I have treated many patients who had pain between the shoulder blades and were diagnosed with either a cervical herniated disc, stenosis or pinched nerve. This led to treatment at the cervical spine including epidural nerve blocks, pain medication and worst of all many had surgery to the cervical spine which did nothing to resolve the pain between the shoulder blades.
The harsh reality is there was never any chance that pain between the shoulder blades could be resolved by treating structures relating to the cervical spine. This is because none of the cervical spine nerve roots innervate the area between the shoulder blades. Let me make this perfectly clear and reiterate the point. None of the cervical spine nerve roots innervate the area between the shoulder blades. The cervical spine nerve roots innervate the area of the neck and then runs down the arms. C4 innervates the shoulder region, C5 innervates the thumb side of the upper arm and forearm and C6 innervates the thumb and so on. This can be seen by looking at a dermatomal chart. Each nerve root that comes out of the spine innervates a certain area of skin. No cervical nerve roots innervate the mid back.
I can’t make this point any clearer. If you are having pain between the shoulder blades and somebody tries to convince you that it is coming from the cervical spine simply say thank you but no thank you.
The reality is that the odds of pain in this area being from nerves is highly unlikely. The thoracic spine nerve roots innervate an area of skin that runs around the entire torso like hoops at every level of the thoracic spine so this would not account for the pain between the shoulder blades.
The best answer is that the pain is coming from strained muscles called interscapular muscles also known as the mid trapezius and rhomboids. These muscles attach from the spine to the inside edges of the shoulder blades. They are responsible for keeping the shoulder blades secured on the rib cage so muscles that attach from the shoulder blade to the arm can move the shoulder.
To confirm that these muscles are the tissue emitting the pain, you can palpate or touch the muscles from their attachments from the spine to the inside edge of the shoulder blades. Press into the muscles and see if the pain you are experiencing is increased in intensity. If so, this is confirmation that these muscles are the cause of your pain. Strengthening these muscles as well as other muscles such as the rotator cuff, posterior deltoid, the lower traps and the triceps will prevent the muscles from straining and emitting pain between the shoulder blades.
To learn how to diagnose the cause of your pain at the shoulder and other joints including the neck and lower back and how to strengthening the appropriate muscles when the cause is found to be muscular, read my new book, “The Pain Cure Rx: The Yass Method Of Diagnosing and Resolving Chronic Pain” available for preorder on Amazon.com

21 Responses

    1. That is the problem. you took an mri finding and used it without there being any possibility that the finding could create the symptom. the cervical nerve roots run along the upper trap region adn then follow down the arms. the area between the shoulder blades is in the thoracic region and would have to be innervated by thoracic spine nerve roots. these nerve roots create thin slices around the torso so pain just between the shoulder blades could not be from these either. this is why with a proper physical evaluation it can be determined that this type of pain is from muscle strains and the tissues eliciting the pain are actually muscle. it is this lack of commitment to understanding the symptoms versus the blind acceptance of an mri finding which is physically incapable of creating the symptom. i hope this type of logical analysis helps you to understand why the use of the mri to identify the cause of pain must be abolished.

      from now on let’s all come to a valid, logical conclusion about the cause of symptoms before we “treat” the patient. The failure of the exisiting model is evident. At some point there will have to be a recognition that the mri is simply identifying an independent variable to pain and treatment of any of these findings does nothing to resolve the cause of the pain in more than 90% of cases. best of luck to you.

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