Pain that Radiates into the Shoulder

Pain shooting into the shoulders and shoulder pain is a fairly common problem with which a person seeks professional help. It is an uncomfortable and limiting condition.

It can be acute and momentary, when it comes on suddenly and lasts for a short time. The other form is chronic, i.e. recurring and the course is generally protracted.

The muscles and tendons that act to stabilize the shoulder form the so-called rotator cuff. Additionally, the shoulder forms the brachial plexus of the upper limb along with both the scapula and the clavicle. 

This unit enables us to carry out the activities of daily living, lifting hands, loads, rotation, dressing, washing, combing, physical and sporting activities and other common activities. 

The pain may be accompanied by muscle weakness, tingling, pins and needles, numbness, restricted mobility or a worsening condition.

Night pain and sleeping on your side on the painful side can also be a problem. The pain can also worsen in the morning or during the day.

Consequently, with this type of pain, it is necessary to think about the spine as well. Nowadays, the spine is more and more improperly and inappropriately loaded. Sedentary lifestyles and sedentary work contribute significantly and significantly to this. 

These difficulties point to musculoskeletal problems. However, symptoms of organ diseases of the chest or abdominal cavity may also be reflected in this area.

What is behind this problem?
What causes it?
Are there serious diseases to worry about?
Is an examination necessary?
Read on.

Pain radiating into the shoulder as a musculoskeletal problem 

Pain when lifting the arm and when moving indicates a musculoskeletal problem. The pain can be chronic that worsens with activity. 

The form and character of pain can take many different forms and vary from person to person.

Bones are found in that area along with various soft structures, from muscles, tendons, ligaments, bursae (sebaceous sac containing synovial fluid), joint capsules. Thus, the problem can involve any component.

It may be an inflammation of the sebaceous sac (bursae) called bursitis. This is a fairly common problem, which can be caused by repetitive strain and increased load, shocks, accident. 

Bursitis occurs at any age, however, more commonly after the age of 40. It affects joints such as the shoulder, elbow, hip, knee or even the Achilles tendon.

Another example is tendinitis, i.e. inflammation of the tendons. Initially, the problem is irritation of the tendon, which can result in its inflammation. The shoulder joint is most commonly affected, followed by the elbow and wrist.

Tennis elbow or golf elbow and Achilles tendonitis or carpal tunnel syndrome are common. Although these are anatomically inferior parts, pain can radiate from there into the shoulder.

Learn more: Tennis elbow - you don't have to be a top tennis player to get it

Inflammation of the soft structures that accompanies limitation of shoulder mobility is referred to as frozen shoulder, or adhesive capsulitis. 

It can be caused by trauma and injury to the rotator cuff, initially by a functional problem and blockage of the cervical spine, as well as by long-term irritation of the nerves extending from the cervical and thoracic spine.

They add intrinsic risk factors such as thyroid disease, diabetes, Parkinson's disease or cardiovascular disease. 

The manifestation of a painful shoulder is restriction of movement, up to complete inability to move the shoulders and arm. In addition, the pain shoots up the spine or vice versa down the arm to the fingers.

Signs and symptoms:

• pain in the shoulder
• may be burning, stinging, pressing, cracking, popping
• permanent or aggravated by movement during flexion, rotation or other movements
• problem with lifting hands above the head and when lifting a load
• radiating discomfort into the neck, chest or arm

Diseases of the musculoskeletal system and connective tissue are among the most common causes of inability to work and asking for fit notes.

Impingement syndrome is another painful condition. It is based on inflammation of the synovial-sebaceous sac, i.e. bursitis and congestion of muscles, tendons and attachments in the shoulder, scapula and clavicle. 

The cause is not only an injury mechanism, but also incorrect posture, repetitive movements, long-term inappropriate posture, driving, working at the computer, long-term manipulation with smartphones, as well as sports such as volleyball, basketball, handball, weightlifting.

Pain occurs initially with movement in the shoulder, with flexion, internal rotation. It may also be present at night and wake a person from sleep.

Pain emanating from both the cervical and thoracic spine as one of the main causes (neck and shoulder pain)

Today's blue-sky times are bringing more negativity to the spine than one would think. Sedentary lifestyles, mostly sedentary work, lack of exercise and lack of interest in physical activity are taking their toll. 

More and more young people have serious spinal problems. Working in a sitting position, in an office at a desk, a computer. Alternatively, it is work in an unchanging monotonous position and standing. 

Children sit at school, at home doing homework, then sit down in front of the TV, tablet, playing on the computer or with the mobile phone. 

And improper use of air conditioning adds to the problem. 

• How does air conditioning affect our health? Can it be harmful?
• How to use, or set up, the air conditioning correctly and so that it does not harm us?

Former life, work outdoors, in the garden, in the field, children playing in nature. All this is in the past. And it is precisely this nature of lifestyle that overloads the spine, muscles, discs and other structures.

The result is pain, which can stem from functional overload, but also from organic damage.

Examples are facet joint block, which are small joints between the vertebrae, but also pseudoradicular syndrome, or cervicocranial syndrome and cervicobrachial syndrome. 

Nerve pressure causes both local discomfort and radiation, a condition called pinched nerve or radiculopathy.

