Pain Between The Shoulder Blades

What Causes Pain Between Shoulder Blades?

Pain between shoulder blades can have various causes, ranging in severity from 'worrying' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose pain between shoulder blades, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "pain between shoulder blades" as a symptom.  Here are eight of many possibilities (more below):
  • Heart Disease
  • Torticollis
  • Slipped Disc
  • Cervical Arthritis
  • Stomach Ulcers
  • Liver Cancer
  • Gallbladder Disease
  • Angina

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
slight abdominal distension
slightly black/tarry stools
apple-shaped body when overweight
history of NSAID use
severe stiff neck
having non-problematic gallstones
dizziness when standing up
upper abdomen pain after large meals
appendix removed before age 20
rapid pulse rate
significant red blood in stools
shortness of breath when at rest
... and more than 80 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of pain between shoulder blades:
Cause Probability Status
Liver Cancer 94% Confirm
Gallbladder Disease 26% Unlikely
Torticollis 21% Unlikely
Cervical Arthritis 3% Ruled out
Slipped Disc 0% Ruled out
Angina 0% Ruled out
Heart Disease 0% Ruled out
Stomach Ulcers 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate spinal problems, The Analyst™ will ask further questions including this one:
Do you have pain between your shoulder blades?
Possible responses:
→ No / don't know
→ Yes, some
→ Yes, significant
Based on your response to this question, which may indicate pain between shoulder blades, The Analyst™ will consider possibilities such as:
Angina

The constriction caused by Angina Pectoris induces pain between the shoulder blades.

Coronary Disease / Heart Attack

In cases of heart disease, pain will usually be felt in the left or middle of the chest, but it can also be felt in the inner sides of the left arm, neck, jaw, or between the shoulder blades.  This pain, also known as 'referred pain', should not be ignored.  The pain that you experience is a manifestation of something going wrong in your body.

Esophageal Cancer

Pain between the shoulder blades is a sign of advanced disease when related to cancer of the esophagus.  Other symptoms such as progressive swallowing difficulty, weight loss, and loss of appetite would normally be present also.

Gallbladder Disease

The pain is usually felt in the upper abdomen but sometimes the pain may spread to the right shoulder or between the shoulder blades.  The pain often occurs following a heavy or fatty meal and is sometimes one of the main symptoms of a more advanced disease state.

Gastric/Peptic/Duodenal Ulcers

'Ruptured' gastric ulcers which have gone through the stomach wall can cause a sharp pain which sometimes can be described as a pain felt in the region between the shoulder blades.

Liver Cancer

Pain between the shoulder blades is an initial symptom of liver cancer, but would normally be accompanied by other symptoms such as weight loss, loss of appetite, yellowish skin color.

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