It sounds uncomfortable to have a piercing pain around your right shoulder blade that shifts when massaged. This pattern may suggest muscle strain or nerve irritation, possibly related to muscle spasms or posture issues, which can be worsened by smoking habits.

• Given your symptoms and smoking history, it’s important to have a thorough evaluation by an orthopedic specialist or a neurologist to rule out conditions like muscle strain, nerve impingement, or other underlying issues.
• Pain relief medications like Zerodol-MR (which contains a muscle relaxant and an anti-inflammatory) might help, but should only be taken under a doctor’s prescription and supervision.
• Avoid self-massaging aggressively as it may worsen nerve irritation or muscle injury.
• Quitting smoking and gutkha use can improve overall healing and reduce inflammation.
• Seek immediate care if you experience worsening pain, numbness, weakness, or chest discomfort.

Please consult an orthopedic doctor or neurologist promptly for a detailed assessment and appropriate treatment plan. If the pain worsens suddenly or you develop other symptoms, consider emergency care.To narrow down potential causes, we will need some more information.Please tell me your age and gender.