Chest and shoulder pain: Causes, treatment, and seeking help (2022)

Medical conditions affecting the heart or lungs can lead to chest and shoulder pain. Not all causes of chest and shoulder pain are medical emergencies. However, it is important that people speak with a doctor if they experience unexpected or severe chest and shoulder pain.

Shoulder pain can occur due to an injury or medical issue with the shoulder, such as a muscle strain. However, it can also occur due to a condition elsewhere in the body.

This article covers the causes and treatments for shoulder pain that occurs due to a condition in another part of the body and is accompanied by chest pain.

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Chest and shoulder pain can be a medical emergency if it occurs due to a heart attack or pulmonary embolism.

People should seek emergency medical care if they experience:

  • sudden, severe chest and shoulder pain
  • chest and shoulder pain that worsens
  • chest palpitations
  • difficulty breathing
  • dizziness or fainting
  • extreme fatigue
  • coughing up blood

People who have existing heart conditions should be especially conscious of any chest and shoulder pain.

Some causes of chest and shoulder pain can be cardiovascular, or related to the the heart. They include:

Angina

Angina is a symptom of coronary artery disease.

It refers to chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood.

According to the National Heart, Lung, and Blood Institute, angina manifests as a pressure or squeezing sensation in the chest.

While angina usually affects the chest, it can spread to the shoulders, neck, and jaw.

Other symptoms of angina include:

  • burning or aching in the chest that starts behind the breastbone
  • heartburn
  • weakness
  • sweating
  • shortness of breath

Treatment

Depending on the cause and severity of angina, a doctor may recommend a combination of medications and diet and exercise changes.

Learn more about the treatment options for angina here.

Heart attack

A heart attack, also known as myocardial infarction, occurs when the heart does not receive enough blood.

This can happen when a blockage forms in an artery that supplies the heart with oxygenated blood.

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Pain in the center or left side of the chest is the main symptom of a heart attack.

The Centers for Disease Control and Prevention (CDC) describe this type of chest pain as an uncomfortable pressure, squeezing, or fullness.

Other signs to look for include:

  • pain or discomfort in one or both shoulders or arms
  • pain in the jaw, neck, or upper back
  • shortness of breath before or alongside the chest pain
  • dizziness or fainting
  • breaking out in a cold sweat

Compared to males, females are more likely to experience indigestion, nausea, or vomiting during a heart attack.

Learn more about the symptoms of a heart attack in females here.

Treatment

If a doctor suspects a heart attack, they may administer one or more of the following emergency treatments:

  • aspirin to prevent blood clots
  • nitroglycerin to improve blood flow to the heart
  • oxygen therapy

If a doctor confirms a heart attack diagnosis, they will attempt to restore blood flow to the heart using either medication or surgery.

Learn more about the treatment for heart attack here.

Thoracic outlet syndrome

Thoracic outlet syndrome refers to a group of conditions that compress the nerves and blood vessels that pass through the space between the first rib and the collarbone. This is known as the thoracic outlet.

The National Organization for Rare Disorders note that neck injuries, repetitive movements, and poor posture can damage or compress the structures that pass through the thoracic outlet, which can lead to:

  • pain, tingling, or numbness in the arm, hand, or fingers
  • arm swelling
  • a feeling of fullness or aching in the arm
  • neck pain
  • headache
  • pale or white discoloration of the hand and fingers

Treatment

Treatments for thoracic outlet syndrome include:

  • Over-the-counter (OTC) anti-inflammatory medications, such as ibuprofen
  • thrombolytic drugs that break up blood clots
  • surgery
  • physical therapy

Learn more about the treatment options for thoracic outlet syndrome here.

Some lung conditions can cause chest and shoulder pain. They include:

Pulmonary embolism

Pulmonary embolism occurs when a blood clot that developed in a different part of the body travels to the lungs and blocks one of the pulmonary arteries.

This blockage restricts blood flow to the lungs, which can lead to lung tissue damage and reduce the level of oxygen in the blood.

The most common symptoms of pulmonary embolism are difficulty breathing and deep chest pain that worsens when breathing, coughing, or sneezing.

Chest pain related to pulmonary embolism can radiate into the neck and shoulder.

Other symptoms of pulmonary embolism include:

  • rapid breathing
  • increased heart rate
  • cough with or without blood
  • lightheadedness
  • low blood pressure
  • fainting
  • sweating

Treatment

Treatment aims to prevent the clot from growing and to destroy the existing clot. It also aims to prevent new clots from forming.

A doctor can do this via medications.

