What Can Cause Shoulder Blade Pain?
There are some common conditions that can cause someone to feel pain in the shoulder. This may include a rotator cuff tear, rotator cuff tendinitis, frozen shoulder (adhesive capsulitis), and impingement syndrome. When diagnosing shoulder pain the neck must also be ruled out as a cause because often time and issue in the neck can refer pain into the shoulder. Many shoulder pain conditions can be treated without requiring medications, injections, or surgery.
Rotator Cuff Tear
The rotator cuff muscles are a group of muscles that provide stability to the shoulder as it moves through varying degrees of motion. If an injury occurs to these muscles or the tendons (the connective tissue that attaches the muscle to the bone) then certain movements can become painful. This pain can be felt in the top back area of our shoulder or even into the outside upper arm region. Rotator cuff tears can keep you from performing normal daily movements, lifting, or participating in your favorite activities pain free.
Some of the more common signs of a rotator cuff tear include:
- shoulder pain at night
- Pain with raising arm or lowering arm
- Weakness in the arm
Rotator cuff tears usually occur in two different ways. A rotator cuff tear can occur from trauma to the area such as falling on the arm or lifting a heavy object. In this case you will feel immediate pain and likely experience a loss of ability to move your shoulder. A tear can also occur through overuse of the muscle over time which can cause the muscle and tendon fibers to breakdown gradually. This gradual type of tear usually occurs in the 50 + yr and older population and is treatable without surgery.
What can be done about rotator cuff tear?
Contrary to popular belief surgery is not always necessary for a rotator cuff tear. Each case needs to be examined independently to determine what the best option may be for the patient. Recent research has proven that people who undergo physical therapy alone for rotator cuff tears can have the same outcomes and benefits compared to those who underwent surgery. It is important to consult with a trusted and qualified medical professional to help you make this decision based on your personal goals.
Rotator Cuff Tendinitis
Rotator Cuff tendinitis occurs when the tendons (the fibers that connect the muscle to the bone) are overused and become irritated. This over use can lead to inflammation in the tendon and cause pain with movements especially during and after activities that require more use of the shoulder. This most commonly occurs in weight lifters, athletes, and laborers who perform similar motions repetitively. The key to treating rotator cuff tendinitis is to understand the factors that are causing more stress and load to be placed on the tendon. Once those factors are identified and corrected then normal pain free motion can occur.
Some of the common signs of rotator cuff tendinitis include:
- Pain during and after activity (which may last until the next day)
- A dull ache in the shoulder and upper arm region
- Pain that gets better with ice and rest.
What can be done about Rotator Cuff Tendinitis?
Rotator cuff tendinitis is a treatable condition that does not require surgery, medications or injections. The first step required to successfully treat this condition is to understand which specific movements bring about the pain. After this then a proper load management program must be put in place. Typically with tendinitis it is a case where the tendon has been placed under too much͞stress͟ or ͞load͟ which causes it to become painful. Managing the load/stress placed on the tendon is crucial to achieving full recovery. Once these two steps are completed a proper strengthening/stability program can be put in place to make sure that the rotator cuff tendinitis pain does not return. The main point to understand is that this is a treatable condition and you can restore pain free movement with the correct treatment program from a trusted medical professional.
Frozen Shoulder (Adhesive Capsulitis)
Frozen Shoulder which is also known as adhesive capsulitis is a condition in which there is loss of mobility and increased pain in the shoulder. This loss of motion and pain usually occurs gradually over time and can last 12 -18 months. Evidence has shown that this condition mainly affects middle aged women and occurs at increased rates with those who have diabetes or thyroid conditions. People who have frozen shoulder also have an increased risk for it occurring in the opposite shoulder as well. There is still debate on what exactly causes frozen shoulder. It is believed that the condition can be brought about by inflammation to the shoulder joint, an initial shoulder injury that progresses to frozen shoulder, or the body ͞attacking the shoulder joint͟ such as would happen in an autoimmune response.
Some of the common signs of frozen shoulder include:
- Pain in the shoulder and inability to tuck shirt in the back or clasp bra strap
- Loss of motion and increase pain when moving shoulder in any direction
- Pain when sleeping at night
What can be done about Frozen Shoulder (Adhesive Capsulitis)
A structured program that includes hands on treatment to loosen up the joint and muscles along with flexibility and strengthening exercises can help alleviate the pain associated with frozen shoulder. There are 4 different stages of frozen shoulder. The stage that you are in will determine what exercises, stretches, or treatment will work best for you. The stages are 1. Pre freezing 2. Freezing 3. Frozen and 4. Thawing. Once the correct stage is identified you can perform specific flexibility and strengthening exercises to help decrease pain and improve your mobility. Surgery or other invasive procedures are not necessary for this condition as it has a natural course of 12-18 months.
