Can Asthma Cause Pain Between Shoulder Blades? Discover Real Relief

Ever had a patient—or even yourself—complain of this weird, nagging ache right between the shoulder blades and wonder, “Can asthma cause pain between shoulder blades?” Well, same here. As a pulmonary nurse, I’ve heard it enough times in the clinic to know it’s not just a throwaway symptom. And let me tell you, this kind of discomfort can sometimes catch people off guard. Most folks only think of asthma as wheezing, shortness of breath, and that tight, can’t-catch-my-breath feeling. But shoulder blade pain? Not on their radar. Yet I’ve seen it enough that it deserves some real talk.

How Asthma Can Present Beyond the Lungs

Let’s start by breaking a myth: asthma doesn’t just “live” in your lungs. I know, it’s a lung condition at its core, but symptoms can spill over—sometimes in unexpected ways. Pain between the shoulder blades is one of those lesser-known presentations, and from what I’ve seen over the years, it’s not all that rare.

This isn’t about random back pain after sleeping funny. It’s more of a tension or tightness that creeps in, especially during or after an asthma flare-up. I’ve had patients describe it as a burning sensation, dull ache, or pressure that radiates inward toward the spine. And it usually makes them ask, “Is it my lungs? Or is it something else entirely?”

Why Might Asthma Cause Pain in the Upper Back?

There are a few solid reasons why this happens—and believe me, I’ve looked into them both as a clinician and out of sheer curiosity after hearing enough complaints to spark my interest.

• Muscle Overuse: During an asthma attack, people tend to breathe harder and faster. That means the muscles in the upper back, neck, and chest are working overtime. It’s like an upper-body workout, but without the gym. Overuse of these accessory muscles can lead to pain and fatigue.
• Poor Posture from Labored Breathing: When you’re short of breath, you naturally hunch forward. It’s a protective instinct. But over time, that posture can strain the muscles between the shoulder blades.
• Referred Pain: This is one of those fascinating things in medicine. Sometimes pain is felt in a different place from where the problem is. So, inflammation in the lungs or airways might actually be felt in the back.

Understanding the Anatomy Behind It

So what’s going on anatomically? Well, your lungs sit in the thoracic cavity, pretty close to the upper back. When you’re having trouble breathing, your body recruits the scalene muscles, sternocleidomastoid, and trapezius to help get air in and out. If those muscles stay tight or inflamed (which they often do), guess what? Pain shows up—and guess where? Yep, right between the shoulder blades.

Here’s a quick breakdown of what gets involved:

1. Scalene muscles: These run along the sides of your neck and help lift the first two ribs—critical during labored breathing.
2. Trapezius: Big, broad, and always working overtime when you’re in distress. It extends from the base of the skull down to the mid-back, right across the shoulder blade area.
3. Rhomboids and paraspinals: These support posture and stabilize the spine. If you’re sitting hunched over during an attack, these guys take the hit.

Real Talk from the Clinic

I remember one patient, Maria, who came in with what she thought was a back injury. But when we dug deeper, it turned out she was having uncontrolled asthma symptoms. Her breathing was shallow, her posture was slouched, and she was constantly using her accessory muscles to breathe. She didn’t even realize she was doing it—it had just become her new normal. After adjusting her inhaler regimen and focusing on posture and breathwork, that shoulder pain started to ease up. No fancy back treatments needed.

When Should You Worry?

Alright, let’s be real here: not every twinge between the shoulders is asthma-related. But if you’re already diagnosed with asthma and this kind of pain shows up alongside other symptoms—like wheezing, tight chest, or fatigue—it’s worth paying attention. Especially if it happens repeatedly or after a flare-up. And if that discomfort becomes sharp, sudden, or is accompanied by other red-flag symptoms like dizziness or arm pain, don’t play around. That’s ER territory. You don’t want to miss something serious like a cardiac issue.

Red Flags That Aren’t Just Asthma

• Sudden, severe upper back pain with shortness of breath
• Radiating pain into the arm or jaw
• Chest tightness that doesn’t improve with an inhaler
• Unusual fatigue, sweating, or nausea

As much as I’ve seen asthma mimic a lot of things, these signs need immediate attention. Better safe than sorry, right?

Managing the Pain Between Shoulder Blades When You Have Asthma

Now, let’s talk relief. When a patient comes to me asking, “Can asthma cause pain between shoulder blades?” the follow-up question is almost always, “Okay… so what can I do about it?” And that’s where things get interesting. Because while treating the asthma itself is crucial, there’s more we can do to support those poor, overworked back muscles.

I’ve had patients who didn’t just want to breathe better—they wanted to feel better overall. And honestly, who wouldn’t? That’s where a blend of medication, posture awareness, and some good ol’ fashioned stretching comes into play.

