What causes right shoulder blade pain? Related conditions and treatments

Pain in the right shoulder blade can be especially debilitating if you’re right-handed, but it may clear up on its own, depending on the cause

By Jennifer Larson | Dec. 1, 2023 Medically reviewed by Chad Shaffer, MD

Also known as scapulae, the shoulder blades are large triangle-shaped bones in the upper back. When connected with the head of the humerus (the upper arm bone), they create a ball-and-joint socket. Each scapula, which is attached to many muscles and ligaments, moves to keep the shoulder joint in normal alignment as you move your arm.

Since you can’t see them, you may not give much thought to your shoulder blades until something goes wrong. Here’s what you need to know if you develop pain in your right shoulder blade.

What causes right shoulder blade pain?

The most likely cause of right shoulder blade pain is a musculoskeletal problem, according to Christopher Joyce, MD, who specializes in shoulder and elbow surgery with the University of Utah’s Department of Orthopaedics.

As such, some of the possible causes of pain in the right shoulder blade include:

Injury or muscle strain to the right shoulder or back
Scapulothoracic bursitis, which is inflammation in the bursa sacs near the scapula that can develop as a result of overuse from work, sports, or other activities
Other disorders of the scapula, such as scapular dyskinesis, an alteration in the normal resting spot or motion of the scapula
Degenerative disc or disc herniation in the upper back or neck (cervical spine), which can cause pain that may radiate into the shoulder blade area
Poor posture, such as slumping over or slouching, which can lead to back and shoulder pain that may affect the shoulder blades
A compression fracture, which occurs when one of the vertebrae in your upper back weakens and becomes compressed, causing pain in your back and near your shoulder blade

However, it’s possible that some other health condition or referred pain from the surrounding area is causing right shoulder blade pain. Such conditions might include:

Peptic ulcers: Ulcers can develop in the stomach or gastrointestinal tract due to acid. Although many peptic ulcers don’t cause any noticeable symptoms, they can cause gastrointestinal symptoms as well as abdominal, chest, or back pain.
Acid reflux: Gastroesophageal reflux disease (GERD) causes heartburn and acid reflux. But GERD can also cause chest pain that can radiate to the back, and it’s possible to perceive the pain as affecting the shoulder blade.
Gallstones: Gallstones develop when bile or cholesterol hardens into small pebble-like deposits inside your gallbladder. Symptoms commonly associated with gallstones include nausea, vomiting, and abdominal pain, but research suggests that some people may also experience pain that radiates into one of their scapula or mid-back area.
Liver disease: It’s possible to feel some liver pain in your upper abdomen if you have liver disease, but it may also show up in the back or even the right shoulder.
Lung cancer: A type of lung cancer known as lung Pancoast tumor causes tumors to develop in the chest wall. Musculoskeletal symptoms, like chest and rib pain, can develop. Shoulder pain is a very common symptom among people with this type of cancer.

Should I be worried about right shoulder blade pain?

“If pain in the right shoulder blade develops after an injury or accident, that’s a good reason to go ahead and seek medical attention as soon as possible,” says Georgiy Brusovanik, MD, an orthopedic surgeon in private practice in Miami, Florida. Other than that, Dr. Brusovanik recommends seeing a healthcare provider if pain in the right shoulder blade interferes with the ability to carry out normal tasks of daily living or becomes annoying and impossible to ignore.

But, it may not be necessary to worry too much about a mild case of pain in the right shoulder blade. “Shoulder blade pain is usually not a serious problem, especially on the right side,” Dr. Brusovanik says.

Also, it doesn’t necessarily happen more often than pain in the left shoulder blade, according to Gregory V. Gasbarro, MD, a shoulder specialist at Mercy Medical Center in Baltimore, Maryland. “The right shoulder blade is not affected more often than the left,” Dr. Gasbarro notes. “There are a number of reasons that may cause shoulder blade pain, and they all vary in severity.”

However, any new or serious chest pain or upper back pain should be a reason to seek medical attention. Certain serious health conditions can cause pain in the upper back, including a heart attack or an aortic dissection—a tear or injury to the inner layer of the largest artery of the body, the aorta. Even if the pain is not associated with a heart condition, it could be associated with another medical condition that might warrant treatment, such as peptic ulcer disease or gallstones.

How is the cause of right shoulder blade pain diagnosed?

