Question: I always have pain in my right shoulder blade, I have had medication, massage and physical therapy - nothing has helped. What can a chiropractor do?

Answer: Shoulder blade pain is quite common. We treat this regularly in our office, often with good results.

Location of your pain is important to know. If your pain is to the outside of the shoulder blade (scapula) and close to the backside of your shoulder, then your problem may be in the shoulder joint itself, involving the rotator cuff muscles. However, if your pain is between your spine and shoulder blade, then you may have a pinched nerve in your neck causing your problem. And most of the time, your neck doesn't hurt at all!

There are three muscles that attach your scapula to your spine. Two are of interest. One is called the levator scapula and this muscle helps with your shoulder when you reach overhead. It also helps to turn your head when looking from side to side. The other muscle is called the rhomboid and this muscle helps retract or pull back your shoulder blade. Both of these muscles have the same nerve called the dorsal scapular nerve.

This nerve comes primarily from your lower neck between the fifth and sixth neck bones (C5 and C6). This is the most common area in the neck to experience nerve pressure. As we age, the disc between C5 and C6 is usually the first one to degenerate and will allow more pressure to apply to the dorsal scapular nerve.

Pressure on this nerve at the neck causes referred pain into your shoulder blade. This is just like when a heart attack sends pain into your left arm. You may not actually feel pain in your chest because it all is referred to your arm. In the same way pressure on the nerve in the neck causes referred pain to these two muscles in your shoulder blade.

The pain in your shoulder blade can be very frustrating. It can be there in spite of changing positions and can often be a constant, dull ache. Massaging the muscle only gets very temporary relief. The same is true with medication and exercise.
We examine your neck, upper back and shoulder to help determine if the problem is in your neck. X-rays of your neck are important in helping to determine if there is nerve pressure here. We also want to make sure you are healthy otherwise. Sometimes, organ disease will refer pain to this region.

Once we determine this is the dorsal scapular nerve being pinched, we work to relieve pressure through gentle manipulation of your neck. We also work to reduce inflammation through ultrasound and ice treatments directed to your lower neck.

Chiropractic treatment is very safe when performed correctly after a proper history and exam.

After 19 years of practice, we have seen this problem overlooked numerous times. If you can't get rid of your shoulder blade pain, look to chiropractic care for that nagging, aching pain.

Copyright © 2008 - Konicki Schumacher Chiropractic. All rights reserved.

Dr. Tom Konicki is a board certified chiropractic orthopedist and has practiced for many years in South Dayton. You can reach him at or mail your questions to Ask the Chiropractor, 2165 Miamisburg-Centerville Road, Dayton, Ohio 45459.