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A doctor also may perform medical procedures that remove or destroy larger clots.

Learn more about the treatment options for a pulmonary embolism here.

Pneumonia

Pneumonia refers to an infection of the lungs that causes swelling and fluid buildup in the air sacs of the lungs, also called the alveoli.

According to the American Lung Association, pneumonia can lead to a sharp, stabbing chest pain that worsens when breathing deeply or coughing. This chest pain can spread to the shoulder, upper chest, and neck.

Other symptoms of pneumonia include:

  • fever
  • chills
  • cough with or without mucus
  • shortness of breath
  • fatigue
  • loss of appetite
  • nausea or vomiting

Treatment

Treatments for pneumonia include at-home management, medications, and emergency care for severe infections.

Learn more about the treatment options for pneumonia here.

Pancoast tumor

A Pancoast tumor is a tumor that develops in the top of the right or left lung. As the tumor grows, it invades nearby connective tissue, nerves, and muscles, leading to chest pain.

A Pancoast tumor can also spread to the upper ribs and upper vertebrae, which can lead to shoulder and arm pain.

The pain can be severe and persistent. A person may also notice tingling and weakness in the arm, hand, and fingers.

Treatment

The type of treatment for a Pancoast tumor depends on the size of the tumor and whether it has spread to other areas of the body.

Chemotherapy and radiation therapy can kill cancer cells and shrink tumors. A doctor may follow up these treatments with surgery.

Learn more about the treatment options for a Pancoast tumor here.

The following abdominal conditions can cause chest and shoulder pain:

Spleen injury

An injured or ruptured spleen can result in referred pain in the left shoulder, which is pain that travels from its original location to another part of the body.

Referred shoulder pain that relates to a spleen injury is known as Kehr’s sign.

Abdominal tenderness is another common sign of a spleen injury. Other symptoms include lightheadedness, blurred vision, and fainting.

Treatment

Doctors can treat a ruptured or injured spleen with surgical intervention or observation.

Learn more about the treatment options for a ruptured spleen here.

Ectopic pregnancy

An ectopic pregnancy occurs when an embryo implants outside of the uterus, potentially in the cervix, fallopian tubes, or even the abdomen.

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A ruptured ectopic pregnancy can lead to abdominal pain that radiates to the chest and shoulder. This type of chest pain may feel similar to angina or a heavy pressure behind the chest wall.

Treatment

A doctor can treat an ectopic pregnancy with medications that stop cell growth, such as methotrexate. Otherwise, a doctor can surgically remove an ectopic pregnancy.

Learn more about the treatment for ectopic pregnancy here.

Liver disease

Liver diseases, such as cirrhosis and portal hypertension, can have adverse effects on the heart.

Abnormal liver function can lead to symptoms often associated with cardiovascular diseases, such as shortness of breath, swelling of the legs, and chest and shoulder pain.

Other symptoms of liver disease include:

  • swelling and pain in the abdomen
  • dark-colored urine
  • pale-colored stool
  • fatigue
  • nausea or vomiting

Treatment

There are few treatment options available for advanced liver disease.

A liver transplant is often the only way to completely cure liver disease. Other treatments may help slow the progression of liver disease.

Gallstones

The gallbladder is a small organ located on the right side of the abdomen.

It stores and concentrates bile, a digestive enzyme produced in the liver. The highly concentrated bile inside the gallbladder can form hardened deposits called gallstones.

Gallstones do not always cause symptoms, but they can lead to severe, intense pain on the upper right side of the abdomen.

This pain can spread to the chest, shoulder, and upper back. Other symptoms of gallstones include fatigue, nausea, and vomiting.

Treatment

Doctors can remove small gallstones located in the common bile duct using a procedure called endoscopic retrograde cholangiopancreatography.

Doctors can also surgically remove the gallbladder.

Learn more about the treatment options for gallstones here.

The following neurologic conditions can contribute to chest and shoulder pain:

Nerve compression

A compressed, or pinched, nerve may result in chest and shoulder pain.

Symptoms of nerve compression vary depending on the type of nerve that is affected.

However, common symptoms include numbness, tingling, or a burning sensation that radiates from the site of injury to nearby areas.

Shoulder injuries, tumors, and inflammation can all put pressure on nerves, resulting in severe shoulder or arm pain, loss of sensation, loss of muscle control, or muscle weakness in the arm, hand, or wrist.

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Cervical spine disease

The cervical spine refers to the upper portion of the spinal column.

This part of the spine contains nerves that send and receive information between the brain and the head, neck, shoulders, and upper limbs.

