Diagnosing the source of the pain under your shoulder blade and next to your spine can be difficult, as upper back conditions are less common than those affecting the neck and lower back.

Sometimes the cause of upper back pain is easy to find; other times, it's more mysterious.
Causes of Upper Back Pain Video

To help you find a treatment that works for you, or better prepare you for a visit to your doctor, here are 7 possible causes for the pain under your shoulder blade.

Article continues below

1. Poor posture

Prolonged sitting with poor posture may cause your spine to undergo structural changes that eventually cause pain underneath the shoulder blade. Hunching your back, tilting your head down, or sitting to one side—while working behind a desk or reading from a cell phone, for example—can weaken your muscles and place pressure on spinal discs, muscles, and ligaments. This routine imbalance can contribute to upper back pain.

See Posture to Straighten Your Back

2. Improper lifting technique

Lifting weight above your shoulders without proper technique can leave your upper back susceptible to injury. If you lift an object that is too heavy, without keeping your spine aligned or for a prolonged amount of time, you can place undue pressure on your upper back. This move can overstretch the ligaments around your shoulder blade.

See Three Easy Rules to Avoid Back Injury

3. Overuse

Painting a ceiling, helping a friend move furniture, or participating in a softball league are all examples of how you can put your upper back through more work than it’s used to. Overuse can lead to muscle strains and ligament sprains, which can cause pain in the area between your shoulder blade and spine.

See Upper Back Pain from Intercostal Muscle Strain

4. Dislocated rib

It’s not uncommon for a rib to pop out of place or become misaligned after repetitive strain or reaching for an item overhead. Sharp pain near your shoulder blade can result from this activity, and it can sometimes make it difficult to take a deep breath.

5. Fibromyalgia

Fibromyalgia is a chronic pain condition characterized by several symptoms. Some of the more common symptoms are fatigue and widespread pain, including tenderness and pain in the upper back. The pain can range from a dull ache to a sharp, shooting pain, which sometimes comes and goes.

Read about the Characteristic Symptoms of Fibromyalgia on Arthritis-health.com

6. Thoracic herniated disc

A herniated disc in the thoracic spine (upper back) occurs when a disc’s outer layer tears and the inner layer’s nucleus pulposus starts to leak outward, which can cause pain and may inflame a nearby nerve root. A thoracic herniated disc is uncommon, but it is a possible source to consider for the pain underneath your shoulder blade.

See Thoracic Disc Herniation Symptoms

7. Compression fracture

A compression fracture is when a vertebral bone (typically in your upper back) weakens and compresses, causing back pain that feels better with rest or is sensitive to the touch. Compression fractures are most commonly caused by osteoporosis in older adults.

Watch: Spinal Compression Fracture Video

This list of possible reasons for the pain underneath your shoulder blade is not exhaustive, but hopefully, it gives you a helpful starting point on the journey to relief.

Learn more:

Diagnosing Upper Back Pain

Relieving the Pain Under Your Shoulder Blade