Shoulder comprises of a ball and socket joint, which is composed of these bones namely humerus or the arm bone, clavicle or the collarbone, and scapula or the shoulder blade. A layer of cartilage that helps in cushioning the bones is also present. Two main joints also exist, which are acromioclavicular joint, which exist between the scapula, and clavicle. The other joint called the glenohumeral joint which exists between top ball like part of humerus and the outer edge of scapula. This is also known as the shoulder joint.
The shoulder joint is known for its mobility, flexibility, and strength which allows the motion of the shoulder forward and backward, up and down, and in circular motion. This remarkable ability of the shoulder joint is due to the presence of rotator cuff. This cuff is made of some types of tendons. When these tendons get inflamed, damaged or injured, it becomes painful in lifting the arm, thereby causing pain in the shoulder blade.
What is Shoulder Blade Pain?
Shoulder blade pain is a joint pain that occurs as a result of injury, bad posture, psychological stress, spinal diseases etc. Shoulder blade pain may originate in the joint or the associated tendons. Shoulder blade pain get worse with repetitive movements or performing manual labor with the arm. The shoulder blade pain can be of three kinds, which are right shoulder blade pain, left shoulder blade pain and pain between the shoulders. Apart from the injury or damage, the above types of shoulder blade pain occur due to different reasons.
Symptoms of Shoulder Blade Pain
The general symptoms that make the onset of the shoulder blade pain are:-
- Shoulder pain along with a tingling sensation, numbness and burning sensation.
- Stress or pressure which radiates from the shoulder.
- Presence of a grating sound when the shoulder blade is pressed or arms are moved.
Causes of Shoulder Blade Pain
The common causes of shoulder blade pain are:-
- Over usage of shoulder muscles causing a strain on the muscles, consequently leading to shoulder blade pain.
- Incorrect posture while sleeping can also cause shoulder blade pain like sleeping on one side for a long time or sleeping in an unusual posture which could strain the shoulder.
- Shoulder blade pain can also be a result of breaking of scapula as a result of sport injury, or on accident followed by intense pain and swelling.
- Shingles, which occur due to dormant chicken pox, can cause burning sensation or pain in the shoulder blade, especially on the right side.
- Myofascial pain may cause pain in the right shoulder blade due to damage of the tissues that cover the muscle.
- Rotator cuff injury may result in shoulder pain due to damaged or injured tendons located in the shoulder blade region.
- Nerve injury may also cause shoulder blade pain due to damaged nerve in the shoulder and neck regions.
There are various illness that may result in different types of shoulder blade pain, when the pain is not due to any injury or damage in the shoulder. Such kinds of illness are:
|Types of Shoulder Blade Pain||Potential Causes|
|Right Shoulder Blade Pain||Liver Cancer, Gallstones, Rupturing of an abdominal organ like Stomach, Appendix, Spleen or Ovary|
|Left Shoulder Blade Pain||Conditions due to Heart, Pancreas, Bowel, and Spleen|
|Pain between the shoulder blades||Peptic ulcer, Broken vertebra, Gastritis, Hodgkin lymphoma, Esophageal Cancer, Scoliosis, Gastro-Esophageal Reflux Disease, Aortic dissection|
Diagnosis of Shoulder Blade Pain
There are several diagnostic measures that can be taken up to access the presence and intensity of the shoulder blade pain. The prime of all are orthopedic test, and rest depends on the casualty. The various diagnostic tests are:
- Orthopedic Tests: These tests are designed specially to identify the shoulder pathology. It involves the examination of neck, chest, cervical, spinal and armpit regions for the presence of swelling, bruising or deformity in the muscles. The tests are then conducted for the assessment of the stability, power, and the extent of movement of the shoulders. These test include:-
- Painful Arc Test: It aims at identifying the painful arc or the position of maximum pain between 70 to 120 degrees of obstruction.
- Drop Arm Test: It identifies damage in the rotator cuffs by making the patient to lower the abducted arm to the waist slowly.
