20 Potential Causes of Shoulder Blade Pain

2. Arthritis

Arthritis can cause pain around your shoulder blade when it affects the joints in your shoulder. When cartilage wears down or becomes inflamed, bones rub together and cause pain. Your shoulder contains several joints, with the main one being a ball-and-socket joint connecting your upper arm bone to the shoulder blade.

Arthritis in this joint can create deep pain that spreads toward the shoulder blade. You might also notice stiffness, swelling, or a grinding feeling when you move your arm, and the pain often worsens with activity or at the end of the day.

Types of arthritis include osteoarthritis from joint wear and inflammatory arthritis caused by your immune system attacking the joint lining. Treatment includes rest, gentle exercise, and physical therapy to keep the joint moving. Anti-inflammatory or pain-relieving medications may also be used, and in more severe cases, joint injections or surgery may be considered.

3. Tendonitis

Tendonitis occurs when a tendon becomes swollen and irritated. Tendons connect your muscles to your bones and help you lift and rotate your arm. When a tendon becomes inflamed, it can limit smooth movement and cause discomfort during daily activities.

Overuse can cause small injuries in the rotator cuff or biceps tendon, which leads to pain near your shoulder blade or on the outer part of your shoulder. Common symptoms include pain that gets worse when you move your arm, tenderness, mild swelling or warmth, stiffness, or weakness.

Repeated motions, sports like swimming or tennis, and jobs that require lifting or working overhead can raise your risk. Treatment focuses on lowering pain and swelling. Rest, ice, and nonsteroidal anti-inflammatory drugs may help, while physical therapy can improve strength and mobility. In more severe cases, corticosteroid injections or surgery may be considered.

4. Myofascial Pain Syndrome

Myofascial pain syndrome develops when tight knots, or trigger points, form in your muscles and cause pain in your shoulder blade and nearby areas. You may feel a deep, aching pain under or around your shoulder blade, which can spread to your neck, upper back, or arm.

Pressing on the spot may worsen the pain or cause it to travel. This problem often starts from muscle overuse or poor posture. Long hours at a desk, repetitive lifting, or stress can strain your upper back muscles, which causes muscle fibers to tighten and remain that way.

Common signs include a firm, tender knot in the muscle, pain that gets worse with movement, stiffness, limited range of motion, and trouble sleeping due to discomfort. Your daily habits, such as slouching, carrying heavy bags on one side, or holding your shoulders tense, can keep the muscles tight and irritated.

5. Strain

A strain happens when you stretch or tear a muscle or tendon. Straining the muscles around your shoulder blade can cause sharp or aching pain with movement. These muscles help stabilize your shoulder blade and support your neck and upper back during posture control, sudden movements, and steady arm use throughout the day.

Lifting something heavy, pulling with force, or reaching overhead may cause a strain. Poor posture and repeated motions, such as working at a computer without support, can also stress these muscles. Sports like swimming, tennis, and weightlifting often contribute.

Pain from a strain often starts soon after the injury. You may notice soreness, stiffness, or mild swelling, and the area can feel tender when pressed. Moving your arm or turning your upper body may worsen the pain. Mild strains usually improve with rest and simple care, while severe strains can cause lasting weakness or limited movement.

6. Bursitis

Bursitis develops when a small fluid-filled sac in your shoulder becomes swollen and irritated. These sacs, called bursae, cushion your muscles and tendons as they move over bone. Swelling leads to pain around your shoulder blade or the top and side of your shoulder.

You may notice a dull ache that gets worse when you lift your arm or reach behind your back. The area can feel tender when pressed, and sometimes warmth or mild swelling occurs. Common causes include repeating the same shoulder movements, a sudden increase in activity, direct injury, inflammatory joint conditions, or infection in rare cases.

If bursitis affects the back part of your shoulder, the pain can spread toward your shoulder blade. Lying on the painful side may make it worse. Treatment typically begins with rest and ice. Anti-inflammatory medications may help reduce pain and swelling, while physical therapy can improve strength and movement as symptoms ease.

7. Cardiac Conditions

Some heart problems cause pain in your shoulder blade. You may feel the pain on the left side, but it can spread to the right side, arm, neck, jaw, or back. Coronary artery disease limits blood flow to your heart and can cause angina, which feels like pressure, tightness, or pain in your chest and may travel to your shoulder blade.

A heart attack can also cause shoulder blade pain, often lasting more than 15 minutes and not improving with rest. You may feel chest pressure, arm pain, shortness of breath, or sudden fatigue at the same time. Pericarditis, or swelling of the lining around your heart, can cause sharp pain behind your breastbone that may spread to your left shoulder blade.

The pain often feels worse when you lie down or take a deep breath and may improve when you sit up and lean forward. A tear in the aorta, called an aortic dissection, can cause sudden, severe chest or upper back pain that may move between your shoulder blades and requires urgent care.

