Tue 14 March 2017 By Zawn Villines
Reviewed by Christina Chun, MPH
Most people experience shoulder pain, usually due to inflammation or muscle injuries. Much less frequently, shoulder pain can be a sign of lung cancer.
Although shoulder pain is not a hallmark of lung cancer, any persistent unexplained pain warrants a visit to a doctor.
How can lung cancer cause shoulder pain
Lung cancer can cause referred pain in the shoulder. Referred pain is a type of pain that begins in one area of the body but is felt in another. Some types of lung cancer are more likely to cause referred pain than others.
Mesothelioma
Mesothelioma is a type of lung cancer usually caused by long-term exposure to asbestos.
Symptoms are similar to other forms of lung cancer, but a 2015 study found that 14 percent of people with mesothelioma also had shoulder pain. In these patients, shoulder pain was often the first symptom of mesothelioma.
Pancoast lung cancer tumors
Pancoast tumors are a relatively uncommon form of lung cancer. These tumors are located in a groove at the top of the lungs called the superior sulcus. Because this area is close to the shoulder, it can cause intense shoulder pain on the same side where the cancer develops.
A person who has a Pancoast tumor, the type of lung cancer most likely to cause shoulder pain, may also experience a group of symptoms called Horner syndrome. In addition to shoulder pain, people with Horner syndrome may experience:
- changes in the eyes, including droopy eyelids or shrinking in one pupil
- asymmetrical changes in sweating, such as reduced sweating on one side of the face
Metastatic lung cancer
Metastatic lung cancer is cancer that has spread to other areas of the body. When lung cancer spreads to nearby regions, such as the bones, lymph nodes, and other nearby structures, shoulder pain may occur.
Metastatic lung cancer can cause a range of symptoms specific to the body system affected. For example, lung cancer that spreads to the liver may cause symptoms of jaundice, such as yellow eyes. Some common symptoms of metastatic lung cancer include:
- unexplained muscle and bone pain
- changes in the nervous system, such as weakness or tingling, headaches, dizziness, and seizures
- swelling in the lymph nodes
How lung cancer-related shoulder pain feels
Shoulder pain can be a frustrating symptom to diagnose. There is no characteristic cluster of shoulder pain symptoms associated with lung cancer. One study of shoulder pain in people with mesothelioma, for example, found that most people thought the pain was minor, ranking it a 4 on a scale of 1-10. A few people, however, experienced more significant symptoms, including decreased mobility.
Some people with cancer-related shoulder pain experience pain in the arms that radiates down to the hands. This pain may also include numbness and tingling.
Other lung cancer symptoms
Around 80 percent of lung cancer deaths in men and 90 percent in women are due to smoking. Although anyone can develop lung cancer, current and former smokers with symptoms should be particularly concerned.
Shoulder pain is not the most frequent symptom of lung cancer. With the exception of a small number of cases, it’s rarely the first lung cancer symptom.
Common symptoms of non-small cell lung cancer – the most common variety of lung cancer – include:
- a persistent cough
- coughing up blood or rust-colored mucus
- hoarseness or wheezing
- unexplained weight loss
- difficulty breathing
- fatigue and weakness
- long-term infections of the chest or respiratory system, such as pneumonia or bronchitis
Common causes of shoulder pain
Most shoulder pain is due to everyday causes, such as slumping in front of a computer or straining a muscle. Many people experience shoulder pain caused by the following:
- Short-term injuries due to overextending or overusing the muscles of the shoulder. Symptoms typically occur in the injured shoulder only.
- Referred pain from other areas of the body. Neck and back pain may trigger shoulder aches. Weakness in one muscle may cause the shoulder muscles to overcompensate, triggering pain.
- Injuries in the spine, such as herniated disks.
- Osteoarthritis, which occurs over time as cartilage wears down.
- Rheumatoid arthritis, a long-term inflammatory condition.
- Tears in the rotator cuff.
- Frozen shoulder, an injury that limits mobility. Lack of use, rheumatoid arthritis, and unusual tissue growth in the shoulder may cause frozen shoulder.
- Poor posture. Slumping over a computer, holding the body in an awkward position for extended periods, and craning the neck may cause tension and pain in the shoulders. The pain may spread to the neck and back.
Less frequently, various diseases can irritate the nerves of the shoulder, triggering pain. Heart disease, gallbladder disease, and liver disease are common causes of this type of pain. Nerve pain can cause tingling and numbness or a sensation of pins and needles in the shoulder. Its location often changes or expands over time.
Treatment for shoulder pain
Much shoulder pain is temporary, due to overuse, strain, and minor injuries. To treat new shoulder pain, people should try RICE:
- Resting the injured shoulder, avoiding excessive movement or weight-bearing
- Ice can be applied to the area with an ice pack for 20 minutes at a time
- Compressing the area with a bandage or wrap to reduce swelling
- Elevating the painful area
Some people also find that switching between heat and ice packs helps to increase blood flow, speeding healing and reducing pain. Gentle stretching, low-impact exercise, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen can also offer relief.
Shoulder pain that lasts more than a few days, that goes away and then comes back, or that is unbearable warrants seeing a doctor. Depending upon the cause, the doctor may recommend:
- physical therapy
- exercise therapy
- surgery to address structural issues
- alternative treatments, such as acupuncture or chiropractic care
- pain medications to reduce the severity of shoulder pain and improve mobility
Outlook
Lung cancer is one of the most dangerous forms of cancer because it spreads so rapidly. When detected early, 5-year survival rates are around 55 percent. People who have symptoms of lung cancer should therefore seek prompt medical treatment.
Treatment for lung cancer depends on the type of cancer, and whether it has spread to other areas of the body. Some of the most common treatments include:
- surgery to remove tumors
- chemotherapy and radiation treatment
- drugs that block tumors, interfere with their growth, or that treat side effects of cancer
- immunotherapy, a treatment that supports the immune system to fight cancer cells