Pain Under Shoulder Blade

What Pain Under Shoulder Blade Might Indicate


There are several reasons a person could be experiencing pain under shoulder blade. Sometimes, the cause of the pain is obvious. At other times, the cause may be difficult or impossible to determine. There are instances when shoulder blade pain is due to a condition that is physically distant from the shoulder. Shoulder blade pain is most often due to something that can be easily treated. There are times however, when this type of pain can be due to something of a serious nature.



Scapular Bursitis


One of more common causes of this type of pain is bursitis. It’s called scapular bursitis, in reference to the shoulder blade bone, the scapula. One usually associates bursitis with a joint, most often the shoulder joint, or the elbow joint. In the elbow, shoulder, and other joints in the body, there are small sacs called bursae. These small sacs help to keep a joint lubricated, so bone doesn’t rub directly against bone.


If anything irritates the bursae, they can become inflamed and swollen. If the condition becomes chronic, scar tissue can begin to form. The combination of inflammation, swelling, and the presence of scar tissue, can result in pain being experienced when muscle moves across the bursa, and the bursa moves across bone.


The scapula or shoulder blade is one of the three large bones that forms the shoulder. The other two bones are the clavicle or collar bone, and the humerus or upper arm bone. The clavicle doesn’t play a role as far as pain under shoulder blade is concerned, in that it is a relatively motionless bone. What causes bursitis is movement of the humerus or upper arm bone. When the upper arm bone moves, the scapula slides across the ribs at the back of the chest wall. The sliding motion is more pronounced when the arm is moved from side to side, but there is also some movement when the arm is moved up and down.


There are two large muscles involved, the subscapularis muscle and the serratus anterior muscle.  Bursae lie between these muscles and the rib cage. The subscapularis muscle, attached to both the scapula and the humerus, enables the arm to rotate. This muscle is an essential part of what is commonly called the rotator cuff. The serratus anterior muscle attaches to the scapula and to the rib wall. This muscle acts to pull the scapula forward. There are other muscles as well that affect arm and scapula movement with respect to the rib wall, but the two large muscles mentioned here, and their associated bursae, are what are responsible for the pain felt beneath the shoulder blade.


Repetitive motion is usually considered the main cause of bursitis, but it usually isn’t just the motion that’s to blame. There is often some other underlying cause. In the case of scapular bursitis, the cause is often due to muscles that have become weakened to the point that muscle mass has been lost. This results in more pressure being placed on the bursae when the shoulder blade moves across the rib wall, eventually causing them to become inflamed. Scapular bursitis can of course occur in either shoulder. It can occur in both shoulders at the same time, although this is seldom the case.


Poor Posture


Another possible cause of pain under shoulder blade involves nothing more than poor posture. Sitting too long or too often in a hunched-over position is usually to blame. The muscles of the shoulder and upper back, including the neck, can tighten up. This often results in soreness, which can in some cases center beneath the shoulder blades. Gentle stretching is the best remedy for this type of shoulder blade pain, and maintaining good posture can of course help to keep the pain from occurring in the first place.




An injured or torn subscapularis muscle can also be a cause. A fractured scapula would be an obvious cause, but such an injury is rather rare. Of all of the bones in the body, the scapula is one of the bones that is least likely to be broken.


Referred Pain


Sometimes the pain under shoulder blade is referred pain. Referred pain is pain that is felt at a location other than where the injury or disorder causing it is located. Not all of our internal organs have pain nerves. If one of these organs is injured, or is affected by a disorder, the actual pain may be referred to some other location, such as one of the shoulder blades. Pain associated with internal abdominal disorders are quite often felt in the back, and sometimes as far away as the shoulder. If a diagnosis of shoulder blade pain does not indicate that anything is amiss in the area of the shoulder, the pain being felt could be a referred pain.


One type of pain under shoulder blade that can be a possible cause of concern is if it is the left shoulder blade that is hurting, and the pain is accompanied by chest pain and/or a pain running down the arm. That could be a sign of a heart attack.