A pinched nerve, also known as nerve compression, can occur for a variety of reasons. Compression of a nerve in the neck or, less commonly, in the shoulder itself can trigger shoulder blade pain. Overuse, age-related changes and injuries are among the most common causes of this type of nerve compression. The signs and symptoms of a pinched nerve vary, and can occur intermittently or persistently. As pain in the shoulder blade area occurs with many conditions other than a pinched nerve, medical evaluation is needed for an accurate diagnosis and appropriate treatment.
Burning, shooting, stinging, aching or sharp pain in the shoulder blade -- also called the scapula -- commonly occurs if a nerve supplying this area is pinched. Depending on the site of the nerve compression, pain might also extend to other areas of the shoulder, or into the arm and hand.
People whose pain arises from nerve compression in the neck might also experience neck pain and headaches, especially at the back of the head. In some cases, scapular and other pain associated with a compressed nerve decreases or disappears when the neck, head or arm is moved into certain positions. With severe compression, however, pain relief is unlikely with repositioning.
Weakness in the muscles of the shoulder area or arm commonly accompanies a pinched nerve associated with shoulder blade pain. The muscles affected vary, depending on the site of the nerve compression. Doctors test the strength of individual muscles in the shoulder area and arm to help determine whether scapular pain is due to nerve compression and the specific location, if a pinched nerve is identified. Abnormal muscle reflexes might also be a sign of nerve compression.
Muscle weakness associated with a pinched nerve affecting the shoulder blade pain ranges from mild to severe. Mild weakness often goes unnoticed. More severe weakness can manifest as difficulty raising the affected arm overhead or picking up heavy objects, for example. Grasping and twisting motions might be affected if the weakness affects muscles of the lower arm or hand.
Numbness and Tingling
A pinched nerve that triggers pain in the shoulder blade might also cause numbness or tingling in the shoulder, arm or hand. As with other symptoms, the specific location of these sensory abnormalities depends on the site of the nerve compression. A pins-and-needles sensation, that many people refer to as the area falling asleep, is common. Abnormal sensations might come and go, or be relieved by repositioning. Severe nerve compression, however, tends to cause constant sensory abnormalities.
Warnings and Precautions
Many conditions cause pain in the shoulder blade area. Musculoskeletal and nerve compression problems lead the list of possibilities, but the signs and symptoms of these conditions significantly overlap. Therefore, it's important to see your doctor as soon as possible if you experience shoulder blade pain to determine the cause and begin appropriate treatment.
Shoulder blade pain sometimes signals a serious underlying problem distant from the shoulder. This is called referred pain, meaning the discomfort occurs at a site different from the source of the problem. Certain heart, lung, gallbladder, liver and pancreatic disorders, for example, sometimes cause referred pain in the shoulder blade area. Referred shoulder pain is usually accompanied by other warning signs and symptoms. Seek immediate medical care if you experience sudden shoulder blade pain accompanied by any of these signs and symptoms:
-- fever, chills or clammy skin
-- shortness of breath
-- chest or jaw pain
-- rapid or pounding heartbeat
-- nausea or vomiting
-- abdominal pain or tenderness
-- dizziness, lightheadedness or fainting
Reviewed and revised by: Tina M. St. John, M.D.