the left shoulder blade as it could be a sign of a heart attack, and they should seek out immediate attention from a doctor.

A person may also wish to see a doctor in the case of a strain as the doctor may be able to recommend additional treatment.

Symptoms that signal a need for immediate attention include:

  • chest pain

  • shortness of breath

  • rapid or irregular heartbeat

  • sudden difficulty speaking

  • lightheadedness

  • pain, swelling, or redness in the legs

  • coughing up blood

  • fever

  • vision problems

  • paralysis on one side of the body

  • excessive sweating

  • loss of consciousness


A doctor will need to examine a person to work out what is causing the shoulder blade pain. Normal diagnosis starts with an interview in which the doctor will try to work out if there is any simple reason for the pain.

Once the doctor has ruled out simple causes, they may perform some different assessments.

These tests may include:

  • heart tests, such as an electrocardiogram (EKG or ECG) or stress test

  • abdominal tests, such as endoscopy

  • blood work that tests for liver function

  • radiological studies of the chest and back using an MRI or CAT scan

Treatment options

man stretching arms and shoulders
Stretching may help to ease shoulder blade pain.

Treatment depends largely on the exact cause of the pain.

For simple cases of overuse, strain, or sleeping poorly, a person may be able to try a range of treatments from home. These may include:

  • rest

  • ice

  • over-the-counter pain medications, such as ibuprofen

  • medicated rubs and ointments

  • stretching

  • massages

Where there is an underlying disorder, treatment relies on treating the underlying cause. For example, cancer may require radiation, chemotherapy, or other therapies. Heart conditions may need medications that target heart problems.

When a person knows the cause of the shoulder blade pain, treatment is likely to be more effective.

If treatment is not working, however, people must talk to their doctor to see whether their treatment needs changing or adjusting.

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Preventable shoulder blade pain is typically associated with trauma and overuse. Steps to take may include:

  • avoiding potential falling risks

  • wearing a seatbelt in a car

  • easing into any new workout routine

  • changing sleeping positions

Other means of prevention include:

  • eating a balanced diet that is rich in nutrients

  • getting moderate exercise

  • stretching


For simple causes, it is very likely a person will experience a full recovery with minimal medical intervention. In most of these situations, it will probably only take a few days to a few weeks for a person to experience complete symptom relief.

Where the pain is due to an underlying cause, the length of treatment and recovery time will vary greatly.

It is important to know the cause so that an effective treatment plan can be created to address the underlying issues.

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