Rhomboid pain is felt under the neck between the shoulder blades and spine. It’s sometimes referred to as shoulder blade pain or upper back pain.

The rhomboid muscle is located in the upper back. It helps connect the shoulder blades to the rib cage and spine. It also helps you maintain good posture.

How to identify rhomboid muscle pain

With rhomboid pain, you may feel pain in this area as a strain, a shooting pain, or some type of spasm. Other symptoms of rhomboid muscle pain may include:

  • tenderness in the upper back area
  • a popping or grinding noise when you move the shoulder blade
  • tightness, swelling, and muscle knots around the muscle
  • loss of movement, or difficulty or pain when moving the muscle
  • pain when breathing

Rhomboid muscle pain can also cause pain in the mid-upper back, at the backs of the shoulders, or between the spine and the shoulder blade. It can also be felt in the region above the shoulder blade.

Where’s the rhomboid muscle located?

You may develop rhomboid muscle pain as a result of:

  • poor or incorrect posture
  • sitting for extended periods
  • injuries from straining, overstretching, or tearing the muscles
  • sleeping on your side

Overuse of the rhomboid muscle can lead to pain in the shoulders and arms. Sports such as tennis, golf, and rowing can cause pain in this area. Activities and work that require you to extend your arms over the head for a long time, carrying heavy bags and backpacks, and lifting heavy objects can also cause this type of pain.

Resting and refraining from any activity that causes rhomboid muscle pain will help you recover quickly. The first line of treatment is the RICE method:

  • Rest. Rest your arms and shoulders as much as possible. Refrain from any activities that use these muscles.
  • Ice. Ice your shoulder for 20 minutes at a time several times per day. It’s especially important to ice the affected area immediately after a strain or injury.
  • Compression. Wrap the area in a compression bandage to reduce swelling.
  • Elevation. Keep your shoulder and chest lifted or supported using pillows while you’re lying down or sleeping.

You may take over-the-counter pain relievers to relieve discomfort and inflammation. These include ibuprofen (Advil and Motrin IB) and acetaminophen (Tylenol).

You can apply topical pain relievers such as creams, gels, and sprays to the affected area, too. Topical pain relievers such as diclofenac (Voltaren, Solaraze) and salicylates (Bengay, Icy Hot) are thought to have a lower risk of side effects. This is because less of the drug is absorbed into the blood, and the drug bypasses the gastrointestinal tract.

You may consider applying essential oils diluted in a carrier oil to reduce pain and inflammation. Here are 18 essential oils that may help relieve sore muscles.

After a few days of icing your shoulder, you may wish to apply heat. You can use a heating pad or a warm compress. Apply the heat source for 20 minutes at a time several times per day. You can alternate between hot and cold therapy.

If you’ve taken steps to relieve rhomboid muscle pain and you’re not seeing improvement, you may benefit from seeing a physical therapist or a physiotherapist. They can teach you exercises to improve your shoulder pain and prevent it from recurring.

There are several exercises and stretches you can do to relieve rhomboid muscle pain. These exercises can help improve your recovery and prevent pain from returning.

Make sure you’re able to do the exercises without pain or strain. You may need to have a period of rest before you begin these exercises. Don’t push yourself too hard or too soon.

1. Shoulder blade squeeze

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  1. Sit or stand with your arms alongside your body.
  2. Draw your shoulder blades back and squeeze them together.
  3. Hold this position for at least 5 seconds.
  4. Relax and repeat.
  5. Continue for at least 1 minute.

2. Rhomboid stretch

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  1. Stack your hands with your right hand over your left.
  2. Extend your arms out in front of you as you slowly reach forward to feel a gentle stretch between your shoulder blades.
  3. Hold this pose for 30 seconds.
  4. Do the opposite side.
  5. Do this stretch 2 times on each side.

3. Side arm stretch

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  1. Bring your left arm across the front of your body at shoulder height.
  2. Bend your right arm with your palm facing up and allow your left arm to rest in your elbow crease, or use your right arm to hold your left hand.
  3. Hold this position for 30 seconds.
  4. Do the opposite side.
  5. Do this stretch 3 to 5 times on each side.

4. Upper back and neck stretch

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  1. Interlace your fingers and extend your arms in front of you at chest level with your palms facing forward.
  2. Gently bend your neck and draw your chin into your chest.
  3. Hold this position for 30 seconds.
  4. Then, on an inhale, lift your head and look up.
  5. On an exhale, bend your neck and tuck your chin back into your chest.
  6. Follow your breath to continue this movement for 30 seconds.
  7. Release the pose, relax for 1 minute, and repeat once or twice.

5. Neck rotations

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  1. Come into a sitting or standing position with your spine, neck, and head in one line.
  2. On an exhale, slowly turn your head to the right side.
  3. Go as far as you can without straining.
  4. Breathe deeply, and hold this position for 30 seconds.
  5. Inhale to return to the starting position.
  6. Repeat on the opposite side.
  7. Do this 3 times on each side.

6. Cow Face Pose

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  1. Get in a seated position, and extend your left arm up toward the ceiling.
  2. Bend your left elbow and bring your hand to your back.
  3. Use your right hand to gently pull your left elbow over to the right.
  4. To deepen the pose, bend your right elbow and bring your right fingertips to clasp your left fingertips.
  5. You can use a rope or towel if you can’t reach.
  6. Hold this position for about 30 seconds.
  7. Then do the opposite side.

7. Locust Pose

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  1. Lie down on your stomach with your arms next to your body, palms facing up.
  2. Allow your heels to turn out to the side.
  3. Gently place your forehead on the floor.
  4. Slowly lift up your head, chest, and arms as high as is comfortable.
  5. To deepen the pose, lift your legs.
  6. Press your lower ribs, stomach, and pelvis into the floor to further deepen the stretch.
  7. Look straight ahead or slightly upward.
  8. Hold this pose for about 30 seconds.
  9. Release the pose and rest for a bit before repeating the pose once or twice.

The amount of time it takes to recover from rhomboid muscle pain will depend on how severe the strain is. Most mild strains will heal within three weeks. More serious strains can take several months to heal.

It’s important to avoid strenuous exercise and heavy lifting during recovery. Slowly return to your activities once you feel fully healed. Pay careful attention to how your body responds to activities after a period of rest. Notice if there’s any discomfort or pain, and respond accordingly.

See your doctor if you don’t see improvements. Physical therapy may be recommended for chronic strains.

There are steps you can take to prevent rhomboid muscle pain from happening in the future. Here are a few tips and guidelines:

  • Always warm up before a workout and cool down afterward.
  • Practice proper technique when playing sports.
  • Take a break from exercise and activities when you feel sore or tired.
  • Avoid lifting heavy objects, and use proper form when you do.
  • Carry heavy backpacks on both shoulders, not one.
  • Maintain a healthy weight.
  • Exercise and stretch regularly to stay in shape.
  • Practice good posture while sitting, standing, and walking.
  • Take frequent breaks to move around, walk, and stretch during periods of extended sitting.
  • Use protective equipment for sports and work.

Take care of yourself as soon as you start to experience rhomboid muscle pain so that it doesn’t get worse. Take time to rest, and refrain from activities that are causing this pain.

If you experience rhomboid muscle pain regularly, you may wish to work with a personal trainer to learn exercises that can help you correct imbalances in your body. Having regular massages or joining a yoga studio may also help bring positive results.

See your doctor if you experience intense pain that worsens, becomes severe, or doesn’t respond to treatment. They can help you find a treatment plan that works for you.