Shoulder symptom
Back of Shoulder or Shoulder Blade Pain
In plain language: Pain behind the shoulder may come from the shoulder itself, the muscles around the shoulder blade, or the neck. The movement pattern helps narrow it down.
Common sources
The infraspinatus and other posterior rotator cuff tissues may hurt with reaching, rotation, or throwing. Glenohumeral arthritis often produces a deep ache that can be felt toward the back of the joint. Labral and instability problems may also cause deeper pain with clicking or a feeling that the shoulder is shifting.
Pain along the inner border of the shoulder blade often involves muscle overload or poor coordination between the shoulder blade, rib cage, and arm. Neck joints and nerves can refer pain to the same area. Pain that changes with neck position or travels below the elbow increases concern for a neck or nerve source.
How it is evaluated
Your clinician observes shoulder-blade motion and checks the neck, shoulder range, rotator cuff strength, sensation, and specific positions that reproduce symptoms. The examination decides whether the clinical question is mainly about muscle control, a shoulder structure, or a nerve.
X-rays, ultrasound, MRI, or nerve tests may be used selectively. A scan is most useful when it answers a question raised by the history and examination.
Treatment options
Many muscular and movement-related problems improve with a progressive program for mobility, endurance, and shoulder-blade control. Workstation, lifting, and training changes may reduce repeated overload. Joint, tendon, or nerve-directed treatments may be considered only after the likely source is better defined.
When to seek urgent care
Get urgent help after major trauma, with new major weakness or numbness, or with fever and a hot swollen joint. Back-of-shoulder pain with chest pressure, shortness of breath, sweating, faintness, or pain spreading to the jaw or arm requires emergency evaluation.
Sources
- American College of Radiology: Chronic Shoulder Pain
- AAOS: Glenohumeral Joint Osteoarthritis Plain Language Summary
- AAOS: Rotator Cuff Injuries Plain Language Summary
This information is general and cannot identify the source of an individual patient’s pain.
Clinically reviewed by Keley John Booth, MD
Get urgent care for these
- The shoulder looks deformed or a bone may be broken after an injury
- The arm is cold, pale, blue or severely swollen
- New major weakness or loss of feeling
- Fever with a hot, red, swollen shoulder
- Shoulder pain with chest pressure, shortness of breath, sweating, or pain spreading to the jaw or arm
These need assessment now, not an appointment next week. Go to an emergency department or call 911.