Numerous conditions can cause pain in the back below the right shoulder blade. According to the Spine Health website, although upper back pain, including pain below the right shoulder blade, is not a common disorder, problems in this area can cause considerable pain or discomfort when they manifest. Repetitive strain injuries, direct trauma or certain medical conditions can cause pain that arises below the right scapula, or shoulder blade.
Cholecystitis
Cholecystitis can cause pain in the back below the right shoulder blade. According to MayoClinic.com, cholecystitis is an inflammation of the gallbladder. The gallbladder is a small, pouch-like organ situated in the upper right abdomen, just below the liver. The gallbladder is responsible for housing bile -- a fluid that's released into the small intestine. The most common cause of cholecystitis is gallstones that block the only tube leading out of the gallbladder, which can cause an accumulation of bile and subsequent inflammation within the organ. Infection, injury and tumors can also cause cholecystitis. Common signs and symptoms associated with cholecystitis include severe pain in the upper right abdomen that worsens with deep breathing, pain that radiates from the abdomen to the upper right back and shoulder, abdominal tenderness, sweating, nausea, vomiting, loss of appetite, fever, chills and abdominal bloating.
Intercostal Muscle Strain
An intercostal muscle strain can cause pain in the back below the right shoulder blade. York University states that intercostal muscles are the muscles located between the ribs. There are two kinds of intercostal muscles: internal and external. The intercostal muscles help lift and lower the ribs; they also help with breathing. Intercostal muscle strains usually occur among physically active people, such as exercisers and athletes, although anyone can experience an intercostal muscle strain. Athletes who play sports, such as tennis, swimming or basketball -- sports that require twisting of the torso, may be more susceptible to intercostal muscle strains. The most common sign or symptom associated with an intercostal muscle strain includes sharp, stabbing pain in the affected area, especially when breathing. In some cases, intercostal muscle strain-related symptoms may mimic the symptoms of a fractured rib.
Fractured Rib
A fractured or broken rib can cause pain in the back below the right shoulder blade. According to the Sports Injury Clinic website, fractured ribs are a common injury among athletes participating in contact sports. Most fractured ribs are caused by blunt-force trauma to the chest or rib cage. Falls and motor vehicle accidents are other common causes of broken ribs. MayoClinic.com states that common signs and symptoms associated with fractured ribs include pain at the fracture site that's worse when the affected area is pressed, pain with twisting and bending and pain with deep breathing. Certain risk factors may increase the likelihood of a rib fracture such as having osteoporosis or low bone mineral density, participating in contact sports such as football or hockey and having a cancerous lesion or tumor in the ribs. Possible complications associated with rib fractures include pierced blood vessels, a punctured lung and kidney, spleen or liver damage.
