Sudden or gradual onset of pain between and around the shoulder blades is most commonly due to an intervertebral or costovertebral /costotransverse joint injury, muscle sprain, Scheuerman’s disease (adolescents), stress fractures, rib fractures or underlying joint arthropathies (e.g. osteoarthritis, ankylosing spondylitis).
People often complain of pain with rotational movements, side bending and may experience pain with taking a deep breath, coughing or sneezing. Pain may be isolated to either one side of the spine, both the left and right sides or pain may be felt centrally. Occasionally patients may experience pain that refers into the chest region, neck, shoulder, lower back or hip/buttock region.
On assessment, patients tend to have multilevel intervertebral/costotransverse joint hypomobility (lack of mobility) and tenderness over the associated joints and paraveretbral muscles.
Physiotherapy treatment aims to restore mobility using joint mobilisation, manipulation, massage and patient specific postural re-training, stretching and strengthening exercises. Occasionally a corticosteroid injection may be require