Shoulder Pain

Pain behind the shoulder blade

Pain behind the shoulder blade can be an annoying, painful and mysterious issue. Because of its location, it can often masquerade between shoulder and neck pain leaving a person on the fence about where the issue is actually coming from. One area that is often overlooked and disregarded is the joint articulation between the rib head and spinal vertebra known as the costotransverse joint. Just like we sprain our ankles, we can also sprain other joints throughout our body and this particular joint is a very common presentation in the clinic.

Clinical Presentation:

  • Pain that is constant and often very localised to a distinct location upon direct touch
  • Characterised as sharp and “stabbing” in behind the shoulder blade or offset to one side of the spine
  • Aggravated by neck movement, rotation of the torso, and sometimes deep inhalation
  • Sometimes there may be pins and needles/tingling/altered sensation along the arm


  • Poor or awkward postures over a sustained period of time
  • Physical trauma to the rib attachments to the sternum, spine or cage itself
  • Overexertion during physical activities such as exercise
  • Repetitive overhead activities
  • Unfavourable sleeping positions – especially if neck is rotated to one side

Clinical Management:

  • Massage – to reduce the overlying muscle guarding
  • Vibration therapy – Initiates the lymphatic drainage of localised inflammation and reduces overlying muscle guarding/tension
  • Manipulation – Using a short, sharp and specific thrust, the rib head is re-aligned into its normalised position often providing immediate relief

Prevention Strategies:

  • Stretching – regular stretches with the shoulder, neck and thoracic spine will assist keeping the soft tissues lengthened and in less tension
  • Exercise – maintaining a normal exercise regime to keep the body generally mobile and strong
  • Regular spinal checks Seeing you’re Chiropractor for regular spinal checks can often detect these issues before they manifest to pain and dysfunction.

Remember to be proactive and not reactive when it comes to your spinal health! Contact Hands on Health Care clinic today!

February 14, 2018
Georgina Smith