What Is Referred Shoulder Pain?

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.

Symptoms

You might notice several different kinds of pain:

  • Sharp pain under your shoulder blade
  • Dull ache in your shoulder
  • Pain that goes from your neck to your shoulder blade (or vice versa)
  • Stabbing, burning, tingling, or even an “electric” feeling in your shoulder

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.

Causes

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.

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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 includegallstones, 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.

Treatments

Your doctor will need to find out the source of your pain so she 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:

  • Where you feel the pain
  • How long you’ve had it, and if and when it stops
  • Your health history, including any current medical conditions like high blood pressure
  • Any accidents or injuries that could have played a part in your shoulder pain
  • Your doctor also may recommend tests to check for any hidden issues.

Ultrasound , which can give doctors a quick look at your shoulder muscles, joints, and tendons to reveal problems like rotator cuff tears.

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.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on February 6, 2018

Sources

SOURCES:

Mayo Clinic: “Shoulder Pain,” “Gallstones.” 

Journal of Orthopedic & Sports Physical Therapy: “Systemic Disease Mimicking Musculoskeletal Dysfunction.” 

National Heart, Lung, and Blood Institute: “What Are the Signs and Symptoms of Coronary Heart Disease?” 

Cleveland Clinic: “Is Your Shoulder Pain Actually a Neck Problem?” “Shoulder Pain.” 

American Heart Association: “Angina (Chest Pain).” 

JAMA Surgery: “Maneuvers to Decrease Laparoscopy-Induced Shoulder and Upper Abdominal Pain, A Randomized Controlled Study.” 

American Cancer Society: “Signs and Symptoms of Lung Cancer.” 

National Blood Clot Alliance: “Stop the Clot: Take Home Messages.” 

National Health Service (U.K.): “Acute Pancreatitis” 

Arthritis Foundation: “Arthritis & Diseases That Affect the Shoulder.” 

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