The most frequent reasons for back discomfort between the shoulders are musculoskeletal or due to the way the muscles and skeleton interact however it is important to understand that this definition is an umbrella within which a myriad of other causes are. Certain musculoskeletal injuries are severe caused by accident or injury, whereas others develop over time as a result of inadequate alignment or movement or the development of certain illnesses, according to Dave Ochsendorf, a physical therapy therapist who works at Siesta Key Sports and Physical Therapy in Sarasota, Florida.

Poor Posture

In a world in which so many of us spend a large portion of the day at a desk or at a gadget with our shoulders stretched forward and back round bad posture is most prominent of causes of pain in shoulders, claims Ochsendorf. The most common causes of poor posture include slumping as well as “forward forward head posture” where one’s head is positioned forward while standing or walking instead of being in alignment in a straight line with their spine.

“We have many pain-related problems that stem from standing and posture, and these muscles between the shoulders] stay under tension throughout the day,” says Ochsendorf. “We aren’t doing enough to alleviate that tension by opening our chest and our upper back towards the opposing direction and energizing the muscles that are that are between our shoulders.”

In order to determine if bad posture is the sole reason to blame for pain in the shoulders There are several ways that a physical therapist or other health specialist could make a diagnosis starting with observation. “From the moment patients enter the room and we’re watching them to assess how round their shoulders are” Oschsendorf explains. “What extent of a issue do we face in this regard?”

To determine if poor posture can contribute to pain in a patient, Ochsendorf conducts an exam that focuses on moves that cause or ease pain. He then press on ribs, muscles and joints to determine or rule out any other muscles-related issues depending on the degree of tenderness or tightness the patient is in different regions.

For instance the upper crossed syndrome one of the posture-related issues which a physical therapist may be looking for when assessing discomfort between the shoulders. The condition is caused by an imbalance of strength and weakening in specific muscles in the upper back shoulder, chest and shoulders and is often a requirement for exercise or specific exercises to address.

How to correct It: The first step is to identify the root for poor posture. Although “tech neck”–strain in the spine that is caused by constant looking down at your phone typical, the way in which the workstations we use can be a key cause of bad posture. However, there are some adjustments to ensure that the hours you work don’t contribute to back discomfort. As an example, make sure your chair is adjusted so that your feet are level on the floor while your knees and hips are at 90 degrees while your back is well-supported. Use an articulating keyboard that is placed right in front of your and ensure you follow the latest ergonomic guidelines regarding the positioning of your computer, monitor and phones to ensure your hours working aren’t adding to your back discomfort. Oschsendorf suggests that a coworker or friend take a photograph of you working at your computer. “Many of these posture issues are something we’ve been doing for too long and aren’t conscious of it,” he says.

From a medical viewpoint, improving posture is strengthening the muscles between the shoulder blades as well as stretching your chest, ribs and shoulders, so that the shoulder blades stay at a level and roll back to where they are. Ochsendorf often recommends the three stretching exercises listed below to his clients.

  • Stretching your doorway: Stand in a corner or in a doorway, by extending your hand to the wall. Then turn away to stretch your pectoral muscles.
  • The foam roller is stretched: Place a foam roller vertically along your spine and then relax it, allowing your shoulders and chest to expand. You can also place the foam roller parallel to your spine over the shoulder blades and then lay back onto it causing an extension. (This stretch is suitable for those who are able to get up and down safely from the floor.)
  • Personalized exercise: These exercises may include reverse flys, rows or other exercises specific to the reason for an individual’s discomfort.

A visit to a physical therapist may assist with customized treatment strategies. “We massage the area as well as assist patients by stretching or helping to move the vertebrae or ribs by hand,” says Ochsendorf. “There are other options we can use including laser or ultrasound to attempt to reduce certain areas of inflammation.” Ice, heat and anti-inflammatory medication may be suggested.

Other treatments that include chiropractic or massage therapy are also effective in alleviating pain, says Ochsendorf However, he suggests mixing these therapies along with physical therapy. “If you’re looking to pinpoint the cause of the problem to ensure it does not come back then you should not use the band-aid,” he says. “You need to determine the reason for it and the mistakes you’ve made and how you can prevent it from happening again in the future.”

Muscle Strain

A muscle strain happens when muscles are injured as a result of the overuse of it or an injury that causes the muscle to be pulling, twisting, or breaking.

An injury that is caused by overuse can occur due to a movement that you repeat regularly and could be linked to postural problems (having your shoulders turned forward or tilting your head down while you work or using devices is a typical way to put excessive tension on the muscles that connect the shoulders). But, overuse injuries to the upper back could result from any of a range of repetitive actions that are very common in specific professions (like dental work) or in hobbies (like specific sports like volleyball).

Acute muscle strains that occur between the shoulder blades typically occur in the event of lifting something too heavy or lift something using poor technique. There’s also the possibility of suffering an acute strain due to an accident or fall that twists or pulls the upper back muscles.

How to correct the problem: Many of the tips listed above regarding poor posture could help in the event of muscle strains, provided the exercises and stretches do not further aggrave the injury, as per the doctor Dr. Padavan.

The majority of the musculoskeletal issues that cause shoulder pain can be managed conservatively with heat, for example, alternating with stretching, ice, mild range of motion exercises antiinflammatory medication, and creams for the skin, he says.

