@michaelmel I would like to welcome you to Connect. Ten years is a long time to have a problem. This sounds like it may be some type of muscle spasm. I have had similar pains and I have thoracic outlet syndrome as well as being a cervical spine surgery patient. The head and neck are tied to the shoulder and shoulder blade by muscle. It is also common for a spine problem in the neck to cause pain in a shoulder blade.

Poor slouching posture and a forward head position will also cause problems and pain. You may want to consider an evaluation with a physical therapist. My PT also does myofascial release which helps loosen tight tissue and gets the body back in proper alignment. Sometimes a muscle spasm can independently turn one of my cervical vertebrae and that will cause headaches and neck pain. It can get my jaw misaligned and tweak the muscles that turn the head connecting near the ear. There are so many possibilities of what could be causing your pain. A physical therapist would be a very good start.

Here is our discussion about myofascial release. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you heard of myofascial release or worked with a physical therapist before?