Start With the Basics: Asthma Under Control

This is non-negotiable. If your asthma isn’t under control, you’re fighting an uphill battle. I’ve seen this firsthand with patients who forget their controller inhalers or don’t take them consistently. You can stretch all day long, but if your lungs are inflamed and you’re constantly short of breath, your body’s going to stay tense.

• Follow your action plan: Make sure your maintenance inhaler is being used properly. If you’re using your rescue inhaler more than twice a week, it’s time to talk to your doc.
• Know your triggers: Dust, smoke, cold air, pet dander—identify what sets you off and limit exposure. I once had a patient who was getting upper back pain every time she visited her sister’s house… turns out her sister had cats. Connect the dots!
• Get your lungs checked: If you haven’t had a recent spirometry or peak flow test, schedule one. It’s the only way to know how your lungs are really doing.

Simple Stretching & Posture Fixes That Actually Work

Here’s where I share a little trick I use even for myself. Nursing is tough on the back, and I’m no stranger to that scapular soreness. Add in some shallow breathing from stress or asthma and it’s a recipe for tight muscles.

These gentle movements can help release tension and support better breathing mechanics:

1. Wall Angels: Stand with your back flat against the wall, arms up like a goalpost. Slowly slide them up and down the wall. Great for realigning posture and opening up the chest.
2. Child’s Pose with Reach: Kneel, then fold forward with arms extended. Try reaching each hand across to the opposite side. Targets the rhomboids and stretches the spine gently.
3. Doorway Chest Stretch: Stand in a doorway, place forearms on each side, and gently lean forward. This counteracts the hunching posture during asthma episodes.

Try doing these once or twice a day—especially after using your rescue inhaler or after a long bout of coughing. Your back will thank you, promise.

Breathing Exercises to Ease the Strain

One thing I always recommend—whether you’re wheezing or just trying to stay ahead of symptoms—is to practice proper breathing techniques. You’d be shocked how many people, even with asthma, don’t actually know how to breathe efficiently.

Diaphragmatic Breathing (a.k.a. Belly Breathing)

This one is a game-changer. Most people with asthma rely on upper chest breathing, which is shallow and overuses those upper back and neck muscles. Diaphragmatic breathing helps relax your body and strengthens the lungs.

• Lie down or sit comfortably, one hand on your chest and one on your belly.
• Inhale slowly through your nose, aiming to raise the hand on your belly more than the one on your chest.
• Exhale through pursed lips, gently pressing on your belly to fully empty the lungs.

I used to teach this to post-op patients all the time, and it’s just as helpful for asthma. Bonus? It actually helps reduce anxiety—which can also cause you to tense up and breathe wrong.

Pursed-Lip Breathing

This one’s a classic in pulmonary rehab. I’ve taught it to hundreds of patients, and it really helps during asthma attacks or when you feel breathless.

• Inhale slowly through your nose for about 2 seconds.
• Exhale slowly through pursed lips (like you’re blowing out a candle) for 4 seconds.

This technique keeps the airways open longer, making it easier to exhale fully and reduce the air trapping that causes tightness in the chest—and sometimes that referred pain in the upper back.

When It’s More Than Asthma

Let me just put this out there: if you’re dealing with chronic pain between the shoulder blades and your asthma seems fine, don’t shrug it off. It could be a few different things overlapping.

• GERD: Acid reflux can cause referred pain in the chest and back. A surprising number of asthmatics also have reflux, especially if they’re on certain medications.
• Costochondritis: Inflammation of the cartilage in the ribcage can mimic asthma chest tightness and cause radiating back pain.
• Musculoskeletal strain: Maybe from lifting, poor posture, or even sleeping wrong. If your asthma is under control and the pain persists, this might be your culprit.

If I’m ever unsure about a patient’s symptoms, I always encourage them to keep a little symptom journal. Track what triggers the pain, what makes it better or worse, and if it correlates with asthma flare-ups or not. Patterns reveal a lot.

And hey, always trust your gut. If something feels “off,” speak up. You know your body better than anyone else. Your healthcare team’s job (mine included!) is to listen, dig deeper, and help connect the dots.

Preventing Pain Between the Shoulder Blades Long-Term

Okay, so we’ve talked about why asthma can cause pain between shoulder blades and how to manage it. But if you’re anything like most of my patients (or me, honestly), you’d rather *not* deal with it in the first place. Prevention is where it’s at. And trust me, even small daily habits can make a huge difference when it comes to avoiding that upper back tightness that tags along with asthma.

Fix the Posture, Fix the Problem (Mostly)

It might sound simple, but posture is a sneaky little troublemaker. I can’t tell you how many times I’ve caught myself hunched over at the nurse’s station and thought, “No wonder my back’s killing me.” Now imagine having asthma on top of that. The hunched position shortens the front body, strains the back muscles, and restricts full lung expansion.

