Can Massage Therapy Help Pain Around the Shoulder Blade?

Perspective of a Massage Therapist Specializing in Pain Rehabilitation

As a massage therapist specializing in pain rehabilitation, I’ve seen a wide variety of injuries, and one of the most common symptoms I see is pain in the upper back, especially around the shoulder blade. So, can massage therapy help pain around the shoulder blade? Absolutely. But you must know where it’s coming from, in order to treat it.

Most of my clients intuitively think the injury is right there where they feel the pain, but it rarely comes from that area. The muscles in that region are very strong and not often injured.

The true structures causing the pain are ligaments, not muscles, in the neck, through a mechanism called referred pain, where an injury is in one place, but you feel the pain in a different place.

Ligaments are the Secret to Understanding Shoulder Blade Pain

Let’s talk about ligaments for a moment so you understand what they are and what they do. Ligaments are strong cords that hold your bones together, and there are a series of complex ligaments holding the vertebrae (the spinal bones) of your neck together and in place. If you feel the back of your neck, there will be a series of bumps protruding there; the ligaments hold those parts of the bones together. On the sides of your neck, there is another series of ligaments that stabilize it.

Ligaments are the secret to understanding shoulder blade pain: when the lowest ligaments at the side of your neck get injured, they will cause pain in the shoulder blade part of the upper back, down your arm, and sometimes even down your chest.

What Causes Shoulder Blade Pain?

Small little tears, or micro tears, cause the initial pain we feel in the neck, upper back, and shoulder blade area. If you’re lucky, the tears heal well, and the pain disappears in a week or so. Healing well means that the fibers that are damaged heal with good, strong scar tissue in the proper alignment.

More often, poorly formed scar tissue occurs, which causes healing to occur in multiple directions. When this occurs, the fibers are adhered to each other and do not form strong bonds. This leaves the person vulnerable to constant re-tearing of the adhered scar tissue and is what causes chronic pain.

How Does It Feel?

The pain sensation varies and depends on the severity of the injury. If it’s mild, it might just be a continual ache about the size of a quarter at the edge of your shoulder blade, or it may intensify during the day when you’re sitting at the computer. If you try to back up your car while turning your head, you may get a sharp zing of pain in the upper back.

If it’s severe, it can feel like a hot poker stabbing you in the upper back. And if you turn your head in a certain direction, it increases so much that you don’t turn your head again like that for quite a while.

Assessing the Problem

There are a series of simple tests that can help figure out which ligaments are causing the problem. A skilled therapist will start by asking you to turn your head in either direction to see if there is pain and a limit in your movement. Then, they will rotate your head for you to see if or when the pain starts.

Then, the therapist will ask you to tilt your ear toward your shoulder both right and left to see if that causes you pain and limits your movement. Then, they will move you farther if there is no pain.

In the last set of tests, the therapist will ask you to bring your chin to your chest and then look up at the ceiling as far as possible. If there is no pain, the therapist will assist you in those movements to see if going a little farther will reproduce your pain.

If any of these tests are painful, the cause of your pain is the ligaments.

Finding the Exact Source

Next, the therapist will touch each of the ligaments with mild pressure, which tends to refer to pain in these areas. You’ll know when they find the right ones because the ligaments are painful, even when touched extremely lightly. Sometimes, they will briefly even shoot the pain to exactly where you feel it in your upper back and shoulder blade area.

Successful Treatment of the Pain

The best treatment is the one that eliminates the adhesive scar tissue frm your ligaments. There are several different treatment approaches that can accomplish this. Some are performed by a skilled physician using a special type of injection, and others are performed by therapists using orthopedic manual therapy techniques.

When the treatment is successful, you can move your head in all the directions described above without any pain, and you will be pain-free in your daily activities.

A Simple Exercise to Keep Your Neck Healthy

To ensure the ligaments heal in good alignment, try this simple exercise to keep your neck healthy. Lie on your back with your neck supported by a pillow that is 2 to 3 inches thick. Slowly rotate the head so the cheek moves toward the shoulder. Rotate the neck very slowly to the right and left, gently without force. It should take 4 seconds to do each rotation. Perform 50 rotations or 25 sets of rotations, right and left, twice a day.

 

---

If you are experiencing chronic pain and live in the Boston area, schedule a complimentary 10-15 minute phone consultation.

Call for more information →

---

Ben E. Benjamin holds a Ph.D. in Sports Medicine and was the founder and President of the Muscular Therapy Institute in Cambridge, Massachusetts.  He is the author of dozens of articles on working with injuries and chronic pain as well as the widely used books in the field, Are You Tense?, Exercise Without Injury and Listen To Your Pain: The Active Person’s Guide to Understanding, Identifying and Treating Pain and Injury. Dr. Benjamin has been in private practice for over 50 years and teaches therapists throughout the country.