Pain between the scapulae or dorsalgia: symptoms and treatments

Pain between the scapulae often causes great discomfort in people’s lives. Fortunately, it can be treated and relieved by health professionals.

Last update: 22 January, 2022

Pain between the scapulae, in the dorsal region, is a frequent reason for consultation worldwide. the same usually indicates a muscle contracture or injuryHowever, it can also be a warning sign of a more serious condition. Next we tell you more.

The interscapular region is constituted by the dorsal column, where the costal arches articulate and a great variety of muscles are inserted. These musculoskeletal elements are responsible for protecting internal organs such as the heart, lungs and esophagus, as well as the thoracic aorta.

The term back pain It refers to pain located in the back of the body, below the shoulders and between the shoulder blades. This is a symptom that expresses the presence of a condition or disease in the spine or adjacent structures. In addition, some thoracic and abdominal pathologies can radiate to this area.

Symptoms of back pain

The symptoms of pain between the scapulae vary according to the responsible cause. In most cases, back pain is the result of a combination of several pathological agents and affects about half of the adult population at some point in their lives.

This discomfort can occur isolated or associated with other pain in the cervical or lumbar region.. In general, the discomfort caused by a muscle contracture is usually limited to one side of the body and worsens with changes in posture.

Similarly, it is common for back pain of muscular origin to be relieved by pressing hard on the area or by applying cold compresses. But nevertheless, interscapular pain is also the result of inflammatory processes in the spine. In these cases, the discomfort will refer to the center of the back and will subside at rest.

Dysfunction of the organs of the rib cage and abdomen can also present as back pain. In addition, the person will manifest some classic symptoms of the condition. Such is the case of sweating, coldness and loss of consciousness, typical of an aortic aneurysm.

Possible causes of pain between the scapulae

Pain between the scapulae can be osteomuscular or visceral in origin. given the large number of anatomical structures that converge at this level. The condition usually disappears after a couple of days and in some cases it lasts over time.

Muscle strain or pull

Strain of the muscles of the dorsal region is the main cause of pain between the scapulae. Studies estimate a prevalence of back pain due to muscle from 60% to 85% in the adult population.

Among the situations that contribute to this discomfort are the following:

  • Bad posture when standing or sitting.
  • Sports that involve turning the body, such as tennis and golf.
  • excessive effort to lift heavy objects.
  • Sleeping on surfaces with inadequate support.

Similarly, sudden movements and falls can also cause damage to the muscle fibers of the back. In case of suspecting any trauma, it is advisable to apply ice or cold compresses and go to a specialist.

The classic golf movement is associated with pain between the scapulae due to the twist of the back.

disc herniation

Herniated discs in the dorsal column can be responsible for nerve compression, promoting the appearance of pain between the scapulae. The intensity of discomfort varies, worsening when carrying objects or maintaining the same position for long periods of time.

In most cases, the pain is accompanied by numbness, tingling, and heaviness in the shoulder, elbow, and forearm. In general, affected people should rest and take pain relievers. Advanced cases usually require infiltration.

Rheumatic diseases

Degenerative and inflammatory conditions of the musculoskeletal system can cause pain in various parts of the body. Arthritis is a common disease in older adults which can manifest with pain in the neck and in the interscapular region.

Other rheumatic causes of back pain are the following:

  • Spondyloarthrosis.
  • Fibromyalgia.
  • ankylosing spondylitis.
  • Osteoporosis.

Heart problems

In general, myocardial infarction usually manifests with severe pain in the chest that radiates to the shoulder. However, some research suggests that women are more likely than men to experience pain between the scapulae in the event of a heart attack.

In most cases, the pain is compressive in nature and persists for more than 30 minutes. In addition, it is usually accompanied by nausea, shortness of breath, sweating, paleness, and lightheadedness. Given the evidence of these symptoms, do not hesitate to consult.

On the other hand, inflammation of the pericardium that covers the heart or pericarditis can also cause chest pain that radiates to the back. This can be exacerbated by deep breathing or lying down and is relieved by tilting the chest forward.

Thoracic aortic aneurysm

An aneurysm is a dilated artery caused by an acquired or congenital weakness in the wall of a blood vessel. Studies estimate a prevalence of aneurysms in the thoracic aorta of between 6 and 10 cases per 100,000 inhabitants per year. It is more common in men over 60 years of age.

Ruptured thoracic aneurysms usually present with squeezing or stabbing pain in the chest that spreads between the shoulder blades. In addition, it is common for the person to have a cough, hoarseness and difficulty breathing. A ruptured aneurysm is a critical situation that requires emergency care.

abdominal conditions

There are a large number of abdominal problems that can present as back pain. This is a result of the closeness of the affected organ to the back. or by nerve irradiation of pain at this level.

Cholecystitis, pancreatitis, inflammation of the spleen and peptic ulcers are the main diseases associated with this type of pain. Discomfort is usually severe on the side of the body where the dysfunction is located.

Pancreatitis causes such intense pain in the abdomen that it radiates to the back.


Tumors are responsible for causing pain in various regions of the body by compression of nerve pathways. Some types of lung cancer, such as Pancoast tumor, can cause pain between the shoulder blades.

Other neoplasms with the same signs are the following:

  • Esophagus cancer.
  • lymphomas.
  • breast tumors
  • Mesotheliomas.
  • Osteosarcomas.
  • Liver cancer.

Treatment of pain between the scapulae

The treatment of back pain will depend on the condition or disease responsible of the symptoms. In general, the health professional prioritizes the temporary relief of discomfort through the use of analgesic medications, muscle relaxants, anti-inflammatories and corticosteroids.

Muscle contractures usually require massages and physiotherapy sessions to recover the tone of the fibers. Similarly, mild trauma is addressed with measures of bed rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and cold therapies.

For their part, herniated discs and rheumatic diseases require continuous monitoring by a doctor to ensure quality of life. What’s more, the affected person should implement changes in their exercise and diet habits to ensure effective recovery.

Myocardial infarction, pericarditis, and thoracic aneurysms are emergency situations that require hospitalization, pharmacological management, and even a surgical approach. On the other hand, abdominal problems have a high rate of recovery and definitive relief when they are detected in a timely manner.

A common symptom that should not be underestimated

Pain between the shoulder blades is a common symptom that can be taken lightly. In most cases, it indicates the presence of a muscle injury or contracture, but it can also be the result of a serious condition.

In this sense, early attention by a specialist doctor is essential to safeguard the life of the affected person. For this reason, do not hesitate to see a health professional if the pain persists and if it is accompanied by difficulty breathing or loss of consciousness.

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