Pain between shoulder blades: causes, treatments, and exercises

Maybe you notice a nagging ache or sharp twinge between your shoulder blades after sitting at your desk, or your shoulders feel sore after doing chores. No matter the reason, shoulder discomfort can be distracting and make everyday activities more challenging.

“Pain between the shoulder blades can affect how you move, sit, stand, and go about daily life,” says Scott Loving, PT, DPT, a physical therapist at Hinge Health. This kind of pain can show up at any age and regardless of how active you are.

Pain between the shoulder blades isn’t usually a sign of something serious. Simple treatments — especially  gentle movement, targeted exercises, and stress management — can help your shoulders and upper back feel better. 

Learn what causes pain between the shoulder blades, plus what you can do to prevent and relieve it, with tips and exercises recommended by Hinge Health physical therapists.

Causes of pain between shoulder blades

Pain or discomfort between the shoulder blades can happen for many reasons. “People may notice extra tension or soreness in this area after sitting for long periods, lifting, or even during times of stress,” says Dr. Loving, PT, DPT, a physical therapist at Hinge Health. Some common factors that may contribute include:

• Your position. There’s no single “perfect” posture, or right way to sit or stand. Our bodies are meant to move and shift throughout the day. If you spend a long time in one position (say, with shoulders forward, upright and still, or anything in between), you may notice tension build. Changing positions regularly helps.

• Stress and anxiety. Stress and anxiety can make your muscles tense and tight, even when there’s no real danger. This can sometimes lead to muscle spasms or twitches.

• Muscle strain from doing more than you’re used to. Activities like gardening or golf can irritate the upper back and shoulders — especially if they’re new to you or you haven’t done them in a while, says Dr. Loving. When you suddenly do more, go harder, or go longer than usual, it’s common to feel soreness or a mild strain.

• Age-related changes. As we age, the small joints along the back of the spine (facet joints) can get irritated, leading to a stiff or achy feeling between the shoulder blades. This is sometimes called facet joint syndrome — a common, arthritis-type change. People may notice it more when leaning back, turning, or staying in one position too long. “The most common spot is the thoracic spine, right between your shoulder blades,” says Dr. Loving.

• Injury. A fall or car accident can cause pain between the shoulder blades. And although your back is strong, sudden or unfamiliar bursts of effort — like an extra‑hard swing — can sometimes stir up symptoms between the shoulder blades. “A quick increase in effort may irritate the tissues in your upper back and lead to sharper pain,” says Dr. Loving.

• Muscle tension from inactivity. Spending long hours sitting can lead to muscle tension or fatigue around your upper- and mid-back, which may lead to discomfort or even a muscle knot between your shoulder blades. Staying active and doing targeted exercises can help alleviate tension and increase blood flow to these sore areas.

These exercises help ease tension and improve mobility in your upper and mid-back, while also building strength in the muscles that support your shoulder blades. Practicing them regularly can help your back feel more comfortable, stable, and flexible during everyday activities.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for pain between shoulder blades

Whether you’ve got sharp pain, tightness, achiness, or stiffness between your shoulder blades, there are plenty of at-home treatments you can try to find relief. Here’s what Hinge Health physical therapists recommend:

• Targeted exercises and physical therapy. Targeted exercises help improve upper back and shoulder mobility, flexibility, and strength, which can reduce pain between the shoulder blades.You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. 

• Stay active. Gentle activities like walking, biking, or using an elliptical can help ease tension and support healthy circulation. “Moving your arms as you walk brings healthy blood flow to the area, which can warm up your tissues and help them feel more relaxed and comfortable,” says Dr. Loving. 

• Apply heat or ice. Moist heat, like a hot water bottle or warm towel, encourages blood flow to your shoulder blades, which promotes healing. “It can also help relax tight muscles, tendons and ligaments,” Dr. Loving says. Ice, on the other hand, can help reduce swelling. Try both methods or choose the one that works best for you. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pain between the shoulder blades. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for upper back relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain, including pain between the shoulder blades. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How to prevent pain between shoulder blades

While you can’t always prevent pain between your shoulder blades, there are ways you can reduce it. Taking movement breaks throughout the day and simple habits — like staying active, switching up your position, practicing stress relief, and supporting your body with stretches and strength exercises — can all help keep your upper back and shoulders comfortable. These strategies include: 

• Stay consistent with strength training. Incorporating resistance exercises — like lunges, squats, and shoulder presses — can help support your back, core, and entire body. Lower body exercises don’t just benefit your legs — strengthening muscles like the glutes, hamstrings, and core can also help your spine and improve posture, which supports upper body function too. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise each week, plus at least two days of strength training. This routine can help you build and maintain muscle strength, so you can move with confidence and continue to do your daily activities as you age.

• Switch up your position. “Your next position is your best position,” says Dr. Loving. Try to change how you’re sitting or standing throughout the day — adjust your shoulders, switch the leg you’re crossing, or shift how your arms rest. Small changes like these can help your body feel more comfortable.

• Take movement snack breaks. If you spend most of the day sitting, try to take a “movement snack” every hour or so. Movement snacks are small breaks from inactivity. They can include getting up to go to the bathroom, filling up your water bottle, or doing stretches at your desk, like rolling your shoulders. These small but frequent movements can help stave off tension in your shoulders.

• Make simple desk tweaks. Your setup doesn’t have to be fancy, but small changes can help your back and shoulders feel better. Sit back so your chair supports you. If there’s a gap at your lower back, use a small pillow or rolled towel. Bring your keyboard and mouse close, and raise your screen to about eye level with a stack of books so you’re not craning forward. Most importantly, change positions and take short movement breaks throughout the day.

• Take time to unwind. “It’s common to hold stress in your shoulders and neck, which can contribute to pain between your shoulder blades,” says Dr. Loving. Relaxation techniques can include simple activities like short walks, self-massage, warm showers, or deep breathing. Research suggests that mindfulness techniques, like deep breathing, can help ease shoulder pain.

When to see a doctor

Pain between the shoulder blades often improves on its own with simple management. But if your pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Pain doesn’t begin to get better after a week or two, or worsens

• Pain accompanied by numbness or weakness in your arms and hands

• Pain that occurs immediately after a trauma such as a fall or car accident

PT tip: Use a foam roller 

“A foam roller can be a helpful tool for easing tension between your shoulder blades,” says Dr. Loving. Gently rolling in different directions — across, along, or diagonally over your upper back — can help relax tight muscles and provide soothing relief.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

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3. Smith, A. G., Miles, V. N., Holmes, D. T., Chen, X., & Lei, W. (2021). Clinical Trials, Potential Mechanisms, and Adverse Effects of Arnica as an Adjunct Medication for Pain Management. Medicines, 8(10), 58. doi:10.3390/medicines8100058

4. Paultre, K., Cade, W., Hernandez, D., Reynolds, J., Greif, D., & Best, T. (2021). Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review. BMJ Open Sport & Exercise Medicine, 7(1), e000935. doi:10.1136/bmjsem-2020-000935

5. Curtis, L., Shah, N., & Padalia, D. (2023, January 9). Facet Joint Disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541049/

6. American Heart Association. (2024, January 19). American Heart Association Recommendations for Physical Activity in Adults and Kids. American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults