Sounds like upper cross syndrome to me; it's important to keep your back straight while at the computer (put a mirror next to chair if needed, align tops of shoulders with hips and sit up straight, especially with regard to upper (thoracic) back. It helps to consciously squeeze your shoulder blades together so they "touch", with shoulders back and not hunched forward.
Sleeping with your upper back on a firm or hard surface (even a board) will be helpful also; you could even roll a small towel under the lower shoulder blade area and lie on that for relief.
Or use a tennis ball (carefully, but can really "dig it in" where it hurts). Take a few deep breaths while doing this and you may hear some small "cracks" of readjusting vertebrae.
I found that a double dose of aspirin taken with a cup of coffee twice a day was helpful if done with the above (reducing pain and inflammation).
Starting with easy weights, work your middle trapezius area in particular and back in general (pulling motions like pullups), and reduce your pushing motions (like pushups) until muscular imbalance corrected. Bent-over rows work well, but start with an easy weight and work up from there; don't go past the point of pain; the weight may have to be very light at first or just do the motion without any added weight. At the gym you can also do back hyperextensions (the reverse motion from the situp).
A helpful stretch is the pectoral stretch, stick upper arms out to left & right (90 degrees from vertical, to the sides) and then bend forearms so they are pointing up (vertical); stand in a doorway or other structure (columns or curved walls also work well) and place your hands on each side of the doorway and step a little foreward so your pecs are stretched and your shoulders pushed back. A variation of this if sore in bed is to lay on your side and slightly down, place your shoulder on the bed and push down so the shoulder goes back. (I used this successfully when I felt the pain begin to return once.)
If you go to a chiropractor, he should concentrate on your neck and upper back. But if the posture issue is not addressed (especially when sitting), then it will recur.
With upper cross syndrome and the hunched upper back, the neck will try to compensate by bending too high; so after straightening your back and pinching those shoulder blades together, tuck your chin in (rotate head downwards while keeping back straight). This should relieve the pressure on lower cervical (neck) disks caused by this craning of the neck.
There's a related imbalance called lower cross syndrome. Both upper and lower cross get their name from the pairs of muscle groups in imbalance, either in the upper or lower back area. One muscle is too tight and one is too stretched and weakened; the object is to stretch the tight muscles and strengthen (and shorten) the weak muscles.
Personal note: I had a severe attack of this in 2006 and a few relapses before a correct diagnosis allowed the proper therapy to be used.
I've been pain-free since April.
If the posture/slouching issue isn't corrected, it will return (the cause of those occasional relapses, and their cure). Keeping the "pulling" muscles of the back worked out regularly (every other day) relieves symptoms and prevents recurrence, and promotes good posture. After awhile, you'll be more conscious of your back position, and will know when you're slouching, and may even feel a slight twinge under the shoulder blade that reminds you to straighten your back! If, due to a misdiagnosis, a doctor recommends surgery, run, don't walk, for a second opinion, or try the above.
Not so usual disclaimer: I'm not a doctor, but the above worked for me and others. Normally one would say to consult a doctor about medical issues. But if I listened to the first doctor I went to, I'd have had all my neck vertebrae fused needlessly (and that would not have helped the upper cross syndrome at all!). The second doctor admitted this, but I'd already established what worked and didn't work by the time I saw him; he just confirmed that after running tests to make sure there were no pinched nerves, etc. BTW, the first doctor made her cut-happy misdiagnosis before any tests were done. X-rays and MRI showed some bulging/narrowing in lower cervical disks which was asymptomatic and due to the craning of the neck noted above.
Posted By Nick on November 14, 2007 at 14:36:31:
In Reply to: Upper Back/Shoulder pain next to or under shoulder blade
posted by Chris robinson on November 03, 2007 at 08:14:34: