The most common cause of back pain behind the scapula is orthopedic disease. If there is persistent pain in the back of the scapula and the pain worsens with activity, consider fasciitis of the back of the shoulder. In addition cervical spondylosis causing related nerve compression, chronic muscle strain, and trauma can also cause pain. However, if there is paroxysmal radiating pain in the back of the shoulder with chest tightness and sweating, it is considered to be caused by the heart, and the patient needs to register with cardiovascular medicine. Some digestive system diseases can also cause pain in the back of the shoulder, such as cholecystitis, liver lesions, pancreatitis, etc. Patients need to register with gastroenterology.