What to Know About Rhomboid Muscle Pain

Other health conditions that can cause rhomboid pain include: 

Myositis. This condition can cause muscle weakness and inflammation. It usually shows up first in your shoulders and hips.

Polymyalgia rheumatica. This is a disorder that causes shoulder and hip pain and stiffness. It typically affects people over age 50. The pain and stiffness may be worse in the mornings and affect both sides of your body.‌

Rheumatoid arthritis. This is an autoimmune disease that causes your immune system to attack your joints. It usually causes a lot of pain and swelling and can lead to joint deformities. Rheumatoid arthritis can affect your shoulders, which might also affect your rhomboid muscles.‌

Osteoarthritis. It is a degenerative bone disease that causes loss of cartilage. This can cause pain and stiffness. You might not have much movement in your shoulder, which can cause discomfort in the surrounding muscles.

How Is Rhomboid Muscle Pain Diagnosed?

Doctors can usually identify rhomboid pain through a physical exam and your medical history. The goal is to find the true source of the pain.

“Your doctor can often tell if rhomboid pain stems from the irritated muscles themselves or relates to a larger issue affecting the mechanics of the shoulder,” Donohue says.

Your doctor may:

• Check for tenderness or tightness between your shoulder blades
• Test your shoulder’s strength, motion, and stability
• Look for abnormal shoulder blade movement (scapular dyskinesis)
• Review any recent injuries or activity changes

If your pain lasts more than a few months or you have weakness or an injury, your doctor may order more detailed tests, such as an MRI. But most cases don’t need imaging. A hands-on exam is usually enough to find the cause and guide treatment.

Treatment for Rhomboid Muscle Pain

A mild rhomboid strain can heal in as little as a few weeks. A more serious injury, strain, or tear can take longer to heal.‌

There are some things you can do at home to help manage your pain:

• Ice your shoulder.
• Alternate ice with heat packs if there’s no swelling.
• Use pain relievers such as acetaminophen.
• Use nonsteroidal anti-inflammatory drugs.
• Keep your shoulder and arm down.
• Do gentle stretches.
• Sit up straight.
• Use a topical pain cream.
• Get a massage‌.

Rhomboid muscle stretches

You can try stretching out your muscles with different techniques:

Tennis ball. Lay down on the floor and place a tennis ball under your shoulder. Gently roll your shoulder back and forth across the ball. Change positions and repeat.

Foam roller. Lay on the floor and roll your shoulder over a foam roller. This will help loosen and massage the muscles.‌

Self-massager tool. You can buy an electric or battery-operated tool to massage your shoulder. Don’t use high settings that might make it too painful.‌

Warm-up stretches. If you are working out or doing sports, you can help protect your muscles by warming up and stretching before and after exercise. If your muscles are sore from a recent workout, allow them to rest and focus on a different set of muscles.

Taking breaks. If you work at a computer and sit most of the day, take lots of breaks. Stand up, move around, and do some stretches.

Better posture. Find an office chair that has a tall back and sit all the way back with your shoulders against the chair. Keeping your feet on a stool can also help you keep good posture.

Rhomboid muscle exercises

Donohue says stretching restores normal shoulder motion, while strengthening builds stability. You want to do both. 

“Stretching focuses on the ball-and-socket motion of the shoulder,” he says. “Strengthening targets the muscles that support the shoulder blade, like the rhomboids and trapezius, as well as the muscles that move the arm, such as the rotator cuff.” 

The safest way to strengthen your rhomboids and other shoulder blade muscles is to work with a physical therapist. They can teach you how to move your shoulder blades the right way and build strength safely.

Here are a few examples of rhomboid muscle exercises they might suggest: 

Shoulder blade retraction. Stand up and lift your arms out to the sides at shoulder height. Squeeze your shoulder blades together and hold. If there’s limited space, you can perform this exercise while sitting, with your hands resting on your lap. Squeeze your shoulder blades together as if someone told you to sit up straight.

