Medial scapular pain may be caused by physiological factors such as strenuous exercise or shoulder weight-bearing, or it may be caused by pathological factors such as fasciitis, cervical spondylosis and coronary heart disease. 1. Physiological factors: due to strenuous exercise or shoulder overload, the shoulder muscles are pulled, resulting in tension and strain of the surrounding soft tissues, excessive metabolic products in the body and accumulation of lactic acid, which can cause pain in the medial scapula, which can be relieved after sufficient rest or massage. 2. Fasciitis: The fascia around the scapula can cause aseptic inflammation of the fascia due to cold, trauma, and long-term muscle strain, which can lead to pain in the medial side of the scapula. 3. Cervical spondylosis: cervical disc herniation can lead to compression of spinal cord and nerve roots, resulting in pain in the back of the neck and the inner side of the scapula, accompanied by pain and numbness in one or both upper limbs. 4. Coronary heart disease: Coronary heart disease usually causes pain in the precordial area or behind the sternum, which usually reflects to the scapula and can cause pain near the scapula. There may also be other causes of pain in the inner shoulder blade, such as pneumonia, pleurisy, etc. It is recommended to go to the hospital in time, improve the examination to clarify the cause of the disease, and carry out standardized treatment under the guidance of the doctor.