If you’re in extreme painand the pain isn’t getting better over time, or it’s getting worse despite treatments that aren’t working, seeing your health professional to get an official diagnosis and treatment plan is vital.

Restricted Rib or Vertebrae

Have you ever felt a neck kink where it is a bit pain-free and stuck? “The similar problem can occur with your vertebrae” Ochsendorf says. Ochsendorf. “Each vertebrae has a bone connected to it. The tiny joints that the rib enters or an interthoracic joint between two vertebrae, could be, without an appropriate way to put it, become imprisoned.” This instance there is a limitation in movement and attempting to extend beyond a specific range of motion could be to be painful, he says.

Additionally, this issue can be closely related to posture. Poor posture could cause this issue, and this problem could recur if you have poor posture.

How to solve the issue: The foam roller is the perfect solution in this instance, since the primary purpose is to achieve more extension, according to Ochsendorf saying that gentle rolling over your foam roller can be the easiest method to allow that extension to occur. “Doing some stretching in the rotational direction can aid in releasing things for a second time,” he says. However, as is the case in the case of posture, it’s crucial to determine the cause of the issue, and it’s recommended to be assessed by a healthcare doctor if you believe you’re suffering from a strained rib or vertebrae.


Other types of injuries like pinched nerves, discs that bulge and vertebral compression fractures may also cause pain between the shoulders, according to Ochsendorf. These kinds of injuries require a medical assessment and treatment options vary.

The Pinched Nerves

The pinched nerve located in your neck is something Dr. Ochsendorf is often confronted with and often it is possible to check for it via the phone. “I request that they turn their head back towards the side that they’re feeling pain in the shoulders,” he says. “That is a common way to pinch the nerve. In contrast, if they turn their heads down and then to the opposite side the movement should alleviate the discomfort. If you’re moving your head and it’s having an impact on your symptoms, it’s most likely that you have a nerve that’s pinched. nerve.”

What can you do to fix It: In some cases just stretching your head in certain ways regularly helps the area heal, according to Ochsendorf. “It’s simple fix can be taught to people in managing the condition and it’s a good way to heal quickly.” But in some cases, long-term postural issues must be addressed. In that case, treatment for the case takes longer and could require the assistance of the physical therapist as well, he says.

The Bulging of Herniated Disks

Between each vertebrae of your spine is a shock absorber made of gel, known as discs that allow the movement of your spine. The disc can bulge when the disc gets damaged, which causes it to protrude into your spinal canal. The damage could cause extreme discomfort, numbness or even weakness or even numbness. You may not feel anything. A herniated disc in contrast is a disc which has completely ruptured. The risk of this injury is higher to happen in the cervical or lumbar spine however, it could be seen in the thoracic spine as well.

How to solve the problem: Both bulging discs and herniated discs are treated by rest, medication as well as physical therapy. Cortisone injections may be an option for relieving pain , too. While non-operative treatments work for the majority of instances, surgery could be an option in more severe cases that do not improve in the course of about six weeks. If you suspect that you may have a herniated or bulging disc, you must be assessed by your physician.

Vertebral Compression Fractures

Vertebral compression injuries can cause shoulder pain and are typically caused by low bone density, but they can be caused by injuries, like car accidents or falls according to Ochsendorf. “Older people with bone density issues , as well as thoracic Kyphosis (a lower back that is rounded back) are particularly susceptible to fractures in their vertebrae, and they can be damaged by simply bent forward at times,” he says. Everyday activities like turning your back in bed be extremely painful and the problem must be assessed by a medical professional according to him.

How to repair the issue: “A common treatment for vertebral compression fractures is kyphoplasty. This is where the injection of a specific cement is done to improve the shape and the height of the vertebrae, and to reduce pain” Ochsendorf says. Ochsendorf. “Spinal decompression exercises are instructed in physical therapy, and patients can be taught about the importance of posture in daily activities,” Ochsendorf says.


It affects between 2% and approximately 3% of the world’s population, scoliosis is a chronic condition that causes curvature and a rotation of the spine. Muscle spasms as well as local inflammation or degeneration of the intervertebral discs , or joints as a result of scoliosis could be the cause of chronic or acute discomfort between the shoulders’ blades. Scoliosis-related pain is more prevalent in people who suffer from the condition.

What can be done to solve the issue: Early detection of Scoliosis is essential for the reasons that most students are screened for scoliosis with an aide or health care specialist in the schools. If you are being referred to a specialist for further evaluation and found to be scoliosis-prone there are two kinds of treatment objectives which are Morphological (which refers with aesthetics) as well as functional (pertaining to mobility).

There are a variety of treatment options that can be considered, but they differ in each case. The health professional will consult with you to decide on the most effective treatment for you if you’ve been diagnosed with Scoliosis.


Osteoarthritis (OA) in the shoulders isn’t nearly as common as knee or hip, but as per the Arthritis Foundation, approximately one third of all people over the age of 60 are affected by shoulder OA. OA can affect any area of the spine however it is most often found in the lower back or neck region than the thoracic spine. If you’re experiencing tenderness, stiffness or crepitus (a crushing sensation whenever you move) it’s a good idea to consult with your doctor regarding whether you might have OA.

How to treat It: OA is a degenerative joint disorder that can’t be treated, however many treatment options can be helpful. Cold or hot therapy massage, physical therapy stretching, exercise and braces that support the joint will help reduce discomfort. Surgery is an option if none else can help the discomfort.

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