Bent over rows. Stand beside a sturdy chair or bench with a weight in one hand. Place your opposite hand and knee on the seat for support, keeping your back flat and hips even. Pull your shoulder blades together and lift the weight toward your ribs, then lower it slowly. Repeat on the other side.

Reverse fly. Sit on the edge of a chair with a weight in each hand and lean forward from your hips. Keep your back straight. With your arms hanging beside your legs, lift the weights out to the sides until they’re about shoulder height. Lower them slowly. Repeat. 

Pull-down. Stand with your feet shoulder-width apart and hold a resistance band overhead. Your hands should be about a foot apart. With a slight bend in your elbows, pull the band down to shoulder level, then slowly raise your arms back up. Repeat.

Rhomboid Muscle Pain Prevention

You can lower your chances of rhomboid pain by keeping your shoulder and upper-back muscles strong and flexible. To help prevent flare-ups, Donohue suggests these tips: 

Identify the cause. Rhomboid pain often comes from poor posture, overuse, or repetitive movements. Correcting these habits helps reduce strain. 

Maintain good posture. Keep your shoulders relaxed and avoid rounding your upper back, like when you’re using a computer or phone.

Strengthen and stretch. These exercises can restore normal shoulder-joint motion and keep your shoulder blades moving smoothly.

Take breaks from repetitive activity. Give your shoulders time to rest if your job or workouts involve overhead movement.

Address early signs of pain. Use anti-inflammatory medication as directed and try physical therapy.

If you’ve had trauma, weakness, or pain lasting more than a couple of weeks, you may need to see a specialist for a detailed checkup. 

When to See Your Doctor for Rhomboid Muscle Pain

If you have shoulder pain or upper back pain that doesn’t seem to get better, see your doctor or physical therapist.

Donohue suggests seeing musculoskeletal specialists such as orthopedic surgeons, physiatrists, or primary care sports medicine doctors for ongoing rhomboid muscle pain. If advanced imaging or evaluation reveals a structural problem, your doctor may refer you to an orthopedic surgeon.

“Rhomboid pain will usually get better with anti-inflammatory medication and a course of physical therapy,” Donohue says. “But if it keeps coming back or lasts longer than a few months, it’s worth getting checked out to make sure there isn’t something structural going on.” 

If you have any of the following symptoms, see your doctor right away:

• You can’t move your arm
• Your shoulder or arm is swollen
• Your arm or shoulder is numb
• The pain is suddenly severe
• You have pins and needles that don’t go away
• Your shoulder or arm feels hot or cold
• You feel sick
• You have a fever
• You had an accident, and you have severe pain‌

These symptoms could mean that you have a more serious problem, such as a broken bone or a serious muscle tear. 

Takeaways

Rhomboid muscle pain usually comes from overuse, poor posture, or shoulder blade movement issues. Most people get better with rest, anti-inflammatory medicine, and physical therapy. 

If your pain lasts more than three months, or you notice weakness or have an injury, it’s a good idea to see a specialist. That may include a physiatrist, sports medicine doctor, or orthopedic surgeon. 

True rhomboid tears are rare, but in long-lasting or serious cases, your doctor may order imaging to check for other causes.

Rhomboid Muscle Pain FAQs

How long does it take for a rhomboid strain to heal?

Most people start to feel better within about six weeks, though full recovery can take three to six months. If there’s no improvement after three months, that’s a good time to check in with a specialist.

How do you test for a rhomboid tear?

It’s rare to have an actual tear of the rhomboid muscle. Usually, the pain comes from inflammation or overuse. If your doctor suspects a tear, they may order imaging tests such as an MRI. But most of the time, they can figure out what’s going on with a physical exam.

What nerve causes rhomboid pain?

Rhomboid pain can happen if you irritate or injure the dorsal scapular nerve, spinal accessory nerve, or long thoracic nerve. These nerves help control the muscles that attach to your shoulder blades. When they’re not working right, you might feel pain and weakness or have an abnormal appearance of the shoulder blade. 

During an exam, your doctor will check whether your pain seems inflammatory or nerve-related.