1. Bad Posture
Posture is probably the biggest contributor to scapular pain. Many of us spend daily hours sitting in front of a computer, which can definitely lead to discomfort between our shoulder blades, particularly if you slip into a forward-leaning position. This can easily happen when the screen is too far away, or our eyesight is not so good. Consider increasing the font size or lowering the resolution of your screen so you don't lean forward.
When your shoulders are rounded forward instead of down your back and away from your ears, it flexes your neck forward too and causes the shoulders to rotate internally. The muscles on the front of your body, like the pecs or chest, get tight or overworked, and the muscles on the back of your body, like the mid traps, become weak or overstretched. This muscle imbalance leads to discomfort and potentially - a more serious injury.
When you continuously lean forward, the neck and upper traps are stressed too because they must stabilize the head on top of their main purpose - to elevate or shrug the shoulders. This, too, can contribute to the pain.
So, how can you improve your posture? Habits are hard to break, we know, but it’s definitely not impossible. To start, try to sit actively rather than passively. By sitting forward on your chair and staying upright, you’ll avoid relaxing into a poor position. Other steps you can take include:
- Making sure to keep your chest tall, with shoulders rolled down and back and away from your ears.
- Keeping your head over your shoulders, rather than in front of them.
- If you work on a computer, the screen should be at your eye level and the keyboard close enough so you don’t have to reach for it.
For more in-depth tips on improving your posture, take a look at our previous article 8 Great Tips For Improving Your Posture. There is also a variety of exercises that can help you strengthen the muscles in the shoulder area and improve your posture. You can find them here - 10 Easy Exercises to Improve Posture.
2. Nerve compression
There are a number of nerve-related issues which can lead to pain between the shoulder blades. One common trigger for scapular pain is compression of the cervical spine (the neck region). It is usually the result of sitting in a rounded position for long periods of time.
Another possible cause of shoulder blade pain is thoracic outlet syndrome. This is an umbrella name for a group of disorders that occur when the blood vessels or nerves in the space between your collarbone and your first rib are compressed. The common causes for thoracic outlet syndrome include physical trauma from an injury, certain anatomical defects, or pregnancy.
The condition is characterized by pain and weakness in the shoulders, and tingling or pain in the fingers. Usually, physical therapy can help ease those symptoms, strengthen the chest and improve your posture.
Related: Medical Reasons for Shoulder Pain
3. Rotator cuff injuries
The rotator cuff is a group of muscles and tendons that surround the shoulder joint. A tear in your rotator cuff can be caused by overusing or repetitively performing overhead motions. Tennis players and baseball pitchers, for example, who constantly repeat hitting and throwing motions, are at higher risk of rotator cuff injuries. But you don't have to be a professional athlete to suffer from this condition. It can be the result of any repetitive overhead motion, like painting a wall or lifting heavy objects.
Another contributor to rotator cuff tear is age. According to the Journal of the American Academy of Orthopedic Surgeons, people over 40 are more prone to such injuries. If you suspect a rotator cuff injury, consult a doctor for an assessment and a treatment plan. Usually, physical therapy will help, but more severe cases might require surgery.
4. Herniated disc
Another condition that might cause pain between the shoulder blades is a herniated disc. Discs are soft, rubbery pads position between each bony vertebra. They act as shock absorbers to the spine, hold the vertebrae together, and allow for slight mobility in the spine.
Age increases the risk for a herniated disc - a condition where the softer material inside the disc slips through its tough outer layer, sometimes compressing nerves and causing pain. It can also be the result of repetitive and intense exercise.
Besides pain between your shoulder blades, you might experience weakness in the arm, tingling, or burning pain. Occasionally, a herniated disc is treated with surgery. However, depending on the severity, a herniated disc can also be eased with rest, over-the-counter pain relievers, anti-inflammatory medication, and muscle relaxers.
5. Gallbladder issues
The gallbladder is a tiny sac-like organ found under the liver. Its function is to store bile, a fluid produced by the liver that helps break down fatty foods. Gallstones - hard pieces of material often made up of cholesterol - can develop in the gallbladder and block the bile ducts.
While the most common symptom of gallstone disease is abdominal pain, A study published in 2018 found that about 37 percent of patients with gallstone disease complained of shoulder or back pain.
This condition leads to sudden and sharp pain and requires immediate medical attention. The gallbladder is not an essential organ, so surgery to take it out is often a viable treatment if you develop medical issues with it.
When to see a doctor?
Most of the conditions we mentioned above can be tricky to identify and can be easily confused with the effects of bad posture, so it can be difficult to be sure whether your situation requires medical attention.
According to physical therapist Colleen Louw, spokesperson for the American Physical Therapy Association, if you have tried improving your posture and you regularly exercise to strengthen and stretch the muscles of the upper body, yet you still experience pain, it’s time to consult your doctor. “Pain is meant to protect—it’s an output from the brain, based on the perception of threat,” she told the Healthy.
Other things to look out for are: unexplained weight-loss, redness, swelling, or warmth in the shoulder areas. Another common warning sign is waking up at night due to pain. If you notice those warning signs or experience persistent pain between your shoulder blades, it’s best to seek help to avoid any long-term issues.
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