Pain Between Shoulder Blades – Nagging Back Pain
Pain between shoulder blades can produce that nagging type of pain that is difficult to reach. Most often it is related to muscle problems, however, a herniated disc or pinched nerve in the neck can cause pain in this area, along with neck joint irritation. These causes usually respond to neck and/or shoulder movements. This pain can also be referred by the heart, stomach and gallbladder or, if you have osteoporosis, a possible compression fracture.
If there has been a past injury to the area or from years of poor posture, a degenerative condition like arthritis can develop in the area between the shoulders causing upper back pain.
Muscle Pain Between Shoulders
While there are many muscles that can cause pain between the shoulder blades, the major muscles often involved are the trapezius and the rhomboids. The trapezius is a large muscle, while the rhomboid is a smaller muscle that runs between the spine and the shoulder blades.
With typical poor postural habits, the head is in a forward distortion and the back becomes rounded. As the upper back becomes rounded, the rhomboid muscles stretch out. This is typically seen with a slumped posture when sitting at a computer or desk for long periods without proper ergonomics. The muscles become overstretched and weak placing abnormal stress on the muscles and joints, altered motion and, over time, can develop scar tissue from small tears which result in chronic pain.
Treatment of the muscles with heat therapy and massage techniques can help. A particular technique called ischemic compression can be used for tender areas often called trigger points, seen in the picture with the “X”. This technique uses a tennis ball or special muscle release tools. Place the ball on the floor and lay on your back with the ball between the shoulder blades. You can control the pressure and when you find a tender area, hold it until the pain gradually fades – about 20 to 30 seconds, although it may take a minute.
For those with chronic problems that need more than compression due to excessive scar tissue, the help of a professional Massage Therapist or an Active Release Practitioner using very specific muscle therapy can help. Considerable involvement of the trapezius can cause what is often termed trapezius myalgia and the are exercises for the trapezius muscle that have proven beneficial. Since arthritic changes and joint problems may occur, this is a common area for careful and gentle spinal adjustments.
Gentle spinal adjusting is something I learned from the great Reggie Gold, DC many years ago. I cringe when I hear Chiropractors using very rough techniques. Reggie, in addition to being a great communicator, very kind and generous, he was extremely good at adjusting and I urge all DC’s to check out his instructional video on Gentle Adjusting to incorporate the laws of physics and his unique philosophy to make your adjustments gentler and more effective.
The use of lumbar support pillows, which help maintain the normal curve of the lower back when sitting, can help to correct rounded shoulder posture, especially when driving a car or working at a desk. The back of the chair should not be pushed forward and should have a slight backward angle. These tips for reducing postural strain can be very helpful.
For those who sit for long periods and get so involved in work that they forget to take breaks and change postures, a timer set for 20 to 30 minutes can be placed in a location that you must get up to turn it off and reset it can be a great solution.
For some, the use of a posture bracing can assist the muscles of the upper back and spine to assume the correct posture. A universal support will allow gradual adjustments as your posture improves, so it will be a temporary aid.
When using arm rests on a chair, having them too low can stress the trapezius muscle, too high can cause tension of the neck and shoulder muscles, so try to sit close to your desk with the arm rests at desk level.
Often, with rounded shoulder posture, the chest muscles (pectorals) can become tight and the in the door stretch can help with tight pectoral muscles and overstretched trapezius and rhomboid muscles.
For those who like to sleep on their side and have difficulty finding a comfortable position due to pain between shoulder blades, a pillow can be placed under the affected arm to prevent it from rotating forward and stretching the trapezius and rhomboid muscles. There are body pillows that can help keep the back from twisting the lower part of the trapezius and can also fit under the arm at the same time. There are some body pillows that can achieve this without being to heavy or bulky. A neck pillow designed for side sleeping can add the final touch to a comfortable night’s sleep that reduces pain between shoulder blades.
Disc & Joint Pain Between Shoulders
A facet joint problem involving the small joints in the back of the neck may cause pain between shoulder blades. The lower facet joints can radiate pain to this area. This can often be as a result of a whiplash type injury or in those who spend long periods working overhead or looking up. So, this pain might be felt more when tilting the head backward. For those who work in this position, a support for the back of the head can help.
The lower discs in the neck can become herniated, protruded, bulging, torn or degenerative changes can occur which place pressure on the nerves and this may also cause pain between shoulder blades. C7 or C8 nerve pain can radiate between the shoulder blades. Typically, there will be other symptoms like pain or tingling/numbness into the arm or hand, but sometimes neck pain and pain between shoulder blades are the only sign.
Difficult herniated disc cases involving pain between shoulders may require medications and perhaps an orthopedic consultation, however, some home treatments using moist heat, posture changes and spinal decompression may help.
Since these various conditions may occur together, a more comprehensive approach may be required to treat pain between shoulder blades not responding to basic postural modification and conservative therapies.
Nucleoplasty Coblation For Disc Herniation
A 2015 study in the journal Medicine (Baltimore), found coblation technology or nucleoplasty can be an effective, minimally invasive and safe procedure for chronic cervical disc herniation that is producing upper back pain. This usually requires no general anesthesia and is more like a spinal injection procedure as an outpatient procedure.