03 / Understand the area
Around the shoulder blade
The shoulder blade moves with the arm and lies over the rib cage. Pain around it has several possible starting points.
An educational guide that covers the left and right sides alike. Where it hurts is a useful clue, but only a clue.
A useful starting point
What this area can tell you.
An ache beside the shoulder blade may change when you reach, move your neck or keep at something for a long time. Those clues help point the exam, but they don't identify a muscle knot, and they don't prove the blade is out of position. Pain that also reaches your arm, changes when you breathe, or comes on when you're not moving at all changes the picture, and the assessment may need to include the neck, shoulder and chest, not only the spot that hurts.
Notice the pattern
Three questions to bring with you.
You don't need to know what it is before you come in. These are details that help when you tell us what you're feeling.
- Does moving your arm change the pain differently from turning your head?
- Does the pain stay beside the blade, or travel into the arm or chest?
- Is it tied to a long task, or does it happen at rest or when you breathe?
When to get help sooner
New shoulder-blade pain with chest pressure, shortness of breath, faintness or sweating needs emergency care. Fever, a significant injury, or unexplained pain that keeps on at rest should be medically assessed.
Follow the connection
Possible explanations. Better questions.
These guides cover conditions and patterns that may overlap with this area. Think of them as a place to start our conversation: no body map can tell you which one, if any, you have.
Shoulder pain
Pain when you reach, lift or sleep on your side, and the common shoulder-pain patterns behind it.
Read the guide Condition guideNeck pain
Stiffness, referred pain and nerve symptoms, and the questions our exam sets out to answer.
Read the guide Condition guideBack pain
Common back-pain patterns, the warning signs, and what progress looks like in everyday life.
Read the guideWhat the studies found, and where they stop
How the research fits this area.
These studies looked at diagnosed rotator cuff disorders and nonspecific neck pain, both of which can overlap with this area. Neither tells us the cause of pain that's only around the shoulder blade, or how to treat it.
How we select and explain sources ↗Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial
708 adults with a new episode of a rotator cuff disorder.
What it foundMore supervised exercise sessions did not improve the primary outcome over 12 months compared with a best-practice advice session. Injection offered no long-term benefit.
What it can't tell usThe advice session included home exercise and self-management. Major trauma and several other shoulder diagnoses were excluded, and it doesn't compare every shoulder treatment.
Publication details & citation
Hopewell et al. Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial. The Lancet. 2021. DOI: 10.1016/S0140-6736(21)00846-1.
Read the publication recordSpinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial
272 adults with nonspecific neck pain lasting 2 to 12 weeks.
What it foundManipulation performed better than medication at several follow-ups, but there was no important pain difference between manipulation and home exercise with advice.
What it can't tell usTreatment was unblinded. The study doesn't cover every cause of neck pain, instability after trauma, or an unexplained neurological problem.
Publication details & citation
Bronfort et al. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of Internal Medicine. 2012. DOI: 10.7326/0003-4819-156-1-201201030-00002.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.
Your next step
Bring your questions.
We’ll start there.
Your answers to those three questions are where we start. We go over your history and symptoms, examine you, and explain what we found before we recommend anything. If it turns out to be something another doctor should look at, we'll tell you.
Anatomy: BodyParts3D, © DBCLS, CC BY 4.0. Model & rendering credits. Return to the full body explorer.