8. Pulmonary Conditions

Lung problems can cause pain in your shoulder blade area because nerves in your chest share pathways with nerves in your upper back. Your brain may sense lung pain as pain near your shoulder blade. Common pulmonary causes include pneumonia, pleurisy (swelling of the lining around the lungs), collapsed lung, blood clot in the lung, and lung tumors.

Pneumonia can cause sharp pain that worsens with deep breaths or coughing, along with fever, chills, or shortness of breath. Pleurisy often causes stabbing pain that gets worse with breathing or movement. A collapsed lung can lead to sudden, one-sided chest or shoulder blade pain with tightness in your chest and difficulty breathing.

A blood clot in the lung can cause similar pain along with fast breathing or a racing heart. In some cases, lung tumors may cause dull, ongoing pain in the upper back or shoulder blade that does not improve with rest.

9. Rotator Cuff Tear

A rotator cuff tear occurs when one or more of the shoulder tendons tear. These tendons help hold the top of your arm bone in the shoulder socket. When they tear, your shoulder blade area can ache or feel weak. You may feel pain at the top of your shoulder or along the back near the shoulder blade, often worsening when you lift your arm, reach overhead, or reach behind your back.

Lying on the injured side can also increase discomfort. Rotator cuff tears can develop slowly over time from repeated overhead motion, with sports like tennis, swimming, and baseball raising your risk. Jobs that require lifting or reaching above your head can also strain the shoulder. A sudden injury, such as falling on an outstretched arm, can also cause a tear.

10. Fractures

A fracture is a broken bone that can cause pain around your shoulder blade if it involves your shoulder blade, collarbone, or upper arm bone. Most fractures result from trauma such as falls, sports injuries, or car accidents, and older adults have a higher risk due to decreased bone strength.

Common signs include sharp pain after injury, swelling, bruising, trouble moving your arm, and a grinding feeling with movement. You may also notice that your shoulder looks uneven, and moving your arm may feel almost impossible in severe cases.

A fracture of the upper arm bone near the shoulder joint can cause pain that spreads to the shoulder blade. Some breaks need only a sling and early gentle movement, while others require surgery to hold the bone in place. These injuries often heal in about eight weeks, but full recovery can take several months.

11. Whiplash

Whiplash is a neck injury caused by a sudden back-and-forth movement of your head, most often from a car accident, fall, or sports injury. This motion strains the muscles and ligaments in your neck, which leads to pain and stiffness that can spread to your shoulders and shoulder blades.

Some people also notice headaches, muscle spasms, or trouble turning their head. When your neck muscles tighten, they can pull on nearby areas, and this causes aching or burning pain along your shoulder blade. You might also feel soreness in your upper back or arms.

Most cases improve within a few weeks to a few months. You may use over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs or acetaminophen to ease discomfort. In some cases, stronger medications, muscle relaxants, or physical therapy may be recommended if symptoms persist. Gentle daily movement can support recovery, while long periods of rest or prolonged use of a neck brace may slow healing.

12. Stress

Stress can cause shoulder blade pain even without injury by tightening muscles in your neck, upper back, and the area between your shoulder blades. You may hold your shoulders up or hunch forward during long periods of worry or pressure, which leads to soreness, stiffness, and aching pain.

The discomfort may feel dull and constant, or it may come and go. Ongoing stress can also trigger tension headaches and raise muscle sensitivity. This can make simple movements feel harder and increase discomfort during busy or emotionally demanding days.

Stress can also change how you breathe, and shallow breathing limits movement in your upper ribs and chest. It makes the muscles around your shoulder blades work harder. Poor sleep linked to stress may increase pain sensitivity, and your muscles recover more slowly without rest.

13. Dislocation

A shoulder dislocation happens when the top of your upper arm bone slips out of its socket, which causes sharp pain around your shoulder and shoulder blade. Your arm may look out of position or hang at an odd angle, and many people cannot move their arm without severe pain. Common causes include sports injuries, falls, car accidents, or sudden strong muscle tightening.

The shoulder is the most mobile joint in your body, which makes it easier to dislocate than many other joints. Doctors confirm a dislocation with a physical exam and often an X-ray. Treatment usually starts with a closed reduction, where a medical professional gently guides the bone back into the socket and may provide pain relievers or a muscle relaxant.

After the joint returns to place, you will likely wear a sling for days or weeks, and physical therapy helps restore strength and movement. If you dislocate your shoulder more than once, you may face a higher risk of ongoing instability.

14. Spinal Stenosis

Spinal stenosis happens when the space inside your spine narrows, which puts pressure on the spinal cord or nerves, most often in the neck or lower back. When stenosis affects your neck, it can cause pain that spreads into your shoulders and between your shoulder blades, along with aching, burning, or tingling. Some people also notice numbness or weakness in an arm or hand.

The condition usually develops slowly with age as discs in your spine dry out and bulge, and bones and ligaments thicken due to arthritis, reducing the space around your nerves. You may notice that your pain worsens when you stand or walk for long periods, and it may improve when you sit or lean forward.