The common manifestations are pain:

• pain in the back, neck, thoracic back pain
• headache
• pain radiating into the shoulders up to the upper limbs
• pain between the shoulder blades
• pain radiating into the chest
• worsening with movement and change of position

Associated symptoms:

• limited movement
• dizziness
• difficulty breathing, especially deeper breaths
• tingling in the head, shoulder, hands
• sensitivity disorder
• muscle weakening
• nausea

Learn more:

• Radiculopathy
• Pseudoradiculopathy
• Facet syndrome
• Pain in the back, neck, between the shoulder blades, lower back
• How are cervical spine and vertigo related? How to get rid of dizziness?
• 3 symptoms that accompany cervical spine pain. Do you know the causes?
• Vertebrogenic algic syndrome

The spine is also affected by degenerative processes that cannot be avoided due to the ageing process. However, negative factors accelerate their onset. Rheumatic inflammatory processes are also a cause for concern.

• Spondylarthrosis
• Undifferentiated spondylarthritis
• Rheumatism is harmful to the whole organism and at any age
• Spinal injuries

Last but not least: injuries. 

Bump, fracture or dislocation? There may also be instability of the shoulder joint, which is the result of repeated post-traumatic conditions. Symptoms range from a feeling of instability in the shoulder to the joint head popping out of the joint socket, followed by repeated dislocations.

Childhood is characterised by frequent accidents. However, these are not the only ones. Scoliosis, exaggerated kyphosis or lordosis occur in children and during adolescence. Rheumatic diseases are not rare either. 

• Juvenile idiopathic arthritis
• Scheuermann disease
• Scoliosis
• Kyphosis - hyperkyphosis
• Lordosis - hyperlordosis

Another chronic rheumatic inflammatory disease and one that occurs in early adulthood is axial spondylarthritis that primarily affects the spine and SI joints (sacro-iliac joint connection of the spine and pelvis). Other joints are also affected, and the tendon and muscle attachments are not spared from inflammation. 

Pain in the right shoulder and radiating to that area

Pain shooting up the back and under the right shoulder blade to the right shoulder blade can be a symptom of gallbladder and bile duct disease.  

Gallstones, which irritate the wall of both the bile ducts and the gallbladder, are common. It causes a flow blockage. Biliary colic is manifested by abdominal pain, nausea or bloating. 

Inflammation of the gallbladder and bile ducts is another alternative that may be behind this problem. 

Learn more:
Gallbladder and gallbladder pain: what are the most common causes and diseases?

Pain in the left shoulder and pain radiating into the arm

Another example of a disease of the digestive system is pancreatitis, or inflammation of the pancreas. Abdominal pain is typical, which a person typically localizes under the left ribcage and with radiation to the back, under the shoulder blade up to the shoulder. 

There is some indigestion. More in the article What you should know about pancreatitis?

From the belly to the heart...

Cardiovascular diseases are a broad group of diseases that have their basis in atherosclerosis. This is followed by high blood pressure. A typical disease of the elderly is ischaemic heart disease, its painful form is known as angina pectoris. 

Young people have heart attacks, too.

What do these diagnoses have in common? Cardiovascular disability.

The risk is damage to the coronary arteries that supply blood to the heart muscle. When blood flow is restricted and the supply of oxygen and nutrients to the muscle is reduced, a problem occurs.

Symptoms include:

• chest pain
• which can radiate from the chest to the left shoulder, upper arm through the elbow to the fingers of the hand
• but also into the neck, jaw, sledge, back, between the shoulder blades or in the stomach area
• it may be felt as pressure, burning, pinching or other discomfort
• a person is afraid, feels anxiety, fears for his life
• accompanied by:
  • sweating
  • skin pallor
  • malaise
  • sensation of retching to vomiting
  • dizziness
  • general weakness and fatigue

The above are typical, so-called textbook symptoms of myocardial infarction - heart muscle.

Other causes of pain

The above health problems are an excerpt from a diverse range of possible problems. Pain can also come from other neurological, vascular, tumor, chest or abdominal diseases. 

In some cases, the cause cannot be detected at all.  

Diagnosis, treatment

Does the discomfort persist for a long time, or is it too intense? Are there multiple difficulties?

A professional examination is necessary, and this is due to the fact that various diseases may be involved. And they can have a serious course.

History taking is important in the diagnosis, i.e. what the person feels, what preceded the symptoms and what triggered them and the rest of the course.

Other examinations such as blood and urine tests and their laboratory tests are added. 

Imaging methods, mainly X-ray, CT, MRI, but also ECHO, ECG, USG and others, are of great diagnostic importance.

Specialists from several disciplines can work together on a problem.

Subsequently, the diagnosis is followed by treatment. The treatment focuses on the cause, but also on relieving the discomfort (painkillers) and regenerating the musculoskeletal system, through rehabilitation, exercise, spa treatment and other methods.

Without an accurate diagnosis and the discovery of the source of the difficulty, it is impossible to choose a specific treatment.

When should you see a doctor?

Do the difficulties last for a long time, do they recur? Have they been preceded by a more serious injury? Are multiple symptoms associated? Is the onset sudden, sharp and the pain intense to severe?

The recommendation is a professional examination.