What Causes Pain Between the Shoulder Blade and Spine?

Close-up of a person's hand on their upper back near their shoulder blade. The area they are touching is radiating with red color, indicating pain.
  • Back pain affects millions of people in the U.S., but upper back pain can often be prevented through proper posture, correct lifting techniques, and regular exercise.
  • There are several causes of upper back pain, including injury, acid reflux, stress, muscle strain and overuse, and fibromyalgia.
  • Risk factors, such as being overweight, smoking, and poor muscle tone, increase your chances of developing upper back pain.
  • Upper back pain can be safely treated at home. If the pain persists, worsens, or is quite severe, it requires a doctor’s visit. If upper back pain appears after a car accident, be sure to seek medical attention.

According to Georgetown University’s Health Policy Institute, back pain is the leading cause of missed work days in the U.S., with some 16 million adults being affected by the condition.

Back pain can occur for a number of different reasons, including muscle strain, poor posture, and excess weight, but a survey showed that the leading causes of back pain among Americans were stress and lack of exercise or weak muscles.

Treatment and preventative measures may depend on the cause of your back pain, as well as your age and other risk factors.

In this article, we’ll discuss upper back pain, its symptoms, possible causes, and treatment options. We’ll also explore lifestyle changes you can make to ensure back pain doesn’t seriously impact your life.

What is Upper Back Pain?

Upper back pain typically occurs between the shoulders and spine, but it can appear anywhere from the base of the neck to the bottom of the rib cage.

Low back pain and middle back pain are more common than upper back pain.

Upper back pain can be mild to severe. While it may be uncomfortable and inconvenient, in most cases, upper back pain is no cause for concern and can be safely treated at home.

Key Point: What is Rhomboid Muscle Pain?

Another term for upper back pain is rhomboid muscle pain. This refers to pain under the neck and between the shoulder blades and spine.

This type of back pain is typically caused by overworking the back, arms, and shoulders. It’s a common injury among people who:

  • Play tennis, baseball, or volleyball
  • Golf
  • Row
  • Carry heavy backpacks
A young woman in workout clothes is standing outside and holding the area by her neck and right upper back. She is cringing in discomfort.

What Are the Symptoms of Upper Back Pain?

The symptoms of upper back pain depend largely on the cause of your back pain and it will differ from one person to the next. If your symptoms are severe or they worsen over time, make sure you seek medical attention.

Some symptoms of upper back pain may include:

  • Tight or stiff back muscles
  • A throbbing pain
  • A burning sensation or sharp pain
  • A stabbing pain
  • Weakness
  • Tingling
  • Numbness
Key Point: What Are the Serious Symptoms of Upper Back Pain?

If, after a bad night’s sleep, you wake with neck or shoulder pain, it’s probably nothing to be worried about. There are, however, other symptoms that may indicate more serious problems.

Should you experience any of the following symptoms, seek immediate medical attention:

  • You have severe pain
  • You experience unexplained weight loss
  • The pain won’t disappear no matter what you do
  • You have pain in your side
  • You have a fever
  • You have chest pain
  • You experience severe fatigue
  • You have weakness in your legs
  • Pain radiates from your chest to your back
  • Breathing deeply hurts
  • The pain gets worse when you move
  • You experience shortness of breath

What Causes Upper Back Pain?

Upper back pain can occur for a number of different reasons. Once you understand what causes upper back pain, you’ll be in a better position to prevent it.

Listed below are some of the most common causes of upper back pain:

Incorrect posture

Poor posture can be both a cause and a side effect of upper back pain. For example, any injury that affects your spine — whether it’s your cervical or thoracic spine — can affect your ability to stand and sit upright. But sitting or standing incorrectly can also cause improper posture and pain.

If you’re struggling to stand or sit comfortably, it may be due to muscle strain. Prolonged slouching at a desk can do this.

Key Point: What Are the Different Parts of the Spine?

The back comprises three main parts. If any of these parts are injured — whether due to spine fractures or muscle strain — it can impact your ability to perform daily tasks.

The three main parts of the spine are:

  • The cervical spine (upper spine, closest to the neck)
  • The thoracic spine (middle back)
  • The lumbar spine (lower back)


It goes without saying that injuries to your back can cause pain. For instance, if you hurt yourself in a fall or a car accident, any spine fractures you sustain can cause upper back pain.

Injuries that happen over time, for example from lifting heavy objects on a daily basis, can also result in chronic pain.

Improper lifting

You’ve likely heard it before: lift with your legs and not your back. Practicing proper lifting techniques is essential if you want to avoid back pain.

When lifting objects, you should:

  • Straighten your back
  • Look straight ahead
  • Keep your chest out and your shoulders back
  • Slowly lift while straightening your hips and knees
  • Do not bend your back or twist your body while lifting

People who lift heavy objects frequently, like those carrying heavy bags from the grocery store, should always practice proper lifting.


Stress can cause undue tension, which can lead to muscle spasms and muscle strain.

If your upper back pain is caused by stress, your other symptoms may include headaches, sleeplessness, and pain between the shoulder blades.

Muscle strain

Muscle strains can cause spasms and cramps that are incredibly painful — especially when you try to move.

If you experience limited mobility or swelling in your back, you may have a muscle strain.