Evaluation may include checking strength, reflexes, and balance, along with imaging tests such as an MRI or CT scans to confirm narrowing in the spinal canal. Treatment depends on how severe your symptoms are and may include physical therapy, anti-inflammatory drugs, epidural steroid injections, or surgery to relieve nerve pressure.

15. Lupus

Lupus is a long-term autoimmune disease in which your immune system attacks your own healthy tissues, affecting joints, skin, kidneys, brain, and other organs. When lupus affects your joints and muscles, you may feel pain in your upper back or around your shoulder blades that can feel dull, achy, or stiff, and may flare up when the disease is more active.

Shoulder blade pain linked to lupus often happens along with joint stiffness, especially in the morning or after sitting still. Sun exposure and stress can also trigger symptom flares. Doctors diagnose lupus based on your symptoms, a physical exam, and blood tests, as no single test confirms it.

Treatment focuses on controlling inflammation and calming your immune system. Your doctor may prescribe antimalarial drugs, corticosteroids, immunosuppressants, or biologic agents. You also play a key role by resting, staying active within your limits, and protecting your skin from the sun.

16. Mouse Shoulder

Mouse shoulder is pain that develops from long hours of computer use, often felt around your shoulder blade, upper back, or the top of your shoulder. This problem starts with repeated small movements and holding a computer mouse for hours, which keeps your shoulder and arm in a fixed position and your muscles tense.

Over time, this strain can irritate the soft tissues around your shoulder blade and cause aching, stiffness, or a burning feeling. Poor desk setup often makes it worse, especially if your mouse sits too far away or your chair is at the wrong height, which causes your shoulder muscles to work harder.

Rest, gentle stretching, and anti-inflammatory drugs may help reduce pain. Physical therapy can teach you exercises that improve posture and strengthen weak muscles. Adjusting your desk and mouse position also lowers stress on your shoulder.

17. Fibromyalgia

Fibromyalgia is a long-term condition that causes widespread pain and tenderness, including around your shoulder blades. The pain can shift from day to day and may feel worse with stress or poor sleep. This condition also affects how your brain processes pain signals, which makes your body react more strongly to pressure or minor strain.

You may also experience ongoing fatigue, stiff muscles and joints, and frequent headaches. Problems with focus or memory can make daily tasks feel more challenging. Fibromyalgia does not damage your joints or muscles, but it can make daily tasks harder. Reaching, lifting, or sitting upright for long periods may increase your discomfort.

Management often involves a combination of movement therapy, stress control, and certain medications such as antidepressants, antiseizure drugs, or pain relievers. Regular low-impact exercise, such as walking or gentle stretching, may help reduce stiffness in your upper back and shoulders.

18. Neck Pain

Neck pain often spreads to your shoulder blade because tight muscles, irritated joints, or pinched nerves in your neck can send pain into your upper back. You may feel a dull ache, stiffness, or sharp pain when you turn your head, and the pain can also move into your shoulder, upper arm, or cause headaches.

Long hours at a computer, poor posture, or sleeping in an awkward position often trigger this problem. Your neck contains bones, discs, muscles, ligaments, and nerves. When you strain these tissues, they can swell or tighten, pulling on the muscles that attach near your shoulder blade and leading to discomfort in that area.

If a nerve becomes compressed, you might notice tingling, numbness, or weakness in your arm. Burning or shooting pain that travels from your neck to your shoulder blade can also point to nerve irritation.

19. Sports Injuries

Sports that involve repeated arm movements can cause shoulder blade pain. Baseball, swimming, tennis, and weightlifting put stress on your shoulder joint and the muscles around your shoulder blade. Both overuse and sudden injuries can lead to discomfort in this area.

Overuse often leads to strains, sprains, or irritation of the rotator cuff. The rotator cuff is a group of muscles and tendons that keep your shoulder stable. When these tissues swell or tear, you may feel pain that spreads to your shoulder blade.

A sudden injury can also cause pain in this area. Falling on an outstretched arm or lifting too much weight can strain muscles or cause a partial tear. You might notice weakness, swelling, or a clicking sound when you move your arm. You may feel more pain when you lift your arm, reach behind your back, or lie on the injured side.

20. Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease where your immune system attacks the lining of your joints, leading to pain, swelling, and stiffness that can affect your shoulder blade area. You may feel a deep, aching pain around your shoulder or upper back, and the joint can feel warm, tender, or stiff, especially in the morning.

Stiffness often lasts more than 30 minutes after you wake up. This condition often affects more than one joint at the same time, so you might notice symptoms in your hands, wrists, knees, and shoulders. It can also cause fatigue, low-grade fever, or weight loss.

Inflammation in the shoulder joint changes how you move your arm. When the joint does not move well, nearby muscles around your shoulder blade become tight and sore, adding to the pain in your upper back.