03 / Understand the area
Between the shoulder blades
A broad ache between the shoulder blades often gets called tension, but that word doesn't explain why it's happening.
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.
A good first clue is if the pain changes when you move your arms, turn your head, or take a break from something you've been doing for a while. The exam may cover the upper back, neck and shoulders, along with any injury and your general health. Pain when you breathe, symptoms in the chest, or pain that stays intense at rest needs a different level of attention. When it does turn out to be a muscle-and-joint problem, we'll tell you what we think is going on, and everyday tasks like a full day at the desk or reaching overhead are good ways to judge progress.
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 switching tasks or moving your arms change the pain, or does it stay the same?
- Is the ache spread across both blades or mostly on one side?
- Are breathing, chest symptoms, fever or an injury part of the same episode?
When to get help sooner
Sudden severe upper-back pain, or upper-back pain with chest pressure, breathlessness, fainting or sweating, needs emergency assessment. Persistent unexplained pain at rest warrants medical review, and upper-back pain with a fever or feeling unwell needs an urgent medical assessment.
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.
Back pain
Common back-pain patterns, the warning signs, and what progress looks like in everyday life.
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 guideWork-related pain
How your job, any past injury and a practical plan for getting back to work and activity fit together.
Read the guideWhat the studies found, and where they stop
How the research fits this area.
The decision-aid review supports talking through options, benefits and harms together. It isn't a treatment trial for pain between the shoulder blades, and findings about low back treatment can't stand in for evidence about the mid-back.
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.
Decision aids for people facing health treatment or screening decisions
209 studies of decision aids across a range of treatment and screening choices.
What it foundDecision aids improved knowledge and understanding of risks and helped people make choices that reflected their informed values.
What it can't tell usMost of the decisions studied had nothing to do with chiropractic care. It supports laying out the options and trade-offs plainly. It doesn't rank clinics, check credentials or show that any particular treatment works.
Publication details & citation
Stacey et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews. 2024. DOI: 10.1002/14651858.CD001431.pub6.
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.