# Back pain between the shoulder blades: causes, warning signs and what helps

Most of the time it’s a tired, overworked upper back. Sometimes it’s a message from your heart, lungs or gallbladder. Here’s how to tell the difference, and what to do about the everyday kind.

Source: https://nourishandstrong.com/back-pain-between-shoulder-blades
Published: 2026-11-07
Updated: 2026-11-07
By: the Nourish & Strong team
General information, not medical advice.

**The short answer:** most back pain between the shoulder blades comes from strained or overworked upper back muscles, often after hours of slouching at a desk or looking down at a phone. It usually eases with movement, heat and better posture. Less often, the pain is referred from the heart, lungs, gallbladder or esophagus. Call 911 if it comes with chest pain, breathlessness, sweating or nausea.

NHS physiotherapists say the upper back is the least common place to get spinal pain, and most cases get better on their own with time and gentle exercise.

## What causes pain between the shoulder blades?

Muscle and joint strain is the most likely cause. Cleveland Clinic also lists sprains, herniated disks, osteoporosis and arthritis. Pain can also be referred: your brain reads a signal from an organ as coming from your back.

| Cause | What it often feels like | What to do |
| --- | --- | --- |
| Muscle strain or posture | Ache or tightness that builds after sitting, driving or screen time and eases when you move | Self-care: movement, heat, stretches |
| Repetitive strain from work | Soreness after the same task, day after day | Change the setup, take breaks |
| Disk or nerve problem | Pain that spreads, with tingling or pins and needles | See a doctor |
| Esophagus spasm | A twisting pain right between the shoulder blades | See a doctor |
| Gallstones | Severe pain in the upper right belly lasting over 30 minutes, sometimes spreading to the back | Urgent care; 911 if severe |
| Heart attack or angina | Chest pressure or squeezing, pain in the back, arms, neck or jaw, breathlessness | Call 911 |
| Pulmonary embolism (lung clot) | Sudden breathlessness, chest or upper back pain that’s worse when you breathe in | Call 911 |
| Aortic dissection | Sudden, severe tearing or ripping pain that moves from the chest to under the shoulder blades | Call 911 |

The serious causes are much rarer. Aortic dissection, a tear in the body’s main artery, affects around 3 in 100,000 people a year, according to MedlinePlus.

## Can pain between the shoulder blades be heart related?

Yes. The National Heart, Lung, and Blood Institute (NHLBI) lists pain in the back, shoulders, arms, neck or jaw as heart attack symptoms. Chest pain, heaviness or discomfort is the most common sign, but symptoms can start slowly, be mild, and come and go over several hours.

**Heart attack signs can differ by sex.** Men and women both often have chest pain. The NHLBI says women are more likely to also have pain in the shoulder, back or arm, shortness of breath, unusual tiredness and weakness, an upset stomach, or anxiety. These can happen with or without chest pain, so many women don’t recognize them as a heart attack.

**Call 911 right away if your back pain comes with:**

- Chest pain, pressure, squeezing or heaviness
- Pain spreading to your arm, neck or jaw
- Shortness of breath, sweating, nausea, or light-headedness
- A sudden, severe tearing or ripping pain
- Sudden difficulty breathing, or a racing heartbeat

Don’t drive yourself. The NHLBI says an ambulance is the safest way to the hospital. Call even if you’re not sure it’s your heart.

## Can gallbladder or stomach problems cause pain between the shoulder blades?

They can. Cleveland Clinic says gallbladder pain often spreads to the right side of the rib cage, the right shoulder blade and the back. Gallstones are the most common cause. A gallbladder attack usually brings pain in the upper right belly, often after a heavy meal and in the evening or at night, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

- **Gallstones:** the NHS says to get urgent advice for belly pain lasting longer than 30 minutes. Get emergency help if the pain is sudden and severe, spreads to your back while you’re being sick, or comes with a high temperature or yellow skin or eyes.
- **Pancreatitis:** severe, sharp upper belly pain that spreads to the sides and back, often worse after eating or lying down. Get emergency help if it spreads to your back.
- **Esophagus:** a spasm can feel like a twisting pain right between the shoulder blades, according to Cleveland Clinic.
- **Shingles:** tingling or painful skin on one side of the body, with a rash a few days later. See a pharmacist or doctor early.

Lung problems can also hurt in the back. Cleveland Clinic notes that pleurisy, an inflamed lung lining, causes back pain when you breathe.

