Understanding the irritating stabbing sensation you feel in between or under the shoulder blades is often thought of as a pinched nerve.
People will spend lots of time and money trying to massage out the knots and tight muscles in their upper back trying to relieve it only to find the pain returns within a few hours to days. So where, what nerve is being pinched and why does it hurt right there? A few years ago I recorded a video discussing all about it.
We’re going to explore the common factors connecting cervical disc herniation, discogenic pain, and pinched nerve pain. It’s a straightforward examination of what ties these spinal issues together.
Understanding the Culprit: The Cervical Spine:
To fully understand how this pain is interpreted we need to understand some basic anatomy. The cervical spine is made up of boney vertebrae that protect the spinal cord and nerves.
The vertebrae are stacked on balloon-like, shock absorbing discs that give the neck movement and give space for nerves from the spine to exit and travel to the body. The bony vertebrae also give muscles the place to hold on and allow the neck to move.
The discs can get injured and push into the space where the nerves exit indicated by the red are in the photo above labeled “herniated disc”. Then the nerve becomes involved and it can radiate pain.
Radiating pain is pain that presents in a different part of the body from where the injury actually is. This can cause confusion for treatment because people will treat where the pain is but not where the injury is.
The pinched nerve sensation in your middle back is just one of these cases. The pain between your shoulder blades on one side more than the other is a referral pain pattern from the neck.
We’ve known this since Dr Cloward released this paper from 1959. In it he describes his procedure of entering a needle to the front of the cervical disc until the patient said they felt pain.
The patient was then asked to locate the pain and they would indicate on their body where they felt the pain. Based on what level of cervical disc Dr Cloward was on would determine where the patient was feeling the pain (see image 1056 from the article).
Even more interesting, when Dr Cloward injected numbing medicine (lidocaine), the patients would report the pinched nerve pain in their middle back would go away instantly. For more information on this condition watch this video on our youtube channel.
What Causes this Pain:
Contrary to popular belief, it’s not a nerve in your shoulder blade being pinched at all; it’s the cervical disc radiating pain. This can happen from sleeping wrong, poor or sustained posture, history of neck injury just to name a few.
The Rescue Plan: Effective Exercises at Home:
Now that we’ve exposed the culprit, let’s talk about solutions. Here are some simple exercises you can do at home that actually treat the injured area:
#.1 Neck Rotations and Extension:
Gently tilt your head to one side, holding for 15 seconds. Repeat on the other side. This helps stretch the muscles around the cervical spine that are often neglected compared to the flexion, or looking down..
Here are two videos you can use as examples.
#2. Shoulder Blade Squeezes:
Sit up straight and squeeze your shoulder blades together as if you’re holding a pencil between them. Hold for 10 seconds and repeat. This is called an isometric contraction and it’s designed to increase the strength of our postural muscles. These muscles are responsible for bracing our upper trunk to help with our neck and shoulder function. So many muscles that support our head and neck anchor into the upper back. Watch this video for a demonstration of these exercises.
#3. Chin Tucks:
Gently tuck your chin towards your chest, creating a double chin (temporarily, don’t worry!). Hold for 15 seconds, then release. This helps lengthen the spine and strengthen muscles in the cervical spine. Visit our youtube here for a video demonstration.
Remember, the key to overcoming this pinched nerve pain is understanding the real culprit—the cervical spine. No need to blame shoulder blades or muscle knots or resort to drastic measures like pills, injections, or surgery. These exercises are easy for you to do at home or in your office to give you relief fast.
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For more related and knowledgeable articles:
Listen to our podcast: How can I relieve neck pain at home? Ft. Dr. Andrew Minkley, MD from Desert Spine and Sports Physicians | Episode 25
Read Our Blog: 13 Ways To Relieve Ache and Pain
Watch our Physical Therapy success stories to learn more about how we helped our patients have a better life:
Neck Pain (Automobile Accident) - Dr. Castro's Success Story
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Dr, Nick’s greatest passion is seeing his patients recover from injury and return to their activities that bring them joy.
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