Wearing a heavy backpack

Carrying heavy bags every day can greatly contribute to chronic pain and back issues.

Those who wear heavy backpacks or carry bags that strain the back (like messenger bags or handbags) can often be seen leaning forward or to the side. This affects posture and can cause long-term neck, shoulder, and back problems.

Overuse or repetitive movements

Athletes are most prone to back pain that stems from overuse or repetitive movements. This type of back pain happens due to wear and tear over a prolonged period.

Repetitive moments — such as running, jumping, or throwing a ball — can cause rotator cuff tears. This type of injury affects the muscles and tendons that stabilize your shoulder joint.

Key Point: What Are the Symptoms of a Rotator Cuff Tear?

The rotator cuff is the name given to the group of muscles and tendons that allow you to lift and rotate your arms.

If you suspect you’ve injured your rotator cuff, you may experience the following symptoms:

  • Difficulty raising your arms
  • Pain when you move your arms or lie on them
  • Shoulder weakness
  • Limited mobility
  • A clicking or popping noise when you try to move your arm

Spinal deformities

Conditions such as scoliosis can place stress on discs and cause muscle spasms that result in chronic pain.

Acid reflux

If you experience back pain after eating a meal, it might be related to acid reflux or other digestive issues. For example, GERD (gastroesophageal reflux disease) can cause referred pain between the shoulder blade and spine.

Key Point: What is Referred Pain?

Referred pain occurs when you hurt yourself or have an issue in one part of the body and the pain is felt in another part. For example, when you have a heart attack but feel the pain in your jaw.


Also known as fibrositis, fibromyalgia is a disease that causes general pain and tenderness in the body. It can sometimes affect your upper back, making your muscles feel as though they’re overworked or strained.

What Causes Upper Back Pain in Seniors?

When older people (aged 60 and up) develop upper back pain, it might be caused by one of the following:

  • Arthritis
  • Inflammatory conditions
  • Vertebral fractures
  • Osteoporosis
  • Herniated discs
  • Spinal stenosis
  • Cancers (for example, pancreatic cancer)

What Are Some Risk Factors for Upper Back Pain?

Sometimes we can’t prevent upper back pain — accidents and injuries happen from time to time — but there are certain risk factors that make us more prone to developing back issues.

Some risk factors that increase the likelihood of back pain include:

Being overweight

When our bodies carry excess weight, our muscles, bones, and tendons take more strain, leaving us more vulnerable to injuries.


Nicotine in the bloodstream affects your body’s ability to heal, thereby preventing disc regeneration in your spine. This means your back will be more susceptible to pain caused by injuries or stress.

Contact sports

High-contact sports, such as football and soccer, increase the likelihood of injuries that can cause upper back pain.

A sedentary lifestyle

Improper posture and lack of exercise can weaken your back muscles.

Poor muscle tone

Weak back and abdominal muscles encourage forward-leaning and improper posture, increasing the likelihood of chronic back pain.

How Can I Prevent Pain Between the Shoulder Blade and Spine?

There are some easy things you can do to protect yourself from back pain and injuries. If you want to avoid unnecessary discomfort and physical therapy bills, you should:

  • Keep a good posture at all times — when you’re standing, sitting, walking, and sleeping
  • Get regular exercise
  • Maintain a healthy weight
  • Quit smoking
  • Avoid carrying items that are too heavy
  • Practice proper lifting techniques
  • Eat a balanced diet
  • Avoid static positions (move around often)
  • Lower your stress levels

How Can I Treat Upper Back Pain?

Upper back pain can be treated with a combination of different therapies and over-the-counter medicines.

If your back pain doesn’t get better within two weeks, or it starts to get progressively worse and affects your ability to move or do daily tasks, seek medical attention.

Some treatments for upper back pain include:

  • Heat or ice packs applied to the area
  • OTC pain medication, such as ibuprofen and aspirin
  • A medium-firm mattress
  • Orthopedic cushions (especially if you’re sitting for long periods)
  • A standing desk
  • Gentle stretches
  • Pilates and yoga
  • Easy exercises, such as walking
  • Physical therapy sessions
A man at a session with a physical therapist. He is doing a plank while supporting his arms on a large ball. The physical therapist has her hands under his torso for extra support.

When Should I See a Doctor for Upper Back Pain?

If your upper back pain is severe, your symptoms worsen over time, and pain relievers or other over-the-counter medicines don’t seem to help, speak to your doctor or get in touch with a physical therapist.

If you exhibit any of the more serious symptoms mentioned above, seek medical care to get the proper treatment and rule out any underlying conditions, such as cancer.

In the event that you develop upper back pain after a car accident, seek professional medical advice. Even if you feel fine after an accident, lingering pain can be a sign of a muscle tear or inflammation. Getting proper treatment can help you avoid chronic pain.

Where Can I Learn More About Upper Back Pain?

Have you been experiencing mild discomfort or severe pain in your upper back?

Maybe you hurt your back doing some heavy lifting at work, or perhaps all those hours of poor posture in front of the computer have finally caught up with you and you’d like to do something about it.

Whether you’re struggling with shoulder pain, muscle strain, or a herniated disc that’s causing debilitating pain, LifeMD can help. Make your first appointment, and get ready to meet a board-certified doctor or nurse practitioner over your smartphone, computer, or tablet.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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