## What stretches help pain between the shoulder blades?

Gentle moves that open your chest and strengthen the muscles that pull your shoulders back. These six come from Cleveland Clinic and NHS guidance. Stop if the pain gets sharper.

### 1. Chin tuck

Sit tall. Pull your chin straight back without looking up or down, as if making a double chin. Hold for several seconds, then relax. Repeat through the day.

### 2. Wall angels

Stand with your head, shoulder blades and hips against a wall. With palms facing out, slide the backs of your hands up the wall over your head, then slowly back down.

### 3. Doorway chest stretch

Stand in a doorway with your elbows bent at 90 degrees and palms on the frame. Step one foot back and lean forward until you feel a stretch across your chest. Hold for a few seconds, then switch legs.

### 4. Shoulder blade push

Lie on your back with your knees bent and palms facing up. Push your shoulder blades down and back into the floor. Hold, relax and repeat.

### 5. Band row

Loop a resistance band around a doorknob and hold one end in each hand. Pull your elbows back close to your sides and squeeze your shoulder blades together. Keep your elbows low.

### 6. Neck stretch

Sit upright and hold your left shoulder down with your right hand. Slowly tilt your head to the right. Hold for 5 seconds and repeat 3 times on each side.

NHS physiotherapists suggest stretches little and often, and strength moves like the row in 3 or 4 sets of 8 to 12, about 3 or 4 times a week. Expect some change within 6 weeks. Our [gentle exercises for lower back pain](https://nourishandstrong.com/exercises-for-lower-back-pain) pair well if your whole back feels stiff.

## How should you sit at a desk to stop upper back pain?

Keep your head over your shoulders and your shoulders relaxed. Cleveland Clinic says your head weighs about 10 to 12 pounds, and the farther it moves forward, the more strain it puts on your neck.

| Setup | Target |
| --- | --- |
| Screen height | Your eyes land near the bottom of the top third of the screen |
| Elbows | Bent at about 90° while you type |
| Hips and knees | About 90° |
| Feet | Flat on the floor, or on a footrest |
| Laptop | Raise it and use a separate keyboard and mouse |
| Movement | Stand, stretch or walk every 45 to 60 minutes |

A Cleveland Clinic physical therapist suggests a timer every 10 minutes or so as a reminder to check your posture. If your lower back aches too, read about [lower back pain from sitting](https://nourishandstrong.com/lower-back-pain-from-sitting). For a full routine, try these [upper back pain exercises](https://nourishandstrong.com/upper-back-pain-exercises), and if your neck aches too, these [neck pain exercises](https://nourishandstrong.com/neck-pain-exercises).

## How should you sleep with pain between your shoulder blades?

Sleep on your back or side with your head, shoulders and hips in line. Cleveland Clinic says back sleeping puts the least pressure on your spine, and stomach sleeping is the position most often linked to pain.

- **On your back:** use a pillow that keeps your chin level, neither tipped up nor down.
- **On your side:** choose a pillow thick enough that your head doesn’t droop, look forward instead of tucking your chin, and put a pillow between your knees.
- **Switch sides** regularly.
- **Stretch before bed** to ease tension built up during the day.

The NHS says an ice pack or a heat pack wrapped in a tea towel can ease pain, with heat best for stiffness and muscle spasms. Avoid long spells in bed, because staying active helps you recover faster.

## When should you see a doctor for pain between the shoulder blades?

See a doctor if the pain isn’t better after a week, Cleveland Clinic advises. The NHS also suggests seeing a doctor for back pain that comes from between your shoulders, gets worse at night, or doesn’t improve with home care. Make an appointment sooner if:

- The pain started after a fall or injury
- You have osteoporosis and the pain started suddenly
- You have a fever, feel unwell, or are losing weight without trying
- You have tingling or numbness in your buttocks, legs or feet
- There’s a lump or swelling, or your back has changed shape

Get emergency care for weakness in one or both legs, or loss of bladder or bowel control.

## Your next step

Today, raise your screen and try the chin tuck. Tonight, check your pillow height. If a sore knee keeps you awake, read about [knee pain at night](https://nourishandstrong.com/knee-pain-at-night). For a plan to keep handy, see [how to get rid of back pain](https://nourishandstrong.com/how-to-get-rid-of-back-pain) and the free [back pain rescue card](https://nourishandstrong.com/back-pain-rescue-card). If your lower back hurts too, [The Back Pain Reset](https://nourishandstrong.com/back-pain-reset) below sets out ten-minute sessions for 28 days.

