Periscapular Pain

Periscapular Pain


Discomfort in the area surrounding your shoulder blade at the back, typically between the shoulder blades with some radiation into the neck, is very common. It may be brought on by an accident or increase in strenuous activity. Even extended periods looking at a screen beyond what you are used to or in unfamiliar desk arrangements can trigger this issue. This can also develop after true internal shoulder problems because the shoulder blade has more work to do if the ball and socket joint is limited in its range.

MRI findings of tears and other defects may be completely incidental to this problem. Indeed, it is often the case that the distribution of pain in the shoulder is remote from any changes seen on imaging and that there are no signs or symptoms consistent with the radiology. This is especially common in periscapular pain.


Physiotherapy including friction therapy (massage, acupuncture, ultrasound etc.) and a rehab plan to strengthen the muscles around the shoulder blade and improve core posture of the spine (especially the thoracic and cervical range) is the mainstay of treatment. Trigger point injections can sometimes help and occasionally a pain management specialist may be required for these or other options.

Surgery is very rarely of use in these situations except where a symptomatic internal derangement is precipitating alterations in shoulder blade posture and movement. This is a subtle area and clinical examination, diagnostic injections, correlation with imaging and other modalities may need to be employed before moving to surgery.


Management of these problems is predominantly rehab based. Developing a relationship with a good physio and actually doing the prescribed exercises is key. The process may be long and complete eradication of the problem may not be possible. Controlling it to the point where it is not getting in the way is the goal.


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