There are two main reasons for pain in the middle of the scapula in the back. In the first case, due to fatigue and strain of the muscles on the inside of the scapula. For example, when sitting, due to the long time spent looking down at the computer, reading a book or newspaper, and the lack of support for the bilateral elbow joints, it will lead to strain on the scapular raphe and rhomboid muscles of the back. This can lead to inflammatory lesions over time, stimulating the peripheral nerves and causing pain in this position, often accompanied by cold. Because of the cold, blood circulation will be further slowed down, muscle tissue will become more tense, and pain will be more obvious. When the pillow is too high during nighttime sleep, the muscles of the back are constantly stretched and tense, which also tends to form strain and inflammatory stimulation. In the second case, the muscles, tendons, ligaments, fascia and other soft tissues in the middle of the scapula are repeated due to the persistence of inflammation. Calcium salts are gradually deposited, as well as fibrin forming adhesions in these soft tissues, and there will be significant pain. In this case, you have to go to the hospital for massage and flicking to gradually loosen the adhesions as well as the tense muscles, and the pain can be significantly relieved.