Asthma Might Be Behind That Nagging Pain Between Shoulder Blades
Last Updated on May 30, 2025 by Bianca Nala
Ever had a patient—or maybe even yourself—ask, “Can asthma cause pain between shoulder blades?” At first glance, it might seem like a stretch, right? But as someone who’s been a pulmonary nurse practitioner for years, let me tell you, this is a surprisingly common complaint. I’ve had folks come into the clinic convinced they were dealing with something heart-related or maybe even a pulled muscle, only for us to realize the root cause was actually asthma. Yep, asthma isn’t always just about wheezing and shortness of breath.
Understanding the Link Between Asthma and Shoulder Blade Pain
Now let’s dig into what’s really going on here. Asthma is typically associated with airway inflammation, mucus production, and bronchial constriction. We usually think of it as a “chest” condition—and it is—but when your breathing is compromised, you start to rely more heavily on your accessory muscles. That includes the muscles around your upper back, neck, and shoulders.
So, can asthma cause pain between shoulder blades? Absolutely, especially during a flare-up or prolonged episode. I’ve seen patients use their scalene and trapezius muscles so much trying to breathe that they end up sore for days. Imagine trying to run a marathon while barely being able to breathe—you’d compensate with whatever muscles you could, and they’d let you know afterward.
Muscle Strain from Labored Breathing
This is probably the most common explanation for that mid-back discomfort. When you’re working overtime just to get air in, your muscles do too. The strain from constant tension and poor posture (like hunching over when trying to breathe) can lead to aching between your shoulder blades.
- Scalene muscles – These are neck muscles that often get overused during asthma episodes.
- Trapezius muscles – Running from the neck to the middle of the back, they’re heavily involved in labored breathing.
- Intercostal muscles – Located between your ribs, these also pitch in and can become sore.
From a clinical standpoint, this kind of muscle-based pain tends to be dull, aching, or even burning in quality. It may feel worse with deep breaths, physical activity, or after coughing fits.
Inflammation and Referred Pain
Another sneaky factor? Inflammation. If your bronchial tubes are inflamed, it can sometimes lead to referred pain. That’s pain felt in a different location from its actual source—sort of like how a heart attack might present with jaw or arm pain.
In some cases, asthma-related inflammation may irritate nearby nerves or tissues, leading to pain radiating to the upper back. It’s not super common, but I’ve seen it, especially in people with long-standing asthma or frequent exacerbations.
Why This Pain Is Often Misdiagnosed
I can’t count how many times I’ve had someone referred to cardiology or orthopedics before ending up in my office. When you say “pain between my shoulder blades,” most folks don’t immediately think asthma. And honestly, that makes sense. It’s not the textbook description. But that’s exactly why we need to talk about it.
Can asthma cause pain between shoulder blades? Not only can it, but it often does—it’s just underreported. The overlap with musculoskeletal pain, anxiety, and even gastrointestinal issues can really muddy the waters.
- Chest discomfort often overlaps with back pain—especially in people with poor posture or chronic cough.
- Asthma-induced anxiety can amplify pain perception, making it feel more intense or widespread.
- Inactivity during asthma episodes can cause muscle stiffness, especially if patients are lying in awkward positions.
Personal Observations from the Clinic
Just last month, I saw a middle-aged woman who swore she’d pinched a nerve from sleeping weird. She was short of breath, had been coughing on and off for weeks, and was constantly rubbing her upper back. Turns out she was having silent asthma exacerbations. After a proper workup and a tweak to her inhaler regimen, her shoulder blade pain completely resolved.
That’s the thing—when you know what to look for, these puzzle pieces start to fall into place. If you’re experiencing this kind of pain, or treating someone who is, don’t rule out asthma too quickly. It might not be obvious, but it’s definitely in the realm of possibility.
How to Tell If Shoulder Blade Pain Is From Asthma or Something Else
Alright, let’s talk about the tricky part—figuring out where the heck this pain is really coming from. Because not every twinge between your shoulder blades is asthma’s fault. Trust me, I’ve had patients swear up and down it’s their lungs acting up, only to find out it was a desk chair from 2003 wreaking havoc on their posture.
So how do we tell the difference? One of the first things I look at in the clinic is the timing and pattern of the pain. If it flares up during asthma symptoms—like wheezing, coughing, or breathlessness—it’s probably connected. If it pops up after sitting at a computer all day? Maybe not.
Asthma-Related Pain Usually Comes With Other Clues
- Shortness of breath – If you’re gasping or feeling like you can’t get enough air, that’s a red flag.
- Wheezing or coughing – Especially if it’s chronic or flares at night or with activity.
- Fatigue – Breathing shouldn’t be exhausting. If it is, your muscles are probably overcompensating.
I always ask patients whether the pain feels better after using their rescue inhaler or nebulizer. If it does—even just a little—that’s a huge hint that asthma is playing a role. On the flip side, if a heating pad and stretching fix the issue? Then we’re probably dealing with something more orthopedic.
Managing Shoulder Blade Pain When You Have Asthma
Alright, so now that we know asthma can cause pain between the shoulder blades, let’s talk about what to actually do about it. Because walking around feeling like someone jammed a knitting needle between your shoulder blades isn’t fun for anyone.
