Pain Symptom
Upper Back and Shoulder Blade Pain
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
There is a knot or burning ache between your shoulder blades that never quite goes away. It builds at your desk, while driving, or after carrying your kids or a bag. Massage helps for a day. Upper back pain often comes from trigger points in the muscles around the shoulder blade, and sometimes from the neck, and both can be treated at the source.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Upper Back and Shoulder Blade Pain
Upper back and shoulder blade pain is felt between the shoulder blades, along their inner edge, or across the top of the back. It is very common in people who sit at computers, drive, carry children or bags, or do overhead work.
The most common sources are trigger points in the rhomboids, middle trapezius, levator scapulae and serratus muscles, which hold the shoulder blade in position. Pain here is also frequently referred from the neck: irritated joints or nerves in the lower neck commonly send pain to the shoulder blade. Stiffness in the thoracic spine and ribs adds to the pattern.
Heart, lung and gallbladder problems can occasionally cause upper back pain, especially with shortness of breath or chest symptoms, and need medical attention. Dr. Gordon finds and treats the muscle, joint and neck sources of upper back pain.
Upper Back and Shoulder Blade Pain at a Glance
Also called
Scapula pain, thoracic pain, pain between the shoulder blades
Common sources
Trigger points in the rhomboids, trapezius and levator scapulae, neck referral, rib and thoracic stiffness
Common triggers
Desk work, driving, carrying, overhead work, stress
Often seen with
Neck pain, headaches, shoulder pain
Important
Upper back pain with chest pain or shortness of breath needs medical care
The Gap in Care
What Tests Check, and What They Can Miss
Upper back pain is often treated where it hurts. When the source is referred from the neck or deep trigger points, local massage gives only short relief.
What routine testing is looking for
- Heart, lung or gallbladder causes
- Fractures
- Disc problems in the neck
- Inflammatory conditions
What often keeps symptoms going
- Trigger points in the rhomboids and middle trapezius
- Levator scapulae tension
- Pain referred from the lower neck
- Stiff thoracic spine and ribs
- Desk and driving posture
These are found with hands-on and neck assessment, which is part of Dr. Gordon's evaluation.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
A knot between the shoulder blades
A tender spot that never fully releases.
Burning ache
Burning or aching along the inner edge of the shoulder blade.
Worse at the desk
Pain building with computer work or driving.
Pain with deep breaths
Discomfort with deep breathing or twisting.
Neck stiffness
Neck tightness along with upper back pain.
Pain after carrying
Pain after carrying children, bags or groceries.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Shoulder blade muscle trigger points
The rhomboids, trapezius and levator scapulae develop trigger points with sustained postures.
Neck referral
Irritated joints and nerves in the lower neck refer pain to the shoulder blade.
Thoracic and rib stiffness
Stiffness in the upper back and ribs loads the surrounding muscles.
Posture and stress
Desk posture and stress keep these muscles working all day.
Your First Visit
How Dr. Gordon Evaluates Upper Back and Shoulder Blade Pain
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
- 1
Records and history review
Dr. Gordon reviews your imaging, physician or physical therapy notes, medications and past treatments so he knows what has been ruled out and what has already been tried.
- 2
Neck screen
Dr. Gordon checks whether your upper back pain is coming from the neck.
- 3
Trigger point mapping
Hands-on assessment of the muscles around the shoulder blade.
- 4
Thoracic and rib mobility
Dr. Gordon checks movement in the upper back and ribs.
- 5
Plan and coordination
A clear plan, plus communication with your physician, orthopedist or physical therapist when that helps your care.
When to see a physician first
- Neck pain with fever and a stiff neck
- Weakness, numbness or clumsiness in the arms or hands that is getting worse
- Trouble walking or new balance problems
- Pain after a significant fall or accident
- Dizziness, double vision, or trouble speaking or swallowing
- Unexplained weight loss or a history of cancer
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for upper back and shoulder blade pain, chosen from your exam findings.
Orthopedic Dry Needling
Dr. Gordon has used dry needling for more than 18 years. Treatment releases deep trigger points in the rhomboids, trapezius and levator scapulae, and the neck muscles that refer pain to the area.
See all servicesNeuro-Functional Acupuncture
Electro-acupuncture along the cervical and thoracic nerve pathways to calm referred pain.
See all servicesDesk Plan & Team Coordination
Workstation and movement guidance, coordinated with your physical therapist or physician.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
From the moment I entered the practice I was greeted with kindness and professionalism as Dr. Gordon took the time to explain what he would be doing to relieve my upper back and neck pain.Denise Ham, Google Review
Upper Back and Shoulder Blade Pain Questions
Answers About Upper Back and Shoulder Blade Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Before You Book
General Questions
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Upper Back and Shoulder Blade Pain
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Further Reading
Pain Between the Shoulder Blades: What Is Usually Behind It
From the blog: Pain between the shoulder blades most often starts in the muscles there or in the lower neck. What drives it, and the warning signs that need a doctor first.
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