- External Rotation Test: This test checks for the out ward rotation of the arm when the elbow is withheld to the side.
- Gross Arm Test: This test focuses on the pain in the acromioclavicular in which the ailed arm is required to be raised to 90 degree, followed by holding the other arm across the chest.
- Scanning Test: These tests are done in order to obtain a clear image of the shoulder blade and the pain causing factors. The usual test include –
- X-ray: It uses electromagnetic radiations which produces an image of the internal structure, tissues, and bones of the shoulder region.
- Magnetic Resonance Imaging (MRI): This procedure involves the combination of magnetic radiations and radio frequencies that provide a detailed image of the ailing shoulder.
- Computed Tomography scan (CT scan): The CT scan utilizes X-rays to generate horizontal or axial images in the form of slices to give detailed information about the bones, muscles and structure of the shoulder region.
- Ultrasound: This technique utilizes the high-frequency sound waves that are reflected by the shoulder region and are translated into the images.
- Electromyogram (EMG): This test is used to evaluate the presence of any nerve injury or damage in the shoulder region that may amount to pain in the shoulder blade.
Treatment of Shoulder Blade Pain
The treatment of shoulder blade pain is mainly following measures to prevent further increase in pain. Medications can also be taken in case the shoulder blade pain doesn’t subside. The various types of treatments available are:-
- Preventive Measures: The measures ensure that the condition of the patient suffering from shoulder blade pain does not get worse and results in gradual relief. Some of the preventive measures include:
- Taking lot of Rest: Rest helps in healing which in turns aids in combating the shoulder blade pain.
- Reducing Physical Activity: It is required to reduce the strain on the shoulder by preventing the occurrence of pain in it due to repetitive motion.
- Heat and Cold Applications to Treat Shoulder Blade Pain: The application of ice packs for compression followed by heat application in alternating manner can soothe the pain. This should be done at least three times a day.
- Proper Posture to Prevent Shoulder Blade Pain:- Following proper posture especially while sleeping can prevent in severe aches and pains around shoulder blade.
- Exercise: Regular exercise can ensure proper healing of shoulder blade pain as it helps in improving strength, flexibility, and mobility of the shoulder joint thereby decreasing the pain around the shoulder blade gradually.
- Physiotherapy for Shoulder Blade Pain: Regular chiropractic sessions can offer substantial relief to the ailing shoulder. The treatment includes a deep friction therapy, which applies direct pressure to the shoulder blades as well as the affected area.
- Medications: In case all above treatments fail to reduce the pain, then pain medication can be taken under medical supervision. These include muscle relaxants, anti-inflammatory drugs and steroidal painkillers.
- Treatment of Possible Illness: In the cases where the shoulder blade pain has been caused due to other illnesses like shingles, nerve damage, or fracture, then medication and treatment should be specific to the illness present.
Exercises of Shoulder Blade Pain
There are exercises which can help in reducing shoulder blade pain and strengthen the shoulder. These exercises help in controlling and supporting the shoulder blade by targeting the scapula muscle and making it stronger by allowing a wide range of motion of the shoulder joint. Some of such exercises for shoulder blade pain are:
- Shoulder Blade Pain Exercise #1- Wall Pushups: The patient stands in front of the wall with feet apart as per the shoulder width and palms placed against the wall in front. Then the patient should push the upper body away from the wall.
- Shoulder Blade Pain Exercise #2- Sitting Shoulder Pushups: In this exercise, the patient sits on the chair with hands on the arm rest and feet flat. Then he or she has to lift the body from the chair with the help of the arms.
- Shoulder Blade Pain Exercise #3- Shoulder Flexion: It involves clapping of hands stretched in front with elbows straight, followed by lifting of arms above the head and subsequently down the head.
One must follow the exercises to prevent any injury to the shoulder and to avoid subsequent pain. However, if the shoulder blade pain has already set in, follow the preventive measures to stop it from aggravating. The preventive measures help in reducing the pain around shoulder blade to a great extent. If it still persists, one must seek immediate help as a shoulder blade pain could also indicate certain serious health problems.