First and foremost—manage the asthma. I know, I know… easier said than done. But I’ve seen patients completely resolve their back pain simply by getting better control of their asthma. That means:
- Using maintenance inhalers consistently, not just when you feel bad.
- Making sure your inhaler technique is actually effective (yep, you’d be surprised).
- Checking in regularly with your provider to adjust meds if needed.
Next up: address the muscle tension. You don’t need a full-on spa day (though hey, I won’t stop you), but a few strategic moves can make a big difference:
- Gentle stretching – Focus on the neck, shoulders, and upper back. Even 5 minutes helps.
- Postural awareness – Don’t underestimate how much poor posture adds to the problem. Think tall spine, shoulders relaxed.
- Heat therapy – A heating pad or warm shower can ease those tight upper back muscles.
When to Get It Checked Out
Now, here’s where my clinician hat comes on a bit stronger. If you’re not sure where the pain is coming from, get evaluated. It’s always better to rule out anything serious—like cardiac issues or a pinched nerve—than to assume it’s just your asthma flaring.
Here are some times to definitely see your provider (or head to urgent care):
- The pain is sudden and sharp, especially if it came on with no warning.
- You’re having chest pain, dizziness, or nausea alongside it.
- The pain gets worse when you lie down flat or wakes you up at night.
- You’re not getting relief from your usual asthma treatments.
Personally, I had a patient a few years ago—a guy in his 40s with well-controlled asthma—come in with what he thought was back strain from lifting boxes. Turns out he was having mild but persistent asthma symptoms all week, and the back pain was his body’s way of saying, “Hey, I’m working way too hard here.” We adjusted his meds, started some light PT, and within a month, the pain was gone.
Our bodies are pretty good at sending signals when something’s off. The trick is learning to listen—and knowing when to call in the pros.
Living with Asthma and Managing Recurrent Shoulder Blade Pain
So, if you’ve made it this far, you’re probably realizing by now that yes—the answer to “can asthma cause pain between shoulder blades?” is a definite and informed yes. And while it might not be the first thing a textbook will tell you, it’s something I’ve seen time and time again in real-world practice.
Managing this kind of pain goes hand in hand with treating asthma as a whole—not just tossing pain relievers at the symptom. It’s about understanding that your respiratory system is part of a bigger, interconnected body, and when one piece is overworked, others step in and often suffer for it.
One patient I worked with—a 27-year-old teacher—dealt with constant upper back pain every allergy season. She was used to dismissing it as stress or bad posture from grading papers. But her peak flow readings were consistently dipping during those same months. Once we added a preventative antihistamine and optimized her controller inhaler, not only did her breathing improve, but the shoulder blade pain she’d just accepted as “normal” disappeared, too.
Supporting Your Body Beyond Medication
There’s more to managing asthma-related pain than inhalers and prescriptions. Let’s talk about holistic strategies—things I often recommend alongside standard treatments:
- Breathing exercises – Techniques like diaphragmatic breathing can offload tension from upper body muscles.
- Physical therapy – Especially useful if your posture has suffered due to chronic asthma episodes.
- Yoga or gentle movement – These help strengthen the muscles that support your lungs without overexertion.
- Mindfulness practices – Stress and anxiety can make both asthma and pain worse. Breathwork and meditation go a long way.
There’s something empowering about learning how to breathe in a way that supports your entire body—not just your lungs. I’ve had several patients tell me that once they learned to breathe *efficiently*, their overall pain levels dropped, even during flare-ups.
When Pain Might Signal Something Else
Now, I’d be remiss if I didn’t mention the “what-ifs.” Just because asthma can cause shoulder blade pain doesn’t mean it’s always the culprit. If the pain is:
- Sharp, radiating down your arm
- Associated with numbness or tingling
- Doesn’t change with breathing
- Worsens when lying flat or after eating
…then it might be time to look beyond asthma. I’ve had patients with gallbladder issues, GERD, even shingles in the early stages—all misattributed to asthma at first. Don’t hesitate to advocate for a thorough evaluation if something feels “off.” And if you’re a clinician reading this—dig deeper when your patient mentions vague back pain with their asthma history. You’ll be surprised how many lightbulb moments you’ll uncover.
Empowering Yourself With Knowledge
Whether you’re living with asthma or caring for someone who is, understanding the full picture matters. Pain between the shoulder blades may not be the most obvious asthma symptom, but it’s valid—and deserves attention.
Education, self-awareness, and a proactive care plan can make all the difference. And remember: no one knows your body better than you. If something doesn’t feel right, trust that instinct and speak up.
I’ve found that when patients feel informed, they feel empowered. And empowered patients make better choices, have better outcomes, and feel more in control of their health journeys. That’s what this is all about—not just symptom relief, but long-term wellness.
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Disclaimer
This article is for informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your physician or a qualified healthcare provider with any questions you may have regarding a medical condition. The experiences shared are personal and should not be taken as a substitute for individualized care.
Bianca Nala is a compassionate Nurse Practitioner with a strong background in primary and respiratory care. As a health writer for Healthusias.com, she combines her clinical expertise with a talent for clear, relatable storytelling to help readers better understand their health. Bianca focuses on topics like asthma, COPD, chronic cough, and overall lung health, aiming to simplify complex medical topics without losing accuracy. Whether she’s treating patients or writing articles, Bianca is driven by a single goal: making quality healthcare knowledge accessible to everyone.
