Back Shoulder Pain: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Back Shoulder Pain
Dr. Garrett Stroup. Physical Therapist in Roseburg Area.


Dr. Garrett C. Stroup

DPT, VRC - Owner and Founder

We help athletes and active adults regain control of their injury without expensive surgeries or medications, so they can keep going.


Back shoulder pain, also known as interscapular pain, is a common complaint that affects people of all ages and lifestyles. The shoulder region is a complex area comprised of bones, muscles, ligaments, and tendons, which work together to provide a wide range of motion and stability. However, due to various factors, the back shoulder area can experience pain and discomfort. In this comprehensive article, we will delve into the causes, symptoms, diagnosis, treatment options, and preventive measures for back shoulder pain.

Section 1: Anatomy of the Back Shoulder

The back shoulder region encompasses the upper back and the posterior aspect of the shoulder joint. It involves several important structures, including:

  • Scapula (Shoulder Blade): The triangular-shaped bone that lies over the upper back and forms the back part of the shoulder joint.
  • Rhomboid Muscles: A group of muscles located between the scapula and the spine, responsible for retracting the shoulder blades.
  • Trapezius Muscle: A large muscle that extends from the base of the skull to the mid-back and plays a crucial role in shoulder and neck movements.
  • Levator Scapulae Muscle: A muscle that elevates the scapula and helps rotate the neck.

Section 2: Common Causes of Back Shoulder Pain

Common Causes of Back Shoulder Pain


Back shoulder pain can result from various factors, including:

  • Muscle Strain: Overuse, poor posture, or sudden movements can strain the muscles in the back shoulder region.
  • Poor Posture: Prolonged slouching or hunching can lead to muscle imbalances and strain on the back and shoulder muscles.
  • Rotator Cuff Injuries: Inflammation or tears in the rotator cuff muscles and tendons can cause pain and limited shoulder movement.
  • Frozen Shoulder (Adhesive Capsulitis): A condition characterized by stiffness and reduced range of motion in the shoulder joint.
  • Cervical Spine Issues: Problems in the cervical spine (neck) can cause referred pain to the back shoulder area.
  • Spinal Conditions: Conditions such as herniated discs or degenerative changes in the thoracic spine can lead to back shoulder pain.
  • Nerve Compression: Compression of nerves in the neck or upper back can cause radiating pain to the shoulder region.
  • Shoulder Bursitis: Inflammation of the bursa sac in the shoulder joint can lead to pain and limited mobility.

Section 3: Symptoms of Back Shoulder Pain

Back shoulder pain may present with the following symptoms:

  • Dull Ache: A persistent, dull ache in the upper back and shoulder region.
  • Stiffness: Difficulty moving the shoulder freely due to stiffness or reduced range of motion.
  • Muscle Tension: Tense and tight muscles in the upper back and shoulder area.
  • Radiating Pain: Pain that may radiate down the arm or to the neck and upper back.
  • Pain with Movement: Discomfort worsens with certain shoulder movements or when lifting objects.
  • Weakness: Feeling weak or unable to perform daily activities that involve the shoulders.

Section 4: Diagnosing Back Shoulder Pain

Diagnosing the cause of back shoulder pain involves a comprehensive evaluation, including:

  • Medical History: The healthcare provider will inquire about the patient’s symptoms, medical history, and any recent injuries or activities that may have contributed to the pain.
  • Physical Examination: A thorough examination of the upper back and shoulder region, assessing range of motion, muscle strength, and areas of tenderness.
  • Imaging Studies: X-rays, MRI, or CT scans may be conducted to visualize the spine and shoulder joint’s internal structures and detect any abnormalities or injuries.
  • Nerve Conduction Study: To assess nerve function and identify any nerve compression or damage.

Section 5: Treatment Options for Back Shoulder Pain

Treatment Options for Back Shoulder Pain


Treatment for back shoulder pain depends on the underlying cause and severity of the symptoms. Common treatment options include:

  • Rest: Adequate rest is essential to allow the back shoulder muscles to heal and recover from strain.
  • Physical Therapy: Targeted exercises and stretches to strengthen the back and shoulder muscles, improve posture, and promote flexibility.
  • Heat and Cold Therapy: Applying heat packs or cold compresses can help reduce inflammation and alleviate pain.
  • Pain Medication: Over-the-counter pain relievers or prescription medications may be used to manage pain and inflammation.
  • Posture Correction: Improving posture through conscious effort and exercises to alleviate strain on the back shoulder region.
  • Massage Therapy: Gentle massage techniques can help relax tense muscles and improve blood flow to the affected area.
  • Trigger Point Injections: Injection of anesthetic or anti-inflammatory medications into specific trigger points to relieve muscle tension and pain.
  • Corticosteroid Injections: Injections of corticosteroids into the shoulder joint or around inflamed nerves to reduce pain and inflammation.
  • Acupuncture: A complementary therapy that involves inserting thin needles into specific points on the body to promote pain relief and relaxation.

Section 6: Preventive Measures for Back Shoulder Pain

Preventing back shoulder pain involves adopting healthy habits and practices:

  • Proper Posture: Maintain good posture during sitting, standing, and walking to reduce strain on the back and shoulder muscles.
  • Ergonomic Workspace: Set up a comfortable and ergonomic workspace to promote proper posture while working.
  • Regular Exercise: Engage in regular physical activity, including exercises that target the back and shoulder muscles, to promote strength and flexibility.
  • Warm-Up and Cool-Down: Always warm up before engaging in physical activities and cool down afterward to prevent muscle strain.
  • Lift Properly: Use proper lifting techniques, bending at the knees and not at the waist, to avoid strain on the back and shoulders.
  • Weight Management: Maintain a healthy weight to reduce pressure on the spine and shoulders.
  • Stress Management: Practice stress-reducing techniques, such as meditation, yoga, or deep breathing exercises.


Back shoulder pain is a prevalent condition that can impact an individual’s daily activities and quality of life. Understanding the potential causes, symptoms, diagnosis, treatment options, and preventive measures for back shoulder pain is essential for effective relief and prevention. Early intervention, proper diagnosis, and adherence to recommended treatments can greatly improve the patient’s quality of life. By adopting healthy habits, managing stress, and seeking timely medical attention when needed, individuals can successfully manage back shoulder pain and enjoy healthy shoulder function and improved overall well-being.

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