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Causes of Right Rhomboid Muscle Pain and Tightness

author avatar Dr. Eric Berg 05/05/2023

Rhomboid muscle pain can be an uncomfortable nuisance. If you find that massage, physical therapy, and strengthening exercises are not improving your rhomboid pain, there may be a hidden underlying cause: the gallbladder. 

Learn about the causes of rhomboid muscle pain—and what you can do about them!

rhomboid muscle strain

What are the rhomboid muscles?

The rhomboid muscles are a small muscle group in the upper back consisting of the left and right rhomboid major and rhomboid minor. The rhomboid muscles connect your shoulder blades to your thoracic spine. 

The right rhomboid major is a small muscle between the right scapula and the thoracic vertebrae. 

Next to the right rhomboid is the levator scapula muscle. This muscle connects the top of the scapula to the neck, or cervical spine. When someone experiences chronic pain and tightness in their upper back, these two muscles are often involved.

rhomboid back muscles

How to identify rhomboid muscle pain 

Upper back pain, neck pain, and shoulder blade pain can all signify rhomboid muscle pain. Rhomboid pain is usually felt in the lower neck and between the upper shoulder blades.  

You may notice increased pain when lifting something heavy or when breathing deeply. Tenderness and reduced range of motion are also common.

If you’re experiencing rhomboid muscle pain, consult with a healthcare professional to determine the underlying cause and develop a treatment plan that’s right for you.

Check out this video to learn how to identify rhomboid pain!

What causes right rhomboid muscle pain and tightness?

Rhomboid muscle pain can be due to muscle injury or excessive use of the rhomboid muscles. It’s also common in people who have sedentary jobs or jobs that require continuous computer work. This type of work can lead to poor posture and pain in the shoulder blade area. 

Tight muscles and shoulder pain on the right side are often related to referred pain. This means that the root cause is coming from somewhere else in the body.

The gallbladder and liver refer pain through the phrenic nerve right up to the rhomboid muscles and levator scapula. This pain is typically felt in the shoulder blade area on the right side. 

For example, this case study published in QJM: An International Journal of Medicine found that a 56-year-old man’s right shoulder blade pain was due to a liver abscess. 

If self-massage or a massage from a physical therapist or chiropractor does not improve the problem, the pain may be a symptom of an underlying problem with your gallbladder

If the pain is only on the right side of your upper back, this also signifies a gallbladder issue rather than a problem with the rhomboid muscle itself. 

According to Dr. Berg, gallbladder issues are caused by “unsaturated fatty acids (as in omega-6 fatty acids), corn oil, canola oil, soy oil, and cottonseed oil”. 

Nuts, chemicals in food, refined carbs, and excess fat can all irritate the gallbladder. 

How to check for referred gallbladder pain

To check for referred gallbladder pain, you’ll want to apply gentle pressure to your gallbladder. To do this, press about two inches below your right rib cage and apply gentle pressure for 30 seconds.

After applying pressure to the gallbladder, check to see if you still feel pain. You should notice that your upper back pain and muscle tension has diminished, or you may even experience instant relief!

If this technique does not eliminate your muscle pain, or your pain is also in your left shoulder, this means that the issue is probably not with your gallbladder. In this case, you’ll want to try a massage ball, foam roller, or heating pad to address your muscle pain. 

gallbladder self-massage

How to get rid of rhomboid muscle pain and tightness

The best way to get rid of rhomboid muscle pain caused by a gallbladder issue is to change your diet.

Start by removing foods from your diet that aggravate the gallbladder and the liver, including sugar, grains, and nuts—these are the most common culprits of gallbladder pain.

Following a keto diet and doing intermittent fasting can greatly improve gallbladder function by reducing insulin spikes and allowing the gallbladder ample time to concentrate bile. 

Increase foods that support the gallbladder—including cruciferous vegetables—and increase your intake of choline. Choline is found in egg yolks and can be taken as a supplement. 

cruciferous vegetables

Key takeaways

Focusing on the health of your gallbladder may significantly reduce right rhomboid muscle pain and other pain in the right shoulder blade area. 

By supporting the gallbladder, you can reduce pressure on the phrenic nerve and relieve referred rhomboid pain. 

Keto and intermittent fasting, cruciferous vegetables, and choline can improve the health of your gallbladder and help reduce right rhomboid muscle pain. 


1. How long does it take to recover from rhomboid muscle pain?

If your rhomboid pain is due to your gallbladder rather than a strain or a more serious injury, you can expect some relief as soon as you apply pressure to your gallbladder. Dietary changes can prevent the problem from happening again.

If you have to remain in a seated position for long periods, try placing a rolled-up towel at the bottom of your chair behind your sacrum. This helps to encourage good posture and relieve strain from your rhomboids as well as the other muscles in your back. It may take a few weeks to see improvement. 

2. What is the cause of right rhomboid muscle pain and tightness?

When your rhomboid pain only affects the right side, it is often due to pressure on the phrenic nerve from your gallbladder. A poor diet can cause the gallbladder to become backed up and enlarged, putting pressure on the phrenic nerve. This causes pain around the right shoulder blade, shoulder joint, upper back, and lower neck.

3. How do I prevent right rhomboid muscle pain and tightness?

Following a healthy diet like keto and intermittent fasting can help prevent right rhomboid muscle pain and tightness. Practicing good posture, stretching to avoid injury, and frequent breaks from long periods of sitting can also help prevent rhomboid pain.

4. Should you massage a rhomboid strain?

Massage is an excellent technique to soothe a rhomboid strain. If you’re experiencing pain on the ride side, the trigger points to relieve the pain are not going to be on the rhomboid muscle itself. Instead, you need to apply gentle pressure to the gallbladder to relieve the pressure that’s being applied to the phrenic nerve.

5. What does a rhomboid strain feel like?

If you have a rhomboid strain or you’re experiencing rhomboid pain, you’ll feel pain and tightness in your shoulder blades, upper back, and neck. This pain will likely intensify with activity. 

6. Why does my rhomboid muscle hurt?

Rhomboid muscles might hurt from injury, overuse, or sedentary jobs that often lead to poor posture. If you’re experiencing pain on the right side, it may be caused by a gallbladder issue. 

7. Is rhomboid pain serious? 

Rhomboid pain typically isn’t serious, but may signify an underlying condition with your gallbladder. It’s important to maintain a nutritious diet to support the health of your gallbladder. 

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