If you have shoulder pain, it’s often caused by problems with your shoulder joint or with the muscles, ligaments, or tendons, around your shoulder. But sometimes the source of your pain can be your heart, belly, or
something else. That’s called referred shoulder pain. Usually, if you have a shoulder problem like a pulled muscle or osteoarthritis, moving your shoulder may make the pain better or worse. But if you have referred shoulder pain, you won’t feel any difference if
you move your shoulder. You might notice several different kinds of pain: Referred shoulder pain is often constant, which means your shoulder will hurt even when you’re resting or not using your arm or shoulder. But it may come and go, too. Several health problems can be behind your referred pain, including: Heart problems, like a
heart attack or angina (chest pain that happens when your
heart isn’t getting enough oxygen). If you’re having a heart attack, you might also have chest pains, which you might mistake for heartburn or an
upset stomach. You might also feel short of breath, or feel pain in your arm, back, jaw, neck, or other areas of your body. If that happens, call 911 right away. Neck problems. A pinched nerve in your neck or other neck problems
can cause shoulder pain. Belly surgery. If you have laparoscopic surgery, which is done through a small cut, on your belly to remove your gallbladder, make your stomach smaller for
weight loss, or for other reasons, you might get shoulder pain afterward. That happens to up to two-thirds of people who have the surgery. Laparoscopic surgery can make your body hang on to carbon dioxide in your belly area. That can irritate your spine and nerves, which can trigger
shoulder pain. Lung problems, like pneumonia or lung cancer. Tumors or swelling in your
lungs may cause shoulder pain.Symptoms
Causes
Blood clot in your lungs. This is called a
pulmonary embolism. It can feel like a pulled shoulder muscle at first. But the pain is usually so bad that you might have a hard time lying down or sleeping. If that happens to you, call your doctor right away. Belly problems. These include
gallstones, pancreatitis (inflammation of the
pancreas), an ovarian cyst, and ectopic pregnancy (a
pregnancy that happens in one of your fallopian tubes). The pain caused from problems in or near your belly can move up to and between your shoulders. Usually, you’ll also notice other symptoms, like nausea and severe pain in your belly or pelvic area. The
shoulder pain and pain in other areas may come on suddenly and feel severe. If you notice these issues, call a doctor or go to the hospital. Your doctor will need to find out the source of your pain so they can decide how best to deal with it. If you’ve had pain in your shoulder for more than a couple of days without an obvious reason, call your doctor. That’s especially important if you’re in a lot of
pain or if you have other symptoms, like shortness of breath. Your doctor will ask about: Ultrasound, which can give doctors a quick look at your shoulder muscles, joints, and tendons to reveal problems like rotator cuff tears.Treatments
X-rays, which can show bone problems.
MRI, which can reveal problems with your muscles, tendons, ligaments, and other tissues.
CT scan, which can show issues with your bones and some of your tendons.
Blood or other tests, especially if your doctor suspects your shoulder pain is caused by a different health problem.
Arm pain can be caused by a wide variety of problems, ranging from joint injuries to compressed nerves. Depending on the cause, arm pain can start suddenly or develop over time.
In many cases, arm pain actually originates from a problem in your neck or upper spine. Arm pain, particularly pain that radiates into your left arm, can even be a sign of a heart attack.
Seek emergency treatment if you have:
- Arm, shoulder or back pain that comes on suddenly, is unusually severe, or is accompanied by pressure, fullness or squeezing in your chest (this may signal a heart attack)
- An obvious deformity or protruding bone in your arm or wrist, especially if you have bleeding or other injuries
See your doctor right away if you have:
- Arm, shoulder or back pain that occurs with any sort of exertion and is relieved by rest — possibly signaling heart disease or chest discomfort caused by reduced blood flow to your heart muscle (angina)
- A sudden injury to your arm, particularly if you hear a snap or cracking sound
- Severe pain and swelling in your arm
- Trouble moving your arm normally or turning your arm from palm up to palm down and vice versa
Schedule an office visit if you have:
- Arm pain that doesn't improve after home care
- Increasing redness, swelling or pain in the injured area
Self-care
Even serious arm injuries can be helped initially with home treatment. If you think that you have a broken arm or wrist, apply ice packs to the affected area and use a sling to help hold your arm still until you can get medical care.
If you have a compressed nerve or repetitive strain injury, be consistent about therapy; maintain good posture; and take frequent breaks at work and during repetitive activities, such as playing an instrument or practicing your golf swing.
Most other types of arm pain will get better on their own, especially if you start R.I.C.E. measures soon after your injury.
- Rest. Take a break from your normal activities.
- Ice. Place an ice pack or bag of frozen peas on the sore area for 15 to 20 minutes three times a day.
- Compression. Use a compression bandage to reduce swelling.
- Elevation. If possible, elevate your arm to help reduce swelling.
Show References
- McMahon SB, et al., eds. Non-specific arm pain. In: Wall & Melzack's Textbook of Pain. 6th ed. Philadelphia, Pa.; Saunders Elsevier: 2013. //www.clinicalkey.com. Accessed Jan. 6, 2016.
- Henderson MC, et al., eds. Arm and hand pain. In: The Patient History: An Evidence-Based Approach to Differential Diagnosis. New York, N.Y.: The McGraw-Hill Companies; 2012. //accessmedicine.com. Accessed Jan. 16, 2016.
- Heart attack. National Heart, Lung, and Blood Institute. //www.nhlbi.nih.gov/health/health-topics/topics/heartattack/. Accessed Jan. 16, 2016.
- Sprains, strains and other soft tissue injuries. American Academy of Orthopaedic Surgeons. //orthoinfo.aaos.org/topic.cfm?topic=A00111. Accessed Jan. 16, 2016.
- LaDou J, et al., eds. Shoulder, elbow, & hand injuries. In: Current Diagnosis & Treatment: Occupational & Environmental Medicine. 5th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. //accessmedicine. com. Accessed Jan. 16, 2016.
March 27, 2021
Original article: //www.mayoclinic.org/symptoms/arm-pain/basics/when-to-see-doctor/sym-20050870
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