Shoulder pain often occurs due to inflammation or muscle injuries. Less frequently, shoulder pain can be a symptom of lung cancer.
Although shoulder pain is not a common symptom of lung cancer, any persistent, unexplained pain warrants a visit to a doctor for further investigation.
In this article, we explain the links between lung cancer and shoulder pain. We also identify the different types of lung cancer that may lead to shoulder pain and other potential causes of this symptom.
Lung cancer can cause referred pain in the shoulder. Referred pain means that pain starts in one area of the body, but a person experiences it in a different area.
Some types of lung cancer are more likely than others to cause referred pain.
Pancoast lung cancer tumors
Pancoast tumors are a relatively rare form of lung cancer. These tumors develop in a groove called the superior sulcus at the top of the lungs. They often cause intense shoulder pain on the same side of the body as the affected lung, as the superior sulcus is close to the shoulder.
Some people with a Pancoast tumor may experience a group of symptoms called Horner syndrome, which might further contribute to shoulder pain. This syndrome can also cause
changes in the eyes, including droopy eyelids or shrinking in one pupil, and asymmetrical changes in sweating, such as reduced sweating on one side of the face.
Mesothelioma is a type of lung cancer that usually develops as a result of long term exposure to asbestos.
The symptoms of mesothelioma are similar to those of other types of lung cancer. However, a 2015 study found that 14.3% of people with mesothelioma had shoulder pain as a first symptom.
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 and lymph nodes, shoulder pain may occur.
Metastatic lung cancer can cause a range of symptoms specific to the body system that it affects. For example, lung cancer that spreads to the liver may cause symptoms of jaundice, such as yellow skin.
Other 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
There is no specific characteristic that defines the shoulder pain symptoms of lung cancer.
One study of shoulder pain in people with mesothelioma found that the participants ranked the pain, on average, as a four on a scale of one to 10. A few people in the study, however, experienced more significant symptoms. These included decreased mobility.
Some people with cancer-related shoulder pain experience pain in the arms that radiates down to the hands. Numbness and tingling may sometimes occur alongside the pain.
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Other symptoms of NSCLC include:
- a persistent cough
- coughing up blood or rust colored mucus
- hoarseness or wheezing
- unexplained weight loss
- fatigue and weakness
- long term infections of the chest or respiratory system, such as pneumonia or bronchitis
Shoulder pain is rare in people with lung cancer.
Most cases of shoulder pain occur due to poor posture or muscle strains. The most common causes of this pain include:
- Short term injuries: These might occur due to overextending or overusing muscles in the shoulder. Symptoms typically only present in the injured joint.
- Referred pain from other areas of the body: Neck and back pain may trigger aching in the shoulder. Weakness in one muscle might cause the shoulder muscles to overcompensate, leading to pain.
- Injuries in the spine: These might include herniated disks, which put pressure on certain nerves. Some of these nerves lead to the shoulder.
- Osteoarthritis: This is a degenerative condition that progresses over time as the cartilage wears down.
- Rheumatoid arthritis (RA): RA is a long term inflammatory condition that can sometimes affect the shoulder. It occurs when the immune system attacks the joints, causing pain and inflammation.
- Tears in the rotator cuff: This shoulder injury impairs a person's ability to move, rotate, and lift their arm.
- Frozen shoulder: This term refers to an injury that limits mobility in the shoulder. Underuse, RA, 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 can all 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 can all cause shoulder pain in this way.
Nerve pain can cause tingling, numbness, or pins and needles in the shoulder. The area of the body that it affects often changes or expands over time.
In many cases, shoulder pain is temporary and occurs due to overuse, strain, and minor injuries. To treat new shoulder pain, people should try:
- resting the injured shoulder, avoiding excessive movement or weight bearing
- applying an ice pack for 20 minutes at a time
- compressing the area with a bandage or wrap to reduce swelling
- keeping the painful area elevated
Some people also find that switching between heat and ice packs helps increase blood flow, promote faster healing, and reduce pain. Gentle stretching, low impact exercise, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also provide relief.
People should visit a doctor if they experience shoulder pain that either lasts more than a few days, goes away and then returns, or becomes unbearable. Depending on the cause, a doctor may recommend:
Lung cancer is one of the most dangerous forms of cancer because it spreads so rapidly. Among those in whom a doctor detects and treats lung cancer before it spreads, about 56% will live for 5 years beyond diagnosis.
However, once lung cancer reaches distant sites in the body, the 5 year survival rate reduces to 5%. For the best chance of survival, people who have symptoms of lung cancer should seek prompt medical treatment.
The treatment options for lung cancer depend 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 or interfere with the growth of tumors or treat other symptoms of cancer
- immunotherapy, which is a treatment that supports the immune system to fight cancer cells
These options might improve a person's outlook if a doctor has detected lung cancer before it spreads. Once lung cancer reaches the lymph nodes and distant organs, the outlook becomes worse.
For people with lung cancer who have a poor outlook, treatment can help improve their quality of life.
However, recognizing symptoms early on is critical for improving the life expectancy of a person with lung cancer. It is vital to seek medical attention for any persistent or particularly intense shoulder pain.
Does lung cancer spread quicker than other cancers?
The rate at which lung cancer spreads depends on its type and its stage at diagnosis, as well as the individual’s health status and response to treatment, among other factors.
According to the American Cancer Society, large cell (undifferentiated) carcinoma is a type of NSCLC lung cancer that tends to grow and spread quickly, which can make it harder to treat. How this compares with other types of cancer is not yet known, however.
Large studies evaluating the spread of lung cancers compared with that of other cancers are necessary to confirm the answer to this question.Christina Chun, MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.