Now Offering Stellate Ganglion Block (SGB) - Relief for Chronic Pain & Stress-Related Conditions
Atlas Pain Specialists Logo, featuring caduceus with snakes and wings icon at on its left side, on a transparent background

How to Relieve Upper Back Pain Between Shoulder Blades

Date: November 19, 2024

Upper back pain between the shoulder blades is a common discomfort that can stem from various causes, including muscle strain, poor posture, and stress. This area, often referred to as the thoracic spine, is crucial for supporting upper body movements and maintaining good posture. 

When pain occurs here, it can disrupt daily activities and reduce overall quality of life. Fortunately, several effective strategies can help alleviate this discomfort. Simple self-care measures such as applying heat or cold, practicing gentle stretches, and maintaining proper posture can significantly relieve tension and pain in this region.

Understanding the Anatomy

Upper back pain between the shoulder blades can stem from various factors, often affecting essential muscle groups like the trapezius, rhomboids, and serratus anterior. These muscles support shoulder blade movement, maintain posture, and contribute to arm function. When they’re overworked, injured, or impacted by poor alignment, pain can surface, disrupting daily activities and comfort. Knowing the anatomy and common causes behind this discomfort can make a big difference in finding effective relief.

The muscles surrounding the shoulder blades play a pivotal role in stabilizing and moving your shoulders. 

  • The trapezius, a large muscle across the upper back and neck, helps with shoulder elevation and rotation. 
  • Beneath it, the rhomboids connect the shoulder blades to the spine, drawing them toward the center and helping maintain good posture. 
  • The serratus anterior runs along the side of the ribs, anchoring the shoulder blades and assisting with forward arm movement. These muscles work harmoniously but can become strained due to tension, poor habits, or injury.

Common causes of pain between the shoulder blades often include muscle strain, poor posture, and injuries, each placing stress on the upper back muscles and leading to discomfort.

  1. Muscle Strain: Overuse or sudden movements can strain the upper back muscles. Activities like heavy lifting, repetitive arm movements, or intense workouts can lead to micro-tears, causing pain and stiffness.
  2. Poor Posture: Prolonged slouching, especially during desk work or screen time, shifts undue stress onto the upper back muscles. This strain creates muscle imbalance, often resulting in soreness between the shoulder blades.
  3. Injuries or Trauma: Direct impacts, falls, or accidents can damage the shoulder blade area, leading to muscle inflammation or even minor tears. This trauma often results in lasting discomfort if left untreated.

How to Relieve Upper Back Pain Between Shoulder Blades

Upper back pain between the shoulder blades is a common complaint, often triggered by muscle strain, poor posture, or injury. Managing this discomfort effectively can make a significant difference in daily comfort and long-term spinal health. 

1. Immediate Relief Techniques

When pain between the shoulder blades strikes, using immediate relief techniques can help reduce discomfort and prevent further strain.

Rest: Taking short breaks from activities that aggravate the pain is essential. Prolonged, repetitive movements or holding certain postures (such as sitting at a desk or carrying heavy loads) can strain the upper back muscles. Brief rest periods throughout the day relieve stress on the muscles and give them a chance to recover. Additionally, positioning yourself to minimize strain—such as lying down or sitting comfortably—can further aid relaxation and prevent the worsening of the pain.

Heat and Cold Therapy: Alternating between heat and cold therapy can be particularly effective. Cold packs help reduce inflammation and numb acute pain, while heat relaxes the muscles and improves blood flow, which aids healing. For cold therapy, apply an ice pack wrapped in a cloth for 15-20 minutes every few hours during the first 24-48 hours. Follow this with heat therapy using a warm towel or heating pad for 15-20 minutes to reduce stiffness. Alternating between the two therapies can provide a balanced approach, reducing pain and promoting recovery.

2. Over-the-Counter Medications

OTC medications offer another avenue for managing pain in the short term. Two commonly used types include NSAIDs and acetaminophen. Below are the types of Medications:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs, such as ibuprofen and naproxen, work by reducing inflammation and pain. They can be especially beneficial for muscle-related pain but should be taken with caution, particularly if you have a history of stomach ulcers or bleeding.
  • Acetaminophen: This medication provides pain relief without the anti-inflammatory effects of NSAIDs, making it a gentler option for some individuals. It is effective for mild to moderate pain and generally has fewer gastrointestinal side effects.


For NSAIDs, follow the dosage instructions on the package or consult a healthcare provider for guidance, particularly if you plan to use them long-term. Acetaminophen also has dosage limits; typically, adults should not exceed 3,000 mg per day to avoid liver damage. It’s wise to consult a healthcare professional if you’re unsure about the best medication for you or have any health concerns that could be affected by these drugs.

