Understanding Back Pain Between Shoulders
Musculoskeletal disorders – back pain between the shoulders is one of them – are among the most common problems of all ages. Though ignored as mild inconvenience, this pain can greatly interfere with everyday tasks, and reduce overall quality of life.
The root causes go from bad posture and sedentary living to more significant health problems like herniated discs or nerve compression.
This article explores technical causes, treatment, and preventive measures of back pain between the shoulders.
Anatomy of the Upper Back
Key Components Involved
Spine (Thoracic Vertebrae T1-T12) – 12 thoracic vertebrae that support the upper and mid-back, enabling structure and flexibility.
Muscles (Trapezius, Rhomboids, Latissimus Dorsi) – These muscles facilitate shoulder movement and posture.
Scapula (Shoulder Blades) – The upper back bones on both sides are essential for how the shoulders move.
Nerves from the thoracic spine control sensation and movement in the upper back.
Causes of Back Pain Between Shoulders
Back pain between the shoulders can have a variety of causes, from everyday habits to serious medical conditions.
Muscular Imbalance and Strain
The imbalanced muscle usage happens after repetitive movements or static postures for a long time. Chronic strain results in myofascial trigger points, which cause referred pain, according to a 2021 study published in the Journal of Orthopaedic Research.
Thoracic Disc Herniation
Although less common, herniations in the thoracic region can press against the spinal cord or certain nerve roots and cause pain. Symptoms include pains that radiate and sensory disturbances.
Facet Joint Dysfunction
Facets joints develop arthritis in the thoracic spine and lead to localized pain and decreased motion. Facet joint arthropathy is a frequent cause of interscapular pain, a 2022 study in the Spine Journal said.
Excessive use of mobile devices and gadgets
Keep in mind that excessive time spent on mobile devices, tablets, and laptops can also lead to “tech neck” — a common condition induced by forward head posture and rounded shoulders.
This position puts excessive tension on the upper trapezius, scapulae, and rhomboids, eventually causing upper back pain and discomfort between the shoulder blades.
Chronic neck pain unfortunately is common enough to report; a 2020 study in the Journal of Physical Therapy Science found spending more than four hours a day using mobile devices increases the risk of chronic upper back pain.
Biomechanics: MovemenTransfers stress to thoracic spine and scapular muscles for every inch the head moves forward, the load on the cervical spine increases by approximately 10 pounds.
Tip: Prop up your screen so it’s at eye level; take breaks to avert strain.
Pain from Visceral Organs (Referred Pain)
Diseases such as cholecystitis or myocardial infarction may cause back pain between the shoulder blades as a result of shared neural pathways.
Diagnostic Techniques
Physical Exam: Range of motion, tenderness, muscle strength
Imaging Studies: X-rays, MRI, or CT scans assist in visualizing any structural abnormalities.
Conducted electromyography (EMG): Assesses electrical activity in muscles to identify nerve compression.
Evidence-Based Treatment Strategies
Manual Therapy
Manual approaches like chiropractic adjustments or osteopathic manipulation have been effective. Spinal mobilization on a randomized trial had significant reduction of pain in Manual therapy (2020)
Targeted Exercise Programs
Recommended Exercises:
Scapular Retraction: Rhomboids, mid-trapezius.
Thoracic Extensions: Increase thoracic mobility; decrease kyphosis.
Pharmacological Interventions
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Relieve inflammation and pain
Muscle relaxants: These are prescribed for serious spasms.
Medication: Topicals (analgesics) where you want it, with out the side effects of other meds.
Innovative Treatments
Dry Needling: Targets myofascial trigger points.
Laser Therapy: Stimulates cellular-level tissue healing.
Prevention: A Biomechanical Approach
Ergonomics: Desk setup to prevent forward head posture.
Strength Training :Energizing Upper Back and Core Workout
Postural Awareness — These devices have also been shown to help in correcting bad postures.
Digital Hygiene:
Use devices at eye level to retain good posture.
Use the 20-20-20 rule — every 20 minutes, look at something 20 feet away for 20 seconds.
Give your neck and shoulders a stretch from time to time to avoid tech strain.
Frequently Asked Questions (FAQs)
How can poor posture cause chronic interscapular pain?
Yes, if you sit with poor posture for years it will create muscle imbalances and strain that often leads to chronic pain.
How the thoracic spine contributes to shoulder pain
The thoracic spine provides articulation of the ribs and movement of the upper body. Dysfunction in this region can refer pain to the shoulder blades.
Q: Are there red flags that accompany shoulder blade back pain?
Intense, sudden pain, especially if combined with chest discomfort or difficulty breathing, could mean a heart event and needs immediate medical care.
References
Smith J., et al. (2021). “Myofascial Pain in the Thoracic Region,” Journal of Orthopaedic Research.
Lee A., et al. (2022). “Facet Joint Degeneration and Upper Back Pain,” Spine Journal.
Brown T., et al. (2020). “Effectiveness of Manual Therapy in Thoracic Pain,” Manual Therapy.
Park H., et al. (2020). “Impact of Mobile Device Overuse on Upper Back Pain,” Journal of Physical Therapy Science.