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Medical Reasons for Shoulder Pain

Edited By: Krista Mc'Farlene
 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: 
 
shoulder pain

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 WebMD, 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.

shoulder pain

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. 

shoulder pain

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. 

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