Here’s what I recommend to my patients (and practice myself):

• Set posture reminders: Use your phone or smartwatch to nudge you every hour to sit tall and stretch.
• Ergonomic work setup: Whether you’re on a laptop or at a desk all day, make sure your screen is eye-level, and your chair supports your lower back.
• Stack the spine: When you sit or stand, imagine stacking your head, ribs, and pelvis like building blocks. That visual helps align your body without overthinking it.

Strengthen to Support Your Lungs and Back

I always say, if you’re strong where it counts, your body won’t have to compensate in weird ways. When asthma flares up, those accessory muscles work overtime. If they’re already strong and conditioned, you’ll experience less strain—and that can mean less pain between the shoulders.

Some exercises I love to recommend (and sneak in between shifts):

1. Resistance band rows: These strengthen the mid-back muscles that get overused during asthma flare-ups. Plus, they feel amazing after a long day.
2. Thoracic extensions on foam roller: A super gentle way to mobilize the spine and release tension across the shoulder blades.
3. Breath-focused core work: Moves like dead bugs and bird-dogs help engage the diaphragm and deep core—both of which support breathing.

Bonus Tip: Keep a Pain & Symptom Log

Not glamorous, but it works. I’ve had patients discover hidden triggers (like weather shifts or specific foods) just from jotting things down. If your shoulder pain flares up at the same time as asthma symptoms—or even before—it’s a clue. Tracking this over time can help your healthcare team fine-tune your treatment plan.

Lifestyle Shifts That Support Both Breathing & Comfort

There’s a reason I keep coming back to the whole “big picture” view. Because asthma isn’t just a lung thing—it’s a full-body, whole-life condition. And that pain between the shoulders? It’s your body waving a little red flag saying, “Hey! Something’s off.”

Here are a few lifestyle moves that can help with both asthma and muscle tension:

• Hydration: Staying hydrated keeps mucus thinner (better for breathing) and helps muscles function properly.
• Magnesium-rich foods: Think spinach, almonds, avocado. Magnesium supports muscle relaxation and can even reduce asthma inflammation.
• Mindfulness & stress reduction: Stress = shallow breathing = tight upper body. Whether it’s yoga, meditation, or just a few quiet minutes a day, find your chill.

One of my longtime asthma patients started daily 5-minute meditation sessions—and guess what? Her shoulder pain episodes dropped significantly. She didn’t change her meds, just her mindset and breathing awareness.

Helpful Resources & When to Seek Extra Help

There’s a ton of support out there, but I always suggest starting with credible sources. And if you’re reading this and thinking, “This all sounds good, but my pain still doesn’t add up,” then it’s time to bring in your provider. Maybe even a referral to a pulmonologist, physical therapist, or respiratory therapist depending on your symptoms.

Some solid places to learn more:

• https://www.nhlbi.nih.gov/ – Asthma treatment guidelines and lung health resources
• https://www.nih.gov/ – General medical research and updates
• https://www.health.com/ – Practical health advice and lifestyle tips

When It’s Time to Call Your Doc

If any of the following apply, don’t wait. Get evaluated:

• Pain between the shoulder blades that’s sudden, intense, or sharp
• Pain that worsens with breathing or doesn’t improve with posture correction
• Asthma symptoms that are getting harder to control

You deserve answers—and relief. Don’t settle for shrugging off the pain just because it’s “not in the lungs.” Your body’s all connected. When one part’s struggling, it shows up elsewhere.

Final Thoughts (From One Nurse to You)

If there’s one thing I’ve learned from years in pulmonary care, it’s that symptoms like pain between the shoulder blades are worth listening to. They’re not always dramatic or life-threatening, but they’re your body trying to speak up. And when you take the time to listen, adjust, and care for the root causes—whether it’s your asthma, your posture, or just your daily habits—you feel better. And that’s what this is all about, right?

Stay curious, stay proactive, and most of all—keep breathing easy.

Disclaimer: This article is for informational purposes only and doesn’t replace medical advice. Always talk to your healthcare provider about any symptoms or concerns you’re experiencing. Don’t self-diagnose or delay getting care when it’s needed.

Bianca Nala

Bianca Nala is a seasoned pulmonary nurse and health writer dedicated to empowering individuals with practical, evidence-based insights into respiratory health. With over a decade of hands-on clinical experience, she specializes in asthma management and holistic wellness strategies.

Bianca’s contributions to Healthusias reflect her commitment to making complex medical topics accessible and actionable. Her articles delve into various aspects of asthma care, including natural remedies, symptom differentiation, and lifestyle adjustments to enhance breathing and overall well-being. Through her writing, she aims to bridge the gap between clinical knowledge and everyday health practices, helping readers navigate their health journeys with confidence.

Explore Bianca Nala’s latest articles on Healthusias to gain valuable insights into managing asthma and improving respiratory health.