Medical Reasons for Shoulder Pain
When it comes to shoulder pain, there could
be a number of reasons. It may range from a pulled muscle to a rotator
-cuff tear, to a heart attack, and even lung cancer. Here is what you
need to be on the lookout for:
Fractured collarbone
Fractures of the collarbone are relatively common and painful. You may
also find it difficult to move your arm after a break, and your shoulder
will hurt and sag forward and downward. But how does this type of
fracture arise? Usually, the cause is a fall on, or a direct impact to
the shoulder. Miho Tanaka, MD, director of the Women’s Sports Medicine
Program and associate professor of orthopedic surgery at the Johns
Hopkins Hospital says if your collarbone is broken you'll likely know
it. “It is very commonly localized, and most people can feel the ‘break’
in their collarbone because it is just under their skin.” Treatment
usually entails an arm sling, stabilizing the area and physical therapy.
If the bones have greatly shifted out of place, you might need surgery
utilizing plates, screws or pins.
Pulmonary embolism
If you think that you have pulled a muscle in your shoulder but the pain
is so severe that you have difficulty sleeping or lying down, get to
the ER immediately. According to doctors, this type of shoulder pain could
be a sign of a blood clot in your lungs. For treatment, you will be
given anticoagulants or thrombolytic drugs to dissolve the clot and
possible surgery. Without proper treatment, a pulmonary embolism can
cause damage to your lungs and other organs, and may even be fatal.
Subarachnoid hemorrhage
Wherever it may occur, a hemorrhaging is terrible - however, it is
particularly bad when it happens in the space between the brain and its
protective tissues. One possible symptom is shoulder pain, as well as
neck pain, vision problems, numbness, confusion, sensitivity to light,
nausea, and seizures. This telltale sign of subarachnoid hemorrhage
(SAH) is a sudden and debilitating headache, which may be caused by a
brain aneurysm, trauma, or blood thinners. You'll need to seek immediate
medical intervention to prevent brain damage and save your life.
Cancer
Shoulder pain may also be a symptom of cancer, most often, lung cancer.
In a 2015 study, 14% of people with mesothelioma, (a type of cancer that
develops from the thin layer of tissue that covers many of the internal
organs (known as the mesothelium) usually the lungs and chest
wall)reported shoulder pain, and this was most often the first symptom.
Other types of lung cancer may also cause shoulder pain, including
Pancoast tumors, which are located in the upper lungs, and metastatic
lung cancer. What's tricky about lung cancer, related shoulder pain is
that it is often called 'referred pain' because it starts elsewhere in
the body and is often mistaken for arthritis. Other telltale signs that
cancer is the cause is that it can be a chronic cough that sometimes
produces blood, labored breathing, fatigue, unexplained weight loss, and
recurrent respiratory infections.
Heart problems
Chest pressure or chest pain is the most common sign of heart issues,
however, shoulder pain can be one too. According to the National Heart,
Lung and Blood Institute, people with angina can experience shoulder
pain. In addition, their arms, neck, jaw or back may also ache. Shoulder
pain is also one of the many signs of a heart attack. Women especially
need to pay attention to this unusual symptom, especially when it is
accompanied by sudden and inexplicable fatigue, lightheadedness,
shortness of breath and indigestion. For women, symptoms tend to be very
different than in men. Women often don't experience traditional chest
pain. So if you're feeling off, see a doctor right away.
Bursitis
It is possible that you have never heard of a bursa before - a
fluid-filled sac that cushions and protects your joints. If it becomes
inflamed, however, it can be extremely painful. A common cause of
shoulder pain, bursitis, typically occurs in people over 50 who have
diabetes, or a weakened immune system. Athletes are also at risk,
particularly those who do a lot of repetitive overhead stretching, such
as basketball players and swimmers. James Fedich, a New Jersey-based
chiropractor says: “I tell patients it’s like a ziplock bag with some
water in it, so it protects you,” Fedich explains. “If you triple the
amount of water in the bag, it gets swollen and hurts.” That pain, he
adds, is “typically constant, present even during rest, and usually gets
worse with activity.” Treatment includes NSAIDs (nonsteroidal
anti-inflammatories), ice, range of motion, and strength exercises as
well as ultrasound therapy.
Thoracic outlet syndrome
When blood vessels or nerves between your collarbone and uppermost rib
(the thoracic outlet) are compressed, it may result in Thoracic outlet
syndrome, characterized by shoulder and neck pain, as well as finger
numbness. This could occur as a result of a car accident, repetitive
activity (from things like typing, or pitching a baseball, as well as
carrying heavy bags, obesity, or pregnancy. It is also possible that you
are born with a predisposition to it if you have an extra rib or tight
connective tissue between your spine and ribs. Physical therapy is the
first line of defense, but in advanced cases, if nothing seems to work,
surgery may be suggested.
Gallbladder problems
Pain in the right shoulder may indicate that you have a gallstone
causing a blockage. Other likely areas for sudden and intensifying pain
include the upper-right abdomen, the center of your abdomen, below the
breastbone, and between the shoulder blades. “A gallbladder issue is
typically diagnosed by a primary-care physician,” says Dr. Tanaka, “and
it would be apparent to them because the shoulder joint itself won’t
hurt with movement.” Other factors that can put you at risk for this
condition include high-fat, high-cholesterol, and low-fiber diets, as
well as having diabetes, or a family history of gallstones, which can
put you at increased risk for this condition. For treatment, medications
to dissolve gallstones are usually prescribed, but this could take
months or years to work fully. Surgery to remove your gallbladder is
also possible.
Pinched nerve
If you suffer from pain, numbness and pins and needles in your shoulder,
arm, and hand, it's possible that you've got a pinched nerve. This
happens when a bone, bulging disc, or swollen tissue compresses the
nerves, extending from the upper spine to the neck and shoulder. Fedich
says, “The nerves come out of the spine in little channels. If the
muscles around the spine pull too tight, as when we sleep awkwardly, the
channel can get closed off, causing a pinch of the nerve. It’s like
someone stepping on a garden hose; water can’t flow freely. In the
spine, that will lead to pain wherever the nerve goes.” Sometimes, the
problem will go away on its own. If not, typical options include
chiropractic adjustments, physical therapy, icing the area, ibuprofen,
and corticosteroid injections.