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Sharp Pain Between the Shoulder Blades

Your Pain Pattern,
What Aggravates It,

The Underlying Anatomy
How to Get Relief,
and more…


How People Describe This Pain Pattern

People complain of sharp pain along the spine of the upper back between the shoulder blades. This can vary a great deal in intensity. It can be nagging and achy or sharp during a deep breath. There are several patterns between the shoulder blades, but this one is right along the spine. Often, people complain of an out-of-place vertebra. People complain about their trunk movement and breathing and not about pain in their arms and neck.

This illustration shows a focus of pain along the thoracic spine, where this often occurs. It may also occur above and below the spot shown, along the spine and ribs. Trigger points in these tiny muscles between the vertebrae create this sharp pain.

When it is more severe and creates a sharp pain on breathing, it is often described as a rib head that is out. There is some truth to that. This pain is often associated with a vertebra that is twisted. The rib head is not seated well into the vertebra and has rotated back. It usually feels like a more prominent bump there.

How You Activate and Intensify This Pain Pattern

Cold Pressed

People complain of this after an awkward position with their arms raised, like painting or installing tile. It can also happen when sitting in an awkward chair at a conference, especially when the hard back of the chair presses into a specific spot in your back. At times, clients report a sharp pain after sleeping on a cold or hard surface. I’ve had that myself.

Twist and Ouch

Some people wake up with sharp pain in the upper back after a previous day of some unusual activity like gardening or moving. As well, it can result from a twisting fall or motor vehicle accident. Sometimes it is twisting while precariously balanced or sneezing creates this sharp pain between the shoulder blades.


The Musculoskeletal Anatomy Behind Your Pain

These tiny muscles adjust the tension and position of vertebrae. They overlap to create a complex set of guy wires to stabilize the spine. This is a problem with the thoracic multifidi. Cervical multifidi produce different referral patterns and are discussed in this post.

You can read more about them in this post about multifidi and rotatores.

Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.

Therapy Notes for Massage and Bodywork

Better Bodywork
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.

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Shoulder hurt From Covid-19 Vaccine?

This post offers quick, lasting relief from pain in your shoulder that came from the vaccine. You need an ice cube and about 2 minutes.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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*This site is undergoing major changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.