Pain between the shoulder blades, called interscapular pain, most often comes from the muscles and joints of the upper back or is referred from an irritated nerve or joint in the neck. Long screen time, a new rowing or pulling program, or sleeping awkwardly can all bring it on. Because heart problems can also cause pain in the upper back, sudden pain with chest pressure, breathlessness, sweating or nausea needs 911, not a physical therapist.
Last reviewed By the Monon Therapy Collective editorial team
Can pain between the shoulder blades come from the neck?
Yes, and it often does. An irritated joint or nerve root in the lower neck commonly refers pain to the inner edge of the shoulder blade, so the problem feels like the upper back even though the source is higher up.
Clues that the neck is involved include pain that changes when you turn or tilt the head, pain that also travels into the arm, and tingling in the fingers. OrthoInfo describes cervical radiculopathy, a pinched nerve in the neck, as pain spreading into the shoulder or arm with numbness or pins and needles in the hand.
| Likely cause | What it tends to feel like | Where to read more |
|---|---|---|
| Upper back muscle or joint strain | Aching or a catching spot beside the spine, worse with long sitting or twisting | Mid back pain |
| Pinched nerve in the neck | Burning along the inner shoulder blade, sometimes with arm pain or tingling | Pinched nerve in the neck |
| Neck arthritis | Stiff neck with an ache that spreads down between the blades | Neck arthritis |
| Increased upper back rounding | Tired, heavy ache by the end of the day | Kyphosis |
| Compression fracture | Sudden sharp pain after a minor fall or lift in someone with osteoporosis | Spinal compression fracture |
Why does the upper back ache after a day at the computer?
Holding the head forward and the arms out at a keyboard for hours keeps the upper back and shoulder blade muscles working at a low, constant level, and they tire. The ache is real, but it usually reflects fatigue and sensitivity rather than damage.
Raising the screen to eye level, bringing the keyboard closer and getting up regularly tend to help, as do movements that rotate and extend the upper back, such as the open book stretch. Strengthening the muscles between the shoulder blades with work like the prone Y, T and W makes long days easier to tolerate.
Which quick checks help narrow down upper back pain?
Notice whether the pain changes with neck movement, arm movement, deep breathing or twisting at the waist. Pain that changes with neck movement suggests a neck source, pain with twisting or a deep breath suggests the ribs and upper back joints, and pain unaffected by any movement needs more caution.
Also note whether you have arm symptoms, a recent fall, a new training program with heavy rows or pull-ups, or known osteoporosis. Pain that no position or movement changes, or that arrives with feeling unwell, is a reason to see a physician rather than to stretch it out.
How do therapists examine and treat interscapular pain?
The therapist screens for heart, lung and abdominal causes first, then examines neck and upper back movement, rib motion, nerve signs in the arms, and the strength and control of the shoulder blade muscles. The aim is to find which region is the source.
When the neck is involved, care focuses there, often with posture-friendly neck exercises such as the chin tuck. When the upper back itself is the source, treatment usually blends mobility work, hands-on techniques to ease stiff joints, and progressive strengthening. Lifters who flared it with a new pulling block often just need the volume adjusted and rebuilt.
Where do I start if the ache between my shoulder blades will not settle?
Start with an examination once the emergency causes are ruled out and the ache has lasted more than a week or two, or keeps returning after desk-heavy weeks. A physical therapist can work out whether the neck or the upper back is driving it, which decides the whole plan.
The physical therapy questionnaire has an “upper back” option; describe what you do for work and training and whether the arm is involved. A person on the matching team reads it and proposes an independent therapist in the network, whose office then confirms benefits and books the visit.
Call 911 for pain between the shoulder blades with
- Chest pain, pressure or tightness, or pain spreading to the jaw or arm.
- Shortness of breath, cold sweat, nausea or light-headedness.
- Sudden, severe, tearing pain that came on without any strain.
- Weakness or numbness in both arms or legs after a fall or injury.
If you think it is an emergency, call 911.