Cervical spine disease includes conditions and injuries that compress or irritate the cervical nerves, resulting in pain, stiffness, or numbness in the neck, shoulders, or limbs.

Cervical spine disease can result from neck or shoulder injuries due to motor vehicle accidents, falls, or sports-related accidents.

Cervical nerve compression can also result from age-related degenerative diseases, such as cervical spondylosis and osteoarthritis.

Herpes zoster

Herpes zoster, or shingles, is an infection that occurs due to the varicella-zoster virus (VZV).

Many people first encounter VZV as children and develop chickenpox. After the initial infection, VZV remains inactive inside bundles of peripheral nerve cells, called neural ganglia.

Shingles occurs when VZV reactivates years later.

Shingles usually causes a painful skin rash that appears on the face and chest.

Treatment

Treatments for nerve-related chest and shoulder pain vary depending on the underlying cause.

Treatments include:

  • OTC anti-inflammatory drugs, such as ibuprofen and acetaminophen, to relieve pain and reduce inflammation
  • corticosteroids to reduce inflammation
  • antiviral medications to treat shingles
  • physical therapy exercises and stretches to stretch and strengthen muscles that may be pressing on a nerve

A doctor seeking to diagnose and treat the causes of chest and shoulder pain will start the process by reviewing a person’s medical history for signs of heart disease or lung problems.

They may ask a person if they have a history of:

  • heart disease
  • heart attack
  • infections
  • pulmonary embolism
  • smoking
  • diabetes or metabolic syndrome
  • liver or kidney disease
  • autoimmune disorders

A doctor will want to know the exact type of chest and shoulder pain a person is experiencing. They may also ask how long a person has been experiencing this type of pain and whether this is the first incident.

Once the doctor knows more about a person’s medical history and symptoms, they will perform a physical exam.

During this exam, a doctor will take a person’s vital signs, such as their blood pressure, heart rate, body temperature, and weight. The doctor will also listen to a person’s heart and lungs.

If a doctor suspects an underlying heart or lung condition, they may order a combination of the following tests:

  • chest x-ray, MRI, or CT scan to get detailed images of the heart or lungs
  • electrocardiogram (EKG) to measure how fast the heart is beating
  • echocardiogram to monitor how well the heart muscle is functioning
  • stress test to see how well the heart functions during exercise
  • blood tests to look for signs of heart attack or infections
  • coronary angiography to identify a narrowed or blocked coronary artery
  • biopsy of the lung tissue to look for signs of excess fluid accumulation in the pleura

Summary

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Pain in the chest and shoulder can have several possible causes, including angina, heart attack, and lung or nerve issues.

People should seek immediate medical attention if they have sudden, severe pain in the chest and shoulder. Although chest and shoulder pain is not always a medical emergency, it is important that people see a doctor to determine the pain’s cause and their best options for treatment.

FAQs

What is the cause of chest pain and shoulder pain? ›

Pain in your chest and shoulder can have many causes. Some of the most common include angina or other heart conditions, gallstones, pericarditis, pleurisy, or pancreatitis. Unexplained pain that occurs in both your chest and shoulder should always be checked out by your doctor.

What are the 3 common causes of chest pain? ›

Causes
  • Heart attack. A heart attack results from blocked blood flow, often from a blood clot, to the heart muscle.
  • Angina. Angina is the term for chest pain caused by poor blood flow to the heart. ...
  • Aortic dissection. ...
  • Inflammation of the sac around the heart (pericarditis).
20 Oct 2021

When should you seek help for chest pain? ›

If your chest pain is new, changing or otherwise unexplained, seek help from a health care provider. If you think you're having a heart attack, call 911 or your local emergency number. Don't try to diagnose the chest pain yourself or ignore it. Your treatment will depend on the specific cause of the pain.

What is the fastest way to cure shoulder pain? ›

Home Care
  1. Put ice on the shoulder area for 15 minutes, then leave it off for 15 minutes. Do this 3 to 4 times a day for 2 to 3 days. ...
  2. Rest your shoulder for the next few days.
  3. Slowly return to your regular activities. ...
  4. Taking ibuprofen or acetaminophen (such as Tylenol) may help reduce inflammation and pain.

Does stress cause shoulder pain? ›

Tension and tightness in your shoulders is common symptom of anxiety and stress. It's part of your body's fight or flight stress response or its way of preparing to confront or survive a perceived physical threat. Fortunately, shoulder pain from stress responds well to yoga, stretching and other relaxation methods.