3 Main Causes Shoulder Blade Pain
Shoulder blade pain is a common condition that affects office workers, manual laborers, athletes, and weight lifters. Many times pain in the shoulder blade can be caused by a problem with the muscles in your upper back which is also called the thoracic spine. Shoulder blade pain can also occur due to problem at with the spine itself. However, a little-known fact is that pain in the shoulder blade may be referred pain from the neck. Often times people fail treatment for their shoulder blade pain because the root cause of the pain (which can be the neck) was not treated. In this article we’ll cover the different possible causes of shoulder blade pain.
1.Upper Back/Thoracic Spine
The upper back (which can also be referred to as the thoracic spine) is the part of the spine that runs down from our neck between the shoulder blades. The upper back plays a roll in the ability to maintain good posture, move the neck, throw a ball, and lift objects at overhead. Good mobility in the thoracic spine is necessary in order to move the arms, upper back, and neck without difficulty. When there is a loss of mobility in the thoracic spine then pain can set it.
Some of the common signs of pain related to the upper back include:
- Pain with prolonged sitting postures
- Pain with overhead lifting
- Pain with twisting your back side to side
If the pain is caused by the upper back region it may feel tight, sharp or a dull ache. Normally the shoulder pain can begin as stiffens and gradually worsen into a sharp sensation if left untreated. This type of pain is usually felt on one side between the spine and the shoulder blade. It can be hard to pinpoint on yourself where the pain is coming from as it may be coming from the muscles in that region or the spine itself. If you feel pain with moving that area of your upper back in certain ways then the pain may be due to a restriction at the thoracic spine.
2.Referred Pain from the Neck
In order to determine the root cause of the shoulder blade pain sometimes areas AWAY from the site of the actual pain need to be considered. For instance, it has been well documented that the neck can actually refer pain down into the shoulder blade region. There have been studies conducted that have shown that certain parts of the neck when pressed upon can refer pain into the shoulder blade region. It is important for any case of shoulder blade pain that the neck be assessed as the possible root cause.
Common signs of shoulder blade pain that comes from the neck includes:
- Pain reproduced with moving the neck
- Pain with prolonged looking down
- Multiple sites of pain including top of the shoulder, neck, and shoulder blade.
Pain in the shoulder blade pain from the neck can be described as a burning or tingling sensation. Often time people will get a massage to the area because it feels as if the muscles in that region have been “pulled”. Unfortunately, the relief from the massage usually does not last long because it does not address the underlying root cause of the pain.
A simple way to decipher whether or not your shoulder blade pain is to move to turn your head side to side and look up then down. If this reproduces some of the pain that you feel in shoulder blade region then there is a possibility that the pain you are experience could be coming from the neck.
3.Poor Posture and Muscle Weakness
Modern desk jobs and increased use of technology have led to greater demands being placed on our upper back and shoulder blade region. Larger amounts of stress are placed on the shoulder blade muscles and upper back as sitting becomes the majority position during the day. When muscles get overworked they then become “fatigued” and tighten up because they are no longer able to perform their job well. This will give the sensation that your shoulder blade region feels “tight” causing you to “stretch” the area out. However typically the underlying root case of the pain is from a “weakness” in key shoulder blade muscles and not a true tightness.
Some common signs of this pain include:
- Pain that increases with sitting as the day progresses.
- Pain that is relieved with laying down
- One sided pain that feels tight or dull ache.
People that experience shoulder blade pain associated with weak muscles typically report they do not notice their symptoms as much during their off days or on the weekend. If the shoulder blade pain occurs during certain lifting or sporting activities and not during rest periods then that can also be a sign indicating muscle weakness. This is because during the “down time”or “off time”the muscles are not placed under as much stress and thus do not get “overworked”. Below is an exercise that can be worked on to improve muscle endurance in your shoulder blades. Start with your elbows and arms up against the table and then slide your arms up the wall. Then return back to start position. Perform in a slow and controlled manner until you feel fatigue in the upper back/shoulder blade region.