## Quick questions

### Why does my back hurt between my shoulder blades?

The most common reason is strained or tired upper back muscles, often from slouching at a desk, driving or looking down at a phone. Repetitive work, sprains and disk problems can also cause it. Less often, the pain is referred from the heart, lungs, gallbladder or esophagus, so pain with other symptoms needs a doctor.

### Can back pain between the shoulder blades be heart related?

Yes. The NHLBI lists pain in the back, shoulders, arms, neck or jaw as heart attack symptoms. Call 911 if the pain comes with chest pressure, shortness of breath, sweating, nausea or light-headedness. Women are more likely than men to have back or shoulder pain with a heart attack, sometimes without chest pain.

### Why does it hurt between my shoulder blades when I breathe?

Pain that gets worse when you breathe in can come from the lungs. Cleveland Clinic lists pleurisy and chest infections, and a blood clot in the lung can cause sudden breathlessness with chest or upper back pain. Call 911 if breathing suddenly becomes hard, and get urgent help if you cough up blood.

### Can indigestion cause pain between the shoulder blades?

It can feel that way. Cleveland Clinic says a spasm in the esophagus can cause a twisting pain between the shoulder blades, and gallstones can send pain to the back. But the NHS lists a feeling like indigestion as a heart attack symptom, so call 911 if it comes with chest pain, sweating or breathlessness.

### Is pain between the shoulder blades a sign of a heart attack in women?

It can be. The NHLBI says women having a heart attack are more likely than men to have pain in the shoulder, back or arm, shortness of breath, unusual tiredness, an upset stomach or anxiety. These can happen without chest pain. Call 911 if new upper back pain comes with any of them.

### How long does pain between the shoulder blades last?

Most muscle-related upper back pain improves on its own with time and gentle exercise. NHS physiotherapists say you should notice some change within 6 weeks of regular exercises and pacing. Cleveland Clinic advises seeing a doctor if it’s not better after a week, and the NHS says to get urgent advice if severe pain starts suddenly.

This article is general information, not medical advice. If back pain comes with chest pain, trouble breathing, sweating or nausea, call 911. If you have osteoporosis, a heart condition or another health condition, ask your doctor which exercises are right for you.

## Sources

- [Cleveland Clinic. Upper Back Pain](https://my.clevelandclinic.org/health/symptoms/22866-upper-back-pain)
- [Cleveland Clinic. Chest and Back Pain](https://my.clevelandclinic.org/health/symptoms/chest-and-back-pain)
- [Norfolk and Waveney Community Musculoskeletal Services (NHS). Upper Back](https://norfolkandwaveneycommunityhealth.nhs.uk/msk/self-help/back/upper-back/)
- [NHS. Back pain](https://www.nhs.uk/conditions/back-pain/)
- [National Heart, Lung, and Blood Institute. Heart Attack Symptoms](https://www.nhlbi.nih.gov/health/heart-attack/symptoms)
- [National Heart, Lung, and Blood Institute. Heart Attacks in Women](https://www.nhlbi.nih.gov/health/heart-attack/women)
- [NHS. Heart attack](https://www.nhs.uk/conditions/heart-attack/)
- [NHS. Pulmonary embolism](https://www.nhs.uk/conditions/pulmonary-embolism/)
- [MedlinePlus. Aortic dissection](https://medlineplus.gov/ency/article/000181.htm)
- [NHS. Gallstones](https://www.nhs.uk/conditions/gallstones/)
- [National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Gallstones](https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/symptoms-causes)
- [NHS. Acute pancreatitis](https://www.nhs.uk/conditions/acute-pancreatitis/)
- [NHS. Shingles](https://www.nhs.uk/conditions/shingles/)
- [Cleveland Clinic. 8 Posture Exercises To Sit and Stand Straighter](https://health.clevelandclinic.org/posture-exercises)
- [NHS. Flexibility exercises](https://www.nhs.uk/live-well/exercise/flexibility-exercises/)
- [Cleveland Clinic. Ergonomics 101: How To Set Up Your Desk To Avoid Aches and Pains](https://health.clevelandclinic.org/heres-how-to-set-up-your-office-to-avoid-aches-pain)
- [Cleveland Clinic. Best Sleeping Positions for Pain](https://health.clevelandclinic.org/best-sleeping-positions-for-pain)