®Cat–camel
Get down on your hands and knees. As you breathe out, round your back up like a cat and let your head drop. As you breathe in, slowly let your lower back sink and lift your head. Move slowly, within a pain-free range.
10 reps16–20%Lifetime prevalence reported in studies; results vary widely between studies
More common in young peopleReported more often in children and adolescents, especially girls, than in adults
Weeks – monthsHow long symptoms can last; most people get better with simple measures
2–3 times a dayRecommended exercise frequency, 10–20 repetitions of each movement
Symptoms
- An ache or sharp pain between the shoulder blades.
- Stiffness when twisting or when you wake up in the morning.
- Tightness or spasm in the back muscles.
- Pain that gets worse when lifting, reaching or sitting for a long time.
- Pain spreading to the ribs or the chest wall.
What causes it?
- Muscles and joints: This is the most common cause. The pain changes with movement, twisting and position.
- Neck: When a nerve root in the neck is compressed, pain can be referred to the shoulder blade area.
- Associated factors: Studies have linked other muscle and joint pain, backpacks, posture, stress and lifestyle with it; but not all of these are proven causes.
- Rarely, internal organs: Pain can also be referred to this area from organs such as the heart and the main artery (aorta).
What helps?
1
Keep moving
The thoracic spine is strong. Carrying on with your daily activities as far as the pain allows supports recovery.
2
Change position
Sitting for a long time can make the pain worse. At your desk, you can get up often, take a few steps and relax your shoulders.
3
Regular exercise
You can do the movements below 10–20 times, 2–3 times a day. A mild stretch is normal; do not push into pain.
4
Breathing and relaxation
Stress can tighten the back muscles. For slow breathing and relaxation, you can try the Three Doors or muscle relaxation page.
If you work at a desk, you can also look at the desk work guide, and if your posture is rounded forward, the kyphosis guide.
Exercises at home
Six exercises to open up the back
Do the movements slowly and with control, within a pain-free range. Stop the exercise if you get chest tightness, breathlessness or new numbness.
Seated trunk rotation
Sit upright on a chair with your feet flat on the floor and your arms crossed over your chest. Without moving your hips, slowly turn your upper body to the right, hold for 2–3 seconds at the comfortable end point, then turn to the left in the same way.
10–20 times each way, 2–3 times a dayUpper back (thoracic) extension
Sit on a chair with a low back and clasp your hands behind your neck. Using the top of the backrest as a pivot, open your chest towards the ceiling and gently lean back. Stretch your upper back, not your neck.
5–10 repsSide bend against a wall
Stand with your back against a wall and your feet hip-width apart. Without lifting your back off the wall, slowly bend your upper body to the side, letting your hand slide down the side of your leg. Feel a gentle stretch along the side of your trunk, then come back up and switch sides.
10 times each side, 2–3 times a dayShoulder blade squeeze
Stand or sit up straight. Without lifting your shoulders towards your ears, draw your shoulder blades back and slightly down towards each other. Hold for 5 seconds, then relax.
10–15 reps, twice a dayResistance band row
Tie a resistance band to a door handle or another sturdy anchor at chest height. Holding the ends of the band and keeping your elbows close to your body, pull back and squeeze your shoulder blades together. Slowly return to the start.
10–15 reps, 2–3 setsFrequently asked questions
Can pain between my shoulder blades come from the heart?
Rarely, yes. In a heart attack, the pain is usually a tightness or pressure in the chest; it can spread to the arm, neck and jaw, and may come with breathlessness, sweating and nausea. Sudden, very severe chest or back pain that feels like tearing can be a sign of a tear in the main artery (aortic dissection). With these symptoms, call 112 without waiting. Pain that changes with movement and position more often comes from muscles and joints, but this alone does not rule out the heart.
Can the pain come from the neck?
Yes. When a nerve root in the neck is compressed, pain around the shoulder blade is common and can sometimes start weeks before arm pain. If you have pain spreading to the arm, numbness or weakness, you can look at the cervical disc herniation guide and see a doctor or physiotherapist.
How long does it take?
The thoracic spine is a strong structure, and most people get better with simple measures. Symptoms can last a few weeks, sometimes a few months. Keeping active and doing the exercises regularly supports recovery.
My child’s back hurts; is it the school bag?
It may be, but it may not be the only cause. Studies have reported back pain more often in children and adolescents, especially girls, than in adults, and backpack use is one of the factors linked with it. Factors such as stress, sleep and activity habits are worth looking at too. If the pain does not settle or there are warning signs, you can have your child seen by a doctor.
When should you see a doctor?
- Urgent: if you have chest tightness or pressure, pain spreading to the arm, neck or jaw, breathlessness, sweating or nausea, call 112 straight away
- Urgent: for sudden, very severe chest or back pain that feels like tearing, call 112 straight away
- Urgent: if you have weakness, numbness or tingling in both legs, difficulty walking, numbness around the groin or buttocks, or problems controlling your bladder or bowels
- If you have unexplained weight loss, severe pain that does not settle, night pain or you feel generally unwell
- If you have pain spreading to the arm, numbness or weakness (you can look at the cervical disc herniation guide)
Sources
- Berkshire Healthcare NHS Foundation Trust. Mid-back pain. Self-care advice, version 1, February 2026.
- Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskeletal Disorders. 2009;10:77.
- Carmichael J, Weber KA, Rubinstein S, Svoboda E, Bade M. Scapular pain in cervical radiculopathy: a scoping review. North American Spine Society Journal. 2025;23:100619.
- NHS. Symptoms of a heart attack. Page last reviewed 31 March 2026.
- HSE. Symptoms of aortic dissection.