What causes pain between shoulder blades?

Pain between the shoulder blades is often caused by muscle strain or poor posture, but it can also come from spinal problems or referred pain from organs such as the heart, gallbladder, or lungs.

Common causes

1. Muscle strain and tension: Overuse, lifting, repetitive movements, or sudden twisting can strain the upper back muscles.
2. Poor posture: Prolonged hunching over a computer or phone can stress the muscles and ligaments in the upper back.
3. Spinal conditions: Problems such as a herniated or bulging disc, arthritis, or degenerative disc disease in the neck or upper back can cause pain that radiates between the shoulder blades.
4. Referred pain from internal organs:
   • Gallbladder problems: Gallstones or inflammation can sometimes cause pain felt near the right shoulder blade, often after fatty meals.
   • Acid reflux/GERD: Esophageal irritation can sometimes feel like upper back pain.
   • Heart problems: A heart attack or aortic dissection can cause pain in the upper back or between the shoulder blades, and in some people—especially women—this can be one of the warning signs.
   • Lung problems: Pneumonia, pulmonary embolism, or pleurisy can cause sharp pain that may worsen with breathing.

Get urgent medical care now if the pain is severe or comes with:

• Chest pain, pressure, or tightness
• Shortness of breath
• Pain radiating to the jaw, neck, arm, or stomach
• Dizziness, fainting, or cold sweats
• Sudden, severe, tearing pain in the upper back

If the pain is mild but persistent, worsening, or unexplained, it’s a good idea to see a healthcare professional.