Getting the right diagnosis is key, according to Dr. Brusovanik, who adds, “The most common cause of shoulder blade pain is referred pain from the cervical spine, which means the pain is actually deriving from a degenerative disc.” But it often gets misdiagnosed. “Many patients undergo various unnecessary medical procedures as well as injections or massages around the shoulder blade, some of which can be aggressive or painful, all due to an improper diagnosis,” Dr. Brusovanik says.

Your healthcare provider may start by asking questions about the pain in the right shoulder blade. For example, Dr. Joyce might ask a patient if they’ve experienced any recent injuries to their shoulder, as well as any history of shoulder or back injuries in the past. He might also ask them when the pain occurs. For example, if a patient feels pain in the right shoulder blade when they use it or try to sleep on it, it could be an indicator that it’s musculoskeletal.

A healthcare provider might also ask a patient if they’re right-handed. People who are right-handed may be at greater risk of developing scapulothoracic bursitis on the right side.

A physical exam is the next step. A healthcare provider may recommend some imaging scans to get a better look at the area. Dr. Brusovanik says that he would do an MRI scan of the neck and cervical spine area. A shoulder x-ray might also be warranted.

“We also want to rule out that the pain doesn’t emanate from the left side as well because serious consideration must be given to a cardiac etiology in that case,” Dr. Brusovanik says.

How long does right shoulder blade pain last?

For some people, pain in their right shoulder blade may only last a short period of time, but it may linger for others. “If the pain persists for a couple of weeks or becomes worse with time, then a visit to a healthcare provider should be considered,” says Dr. Gasbarro.

Dr. Joyce also cautions that anyone who experiences sudden severe pain in their back or chest should see their healthcare provider right away.

How to stop right shoulder blade pain

The cause and extent of the pain will affect what type of treatment a healthcare provider will recommend for right shoulder blade pain. For Dr. Joyce, physical therapy is usually the first step that he recommends for his patients with a musculoskeletal source of pain. “I almost always have people start physical therapy first for two or three months,” Dr. Joyce says. “If that fails, we talk about getting an MRI.”

For example, some people may move their arm or shoulder differently to compensate for an injury or pain in their scapula. A physical therapist can work with them to strengthen the muscles around the scapula so they can move it normally when they raise or lift their arm.

According to the American Academy of Orthopaedic Surgeons (AAOS), surgery is rarely recommended. Instead, treatment for scapular disorders typically involves physical therapy to strengthen the shoulder muscles and restore proper motion of the scapula. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help manage any pain during the process.

Whatever treatment path your healthcare provider recommends to treat your right shoulder blade pain, it’s also a good idea to figure out how to avoid exacerbating the pain as you heal. For example, if you find that certain activities aggravate the pain in your right shoulder blade, be sure to avoid them. “This includes any exercises that you might do at the gym,” says Dr. Christian Busch, a physical therapist with Wild Hawk Physical Therapy in Asheville, North Carolina.

Dr. Busch encourages people to reach out to their healthcare provider or a physical therapist to ask about getting an assessment if they develop pain and it doesn’t improve. “Waiting until the pain has been there for months typically increases the need for a longer recovery period for treatment,” Dr. Busch says.

Living with right shoulder blade pain

Often, experts will recommend rest and ice for injuries. But Dr. Joyce suggests that rest will probably help more with right shoulder blade pain than ice. “Ice really doesn’t seem to be much of a help, but resting might help if it’s an acute injury,” Dr. Joyce says, adding that it would probably be hard for most people to apply ice to their shoulder blade area anyway.

Dr. Busch suggests massaging the area with a small ball, like a lacrosse ball. This can reduce tightness in the muscle or pain in the shoulder blade region. “Sometimes the painful side isn’t the side you need to exercise or massage as much with the lacrosse ball, so it may be best to work both sides even if the pain is only on the right side.”

Dr. Busch also recommends that people consider their posture, especially if they sit at a desk or work on a computer.

Most importantly, seek treatment if the pain persists or gets worse

The causes of right shoulder blade pain vary. They range from injury and overuse to health conditions that create pain that radiates into your back and shoulder blades. Right shoulder blade pain may resolve on its own without treatment and with some rest. Occasionally, the pain could be the result of a very serious health condition that requires immediate medical attention. If right shoulder blade pain persists or worsens—or you begin to have trouble moving your arm—it could be a sign that you do need treatment. Only your healthcare provider can rule out serious health conditions. Visit your healthcare provider to determine the best treatment for right shoulder blade pain.