The phenomenon of muscle soreness and pain in the back below the shoulder blade may be caused by cold back, cervical spondylosis, myofasciitis, muscle injury in the scapular region and other reasons. 1. Cold back: prolonged failure to take warming measures, so that the back of the cold and promote vasoconstriction, resulting in insufficient blood supply of oxygen to the muscles of the back, nutritional insufficiency, which will cause inflammation of the muscles of the scapula region, fascia and other soft tissues and cause muscle soreness and swelling pain in the back under the scapula. 2. Cervical spondylosis: prolonged head-down work will lead to degenerative changes in the intervertebral discs of the cervical spine, which will compress the surrounding nerve roots and cause sensory abnormalities and dysfunction in the innervated area, resulting in soreness and pain in the muscles below the scapula. 3. Myofasciitis: strenuous exercise or catching a cold can lead to aseptic inflammation of the myofascia of the back, resulting in edema, oozing, fibrous changes, which will cause the muscles of the back to produce soreness and swelling and other discomforts. 4. Muscle injury in the scapular region: prolonged stretching exercise or impingement on the scapular region will lead to injury of the muscles and other soft tissues in the scapular region, thus causing local inflammation and muscle soreness in the subscapular region. In short, there are many reasons that cause muscle pain in the subscapularis region of the back, and it may also be muscle strain, etc. If the pain and swelling do not improve after resting, it is recommended to go to the hospital as soon as possible to find out the cause of the disease and actively carry out the treatment.