Home / Conditions / Rhomboid pain
The rhomboids are two flat muscles between the shoulder blades and the spine. Straining them causes an ache or a tight knot between the shoulder blades, often after lifting, rowing, or a long spell hunched over a desk, and most mild strains settle within a few weeks. Pain in this spot has other causes too, so it is worth knowing the difference.
Rhomboid pain is what most people assume when it aches between the shoulder blades, but the same spot can hurt for other reasons. How it started, and what makes it worse, usually tells them apart.
| Rhomboid strain | Pain from the neck | Other causes heart, lungs, main artery | |
|---|---|---|---|
| How it started | After lifting, pulling, rowing, or long hours hunched forward | Gradually, often with a stiff neck | Suddenly, not linked to any movement |
| What makes it worse | Moving the shoulder blade, or pressing the sore spot | Turning or tilting the neck | Exertion or breathing, not moving the arm |
| Other signs | A tender knot beside the shoulder blade | Pain or tingling down the arm, headaches | Chest pain, breathlessness, sweating, or fever |
| What it needs | Easing the strain, stretching, posture changes | The neck assessed and treated | Urgent medical assessment |
Sudden, severe or tearing pain between the shoulder blades, or pain that comes with chest discomfort, breathlessness or sweating, is not a muscle strain — call 995. Pain that catches on breathing in, with a fever or cough, should be seen by a doctor the same day. Weakness or numbness in an arm points to the neck: call the clinic and come in.
The rhomboid muscles run from the spine at the base of the neck and upper back to the inner edge of each shoulder blade, underneath the larger muscle that covers the upper back. They draw the shoulder blades together and hold them steady against the ribs.
What a picture cannot show is why they are easily strained. Pulling and lifting load them suddenly, and long spells hunched forward keep them working for hours — either can leave a sore, tight knot beside the shoulder blade.
It also explains why the neck is so often the real cause. The nerves that supply this area come from the lower neck, so a problem there can send pain to exactly the same spot, even though the muscle itself is fine.
Most rhomboid treatment is simple. A mild strain usually settles within about three weeks; a more serious one can take a few months. If the pain comes from the neck, treating the neck is what helps.
Take a break from heavy lifting, pulling and rowing, and use heat or ice for comfort. Keep moving gently rather than holding the shoulder still, and return to activity gradually.
Gentle stretches for the shoulder blades ease the knot, and strengthening the upper back helps stop it returning. At a desk, regular breaks and a screen at eye level reduce the hours spent hunched forward.
A tight knot that lingers can be eased with massage, or with an injection into the knot itself. See myofascial pain for how these knots are treated.
If the pain turns out to come from the neck, the neck is treated instead — which is why it is examined first, rather than treating the shoulder blade on assumption.
A mild strain usually settles within about three weeks. A more serious one can take a few months. Returning to heavy lifting or pulling too soon is the commonest reason it lingers.
It can contribute. Long spells hunched over a desk or phone keep the muscles working for hours, and regular breaks and a better screen position often help. Posture is rarely the whole story, though.
Keep moving gently. Avoid heavy lifting and pulling for a while, but holding the shoulder still tends to make it stiffer and slower to recover.
A strained muscle between the shoulder blades can catch on a deep breath. But pain on breathing with breathlessness, a fever or a cough can come from the lungs and should be seen by a doctor the same day.
Often, yes. The nerves to this area come from the lower neck, so a neck problem can cause pain between the shoulder blades. Pain that worsens when you turn your neck, or runs down the arm, points that way.
No. Bring any neck or back scan reports, and be ready to say what started the pain.
Myofascial pain · Neck pain · Shoulder pain · Whiplash injury
Be ready to say what started the pain, and whether moving your neck changes it. Both help tell a muscle strain from a neck problem.