3. Physical Therapies and Exercises

Incorporating physical therapies and exercises into your routine can be instrumental in both relieving pain and preventing future occurrences.
Simple stretches can help loosen tight muscles and alleviate discomfort between the shoulder blades.

  • Shoulder Rolls: Gently roll your shoulders forward and backward in a circular motion to relieve tension.
  • Chin Tucks: Draw your chin slightly backward to align your head with your spine, which can ease neck and upper back strain.
  • Chest Openers: Stand tall and clasp your hands behind your back, then gently lift your arms to stretch the chest and shoulder blades.

Strengthening the upper back muscles supports better posture and reduces strain on the shoulder blades. Exercises that target the rhomboids, trapezius, and core muscles are especially beneficial. Regularly performing these strengthening exercises, such as rows or resistance band pull-aparts, can build endurance in these muscles, which helps prevent future pain episodes.
Using tools like foam rollers or massage balls allows you to apply gentle pressure to sore areas, releasing muscle tension. Roll the foam roller or massage ball between the shoulder blades and along the upper back, applying moderate pressure to alleviate tightness. Self-massage can be effective both for immediate relief and as part of a regular routine to maintain muscle flexibility.

4. Posture Correction

Poor posture often contributes to upper back pain, so making ergonomic adjustments can have a substantial impact on pain management.

  • Ergonomic Adjustments: Maintaining proper posture at work and home reduces unnecessary stress on the back. Sit with your back supported, shoulders relaxed, and feet flat on the ground. Position your screen at eye level to prevent slouching, and keep frequently used items within reach to avoid overextending your arms.
  • Supportive Equipment: Ergonomic chairs, lumbar support cushions, and adjustable desks can help you maintain proper alignment and support your spine throughout the day. Investing in these supportive tools can make a difference, especially if you spend long hours sitting or working on a computer.

Professional Treatment Options

Sometimes, professional intervention is necessary to manage persistent or severe pain effectively.

If the pain persists for more than a few weeks, worsens over time, or is accompanied by other symptoms like numbness, weakness, or tingling, it’s essential to consult a healthcare professional. These signs could indicate an underlying issue that requires evaluation and specialized treatment.

Below are the types of healthcare Providers:

  • Physiotherapists: A physiotherapist can guide you through exercises and stretches specifically designed to relieve upper back pain. They can also assess any imbalances and recommend corrective exercises.
  • Chiropractors: Chiropractors can provide spinal adjustments that may relieve upper back tension and restore proper alignment.
  • Massage Therapists: A massage therapist specializing in musculoskeletal pain can offer relief through targeted techniques, easing muscle tension and improving circulation around the shoulder blades.

To maintain a pain-free upper back, adopting certain lifestyle habits and being mindful of body mechanics can prevent future episodes of pain.

Regular exercise and stretching routines that target the upper back and core muscles help maintain strength and flexibility. Incorporating low-impact activities like yoga or swimming can also improve posture and reduce the risk of muscle strain. Additionally, staying active overall and avoiding prolonged sedentary positions can keep muscles from becoming tight or weakened.

Learning proper techniques for lifting, bending, and daily activities can prevent strain on the upper back. For example, when lifting heavy objects, bend at the knees, engage your core, and keep the load close to your body to reduce the pressure on your spine and upper back. Being mindful of your body movements throughout the day can prevent unnecessary stress and improve long-term spinal health.

How a Sedentary Lifestyle Is Fueling Your Back Pain

A sedentary lifestyle is a significant contributor to upper back pain, particularly between the shoulder blades. Prolonged sitting and poor posture can lead to muscle imbalances and increased tension in the thoracic spine, exacerbating discomfort. 

By incorporating regular movement, stretching, and ergonomic adjustments into your daily routine, you can counteract these effects and promote better spinal health. Remember, small changes can make a big difference. Prioritizing physical activity not only helps alleviate back pain but also enhances overall well-being. So, stand up, stretch, and take those necessary steps towards a more active lifestyle for a healthier back!

About Dr. Sean Ormond
Dr. Sean Ormond in black medical uniform and black fog background
Dr. Sean Ormond is dual board-certified in Anesthesiology and Interventional Pain Management. He completed his anesthesia residency at Case Western University in Cleveland, Ohio where he served as Chief Resident, followed by an interventional pain management fellowship at Rush University in Chicago, IL. Following fellowship, Dr. Ormond moved to Phoenix and has been practicing in the Valley for a few years before deciding to start his own practice.
crossmenu