When you hear about back pain, you probably think about middle or lower back pain. But that’s not the only spot where you may ache. You can also experience it in your upper back, right between your shoulder blades.

This specific area is where your rhomboid muscles are, and they have a clear purpose. They support your shoulders, helping you throw, pull, and reach for things over your head. If they’re sore, they can make your life more difficult.

Rhomboid muscle pain can sometimes be hard to figure out. “It tends to just be this annoying pain that people aren’t sure how to get rid of, which can be frustrating,” says Julianne Payton, PT, DPT, a physical therapist at Hinge Health. 

The good news is that you can easily manage rhomboid muscle pain on your own with conservative, at-home measures. Read on to learn more about what causes rhomboid muscle pain, along with how to prevent and treat it — especially with exercises recommended by our Hinge Health physical therapists.

What Are the Rhomboid Muscles?

There are two rhomboid muscles on each side of the spine: the rhomboid major and the rhomboid minor. “These sit between your shoulder blades and attach the edges of the shoulder blades to your spine,” explains Dr. Payton. 

The rhomboids are part of your shoulder girdle, a group of muscles that help move your shoulder blade and keep your shoulder stable. They also help you pull back your shoulder blade, lift and rotate it, and help you throw, pull, and reach overhead.

Rhomboid and Upper Back Pain: A Hinge Health Perspective

Rhomboid and upper back pain can feel frustrating, especially if it persists or interferes with your daily activities. If you experience it, you might be hesitant to move or exercise. You may worry that being active will make your pain worse.

But movement is key to relieve your discomfort, stresses Dr. Payton. “A lot of rhomboid and upper back pain stems from stiffness in the shoulder muscles and joints, as well as the spine,” she points out. “Movement helps to increase blood flow to the area, which promotes healing and reduces stiffness. The more you can move, the more that you’ll improve.”

No matter what’s contributing to your rhomboid and upper back pain, you’re in the right place to get support for dealing with it.

Symptoms of Rhomboid Muscle Pain

If you have rhomboid muscle pain, you may notice some or all the following symptoms:

• Pain between your shoulder blades. “Patients often describe it as nagging, although sometimes it can burn, ache, or throb,” says Dr. Payton.

• Pain that worsens when you do a lot of sitting or standing.

• A feeling of tension or tightness between your shoulder blades.

• A popping or grinding noise near your shoulder blades when you move your shoulders.

Common Causes of Rhomboid Muscle Pain

Rhomboid muscle pain can be triggered by many different things. Here are some of the most common rhomboid pain causes:

• Muscle strain. Your rhomboid muscles are strong and designed to help you pull, throw, and reach overhead. But if you overdo it tossing a baseball with your kids, swinging a golf club, or even carrying a heavy backpack, your muscles may be sore afterwards.

• Staying in the same position. If you are in the same position for most of the day — for example sitting at a desk in front of a computer or bending over a lot — you may develop rhomboid muscle pain, notes Dr. Payton. “Your muscles may tighten and spasm up,” she explains.

• Tightness in the neck. “Pain and stiffness in your neck can be related to your rhomboid muscles,” says Dr. Payton. 

• Arthritis. It’s very normal for your shoulder joints to change as you get older, which can lead to osteoarthritis. Since it can limit movement in your shoulder, you may notice discomfort in surrounding muscles like your rhomboid muscles. 

Treatment Options for Rhomboid Muscle Pain

Most of the time, rhomboid muscle pain can be treated at home. Here’s what Hinge Health physical therapists recommend for rhomboid pain relief, so you can get moving again:

• Gentle movement. Exercises that stretch and strengthen your rhomboid muscles will help to relieve muscle tension and promote better spine support. “You really want to encourage mobility throughout your mid-back, especially since so many of us sit for hours in an office,” explains Dr. Payton. “It’s very common for that area to stiffen up.” There’s also no need to modify your workout, so if you still want to go for that run or sign up for spin class, go ahead. “If your rhomboid muscles start to hurt, then modify the activity, or cut it short,” advises Dr. Payton. “Listen to your body. Some mild discomfort is okay, but if you feel a lot of pain, you may be doing more than your muscles are ready for.”

• Adjust your position. If you stay in the same position for too long, your muscles tend to stiffen up. You can help to avoid this with frequent movement breaks while sitting, says Dr. Payton. It also helps to practice good ergonomics at work. If your sitting position is affecting your rhomboid pain, try sitting in a chair that provides good back support, and adjust its height so that your knees are about level with your hips. (If you’re in a pinch, put a rolled-up towel or pillow behind you at the curve of your back to provide support.) This will help to take pressure off all of the muscles around your spine, including your rhomboid and shoulder muscles.

• Over-the-counter pain medications. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful initially to help ease rhomboid muscle pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. Another option is an over-the-counter nonsteroidal anti-inflammatory cream, such as diclofenac (Voltaren).

• Heat or ice. While ice can help if it’s a new strain since it helps to ramp down inflammation, heat is usually better if muscle pain has been around for a while, notes Dr. Payton. But everyone is different, so it’s best to experiment to see what works for you.

• Massage therapy. Getting a massage from a licensed massage therapist or seeing a chiropractor can help to soothe tense rhomboid muscles, which may reduce pain. A 2021 study published in the Journal of Manipulative and Physiological Therapeutics found that massage of the rhomboid area helped to alleviate pain. These services can make it easier to perform strengthening and stretching exercises, but you don’t want these to be the only treatment modalities you focus on, notes Dr. Payton. 

• Work with a physical therapist. “A PT can help you figure out what’s contributing to your rhomboid muscle discomfort and manage it with exercises to improve your strength and flexibility,” says Dr. Payton. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

“When your rhomboid muscles feel tight or irritated, your first inclination may be to stretch them,” says Dr. Payton. “But these sensations may actually come from weak muscles, so it’s important to strengthen them, too.” These five rhomboid muscle pain relief exercises are recommended by Hinge Health physical therapists.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Try Using a Foam Roller

Foam rolling is a great way to stretch out and massage your rhomboid area, says Dr. Payton. “Place the foam roller crossways, so that it’s perpendicular to your back, not lengthwise against your spine,” she advises. Start with the roller at the bottom of your shoulder blades, or scapula, then roll it all the way up to the top of your shoulders. Rotate the roller from left to the right to get all sore and tight spots.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Chairs. (n. d.). National Institute of Health, Division of Occupational Health and Safety. Retrieved from https://ors.od.nih.gov/sr/dohs/HealthAndWellness/Ergonomics/Pages/ergonomic_chair.aspx

2. Farrell, C., & Kiel, J. (2024). Anatomy, Back, Rhomboid Muscles. PubMed; StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/30521277/

3. Fennell, J., Phadke, C. P., Mochizuki, G., Ismail, F., & Boulias, C. (2016). Shoulder Retractor Strengthening Exercise to Minimize Rhomboid Muscle Activity and Subacromial Impingement. Physiotherapy Canada, 68(1), 24–28. doi:10.3138/ptc.2014-83

4. Fahmy, E. M., Ibrahim, A. R., & Elabd, A. M. (2021). Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized, Blinded Clinical Trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 103–112. doi:10.1016/j.jmpt.2020.07.005