Which exercise is best for chest pain? ›

Examples: Brisk walking, running, swimming, cycling, playing tennis and jumping rope. Heart-pumping aerobic exercise is the kind that doctors have in mind when they recommend at least 150 minutes per week of moderate activity.

Can chest pain be caused by stress? ›

Stress can trigger the release of hormones, like adrenaline and cortisol. This can increase your heart rate and blood pressure as well as make breathing difficult. Your throat may also constrict and your chest muscles might tighten. All of these can cause pain in the chest.

Can a chest infection cause shoulder pain? ›

Chest infections can sometimes cause chest pain or shoulder pain, this is known as pleurisy.

Is heat good for chest pain? ›

Conclusion: Local heat therapy is an effective intervention for preventing and relieving chest pain in patients with acute coronary syndrome.

How do I know if my chest pain is serious? ›

How do I know if my chest pain is serious? Call 911 or have someone take you to the closest emergency room right away if you have chest pain that lasts longer than five minutes and doesn't go away when you rest or take medication. Cardiac chest pain can be life-threatening. Chest pain can be a sign of a heart attack.

How do I know if my chest pain is lungs or heart? ›

With every deep breath or cough, pain pierces your chest. Moving around and changing positions only seems to make it worse, too. If this describes your symptoms, odds are that you're dealing with a lung-related issue. This is even more likely if the pain is focused on the right side of your chest, away from your heart.

Can you have chest pain that is not heart related? ›

In many cases, it's related to the heart. But chest pain may also be caused by problems in your lungs, esophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not.

What fruits are good for shoulder pain? ›

Nutrition is an easy way to reduce shoulder pain
  • Bell peppers.
  • Citrus fruits.
  • Strawberries.
  • Potatoes.
  • Broccoli.
  • Brussels sprouts.
  • Tomatoes.
  • Cantaloupe.
9 Feb 2018

What is the best medicine for shoulder pain? ›

Shoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

What diseases cause shoulder pain? ›

Shoulder pain causes include:
  • Avascular necrosis (osteonecrosis) (death of bone tissue due to limited blood flow)
  • Brachial plexus injury.
  • Broken arm.
  • Broken collarbone.
  • Bursitis (joint inflammation)
  • Cervical radiculopathy.
  • Dislocated shoulder.
  • Frozen shoulder.

What are 5 emotional signs of stress? ›

Warnings signs of stress in adults may include:
  • Crying spells or bursts of anger.
  • Difficulty eating.
  • Losing interest in daily activities.
  • Increasing physical distress symptoms such as headaches or stomach pains.
  • Fatigue.
  • Feeling guilty, helpless, or hopeless.
  • Avoiding family and friends.
16 May 2022

How should I sleep with shoulder pain? ›

A better side-sleeping position is lying on the opposite shoulder with the painful shoulder toward the ceiling. Then place the pillow in the armpit of the injured shoulder to hold it up slightly and take pressure off the rotator cuff.

How do I know if my chest pain is serious? ›

How do I know if my chest pain is serious? Call 911 or have someone take you to the closest emergency room right away if you have chest pain that lasts longer than five minutes and doesn't go away when you rest or take medication. Cardiac chest pain can be life-threatening. Chest pain can be a sign of a heart attack.

How do you know if chest pain is heart related? ›

Chest pain and heart attack symptoms
  1. Uncomfortable pressure, squeezing, fullness, burning, tightness, or pain in the center of the chest.
  2. Pain, numbness, pinching, prickling, or other uncomfortable sensations in one or both arms, the back, neck, jaw, or stomach.
  3. Shortness of breath.
  4. Sudden nausea or vomiting.

How do you know if chest pain is muscular or heart related? ›

The pain of a heart attack differs from that of a strained chest muscle. A heart attack may cause a dull pain or an uncomfortable feeling of pressure in the chest. Usually, the pain begins in the center of the chest, and it may radiate outward to one or both arms, the back, neck, jaw, or stomach.

Does shoulder pain have anything to do with the heart? ›

There are a few different heart disease-related sources of shoulder pain. The condition most commonly associated is probably a heart attack, but other potential cardiac conditions can also trigger this pain.

Where is heart pain located? ›

Chest pain or discomfort.

Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.

How much chest pain is too much? ›

Some types of chest pain should send you to the emergency room — particularly if it lasts for at least five minutes. Symptoms could include new or unexplained chest pain coupled with shortness of breath, a cold sweat, nausea, fatigue or lightheadedness.

Can chest pain be caused by stress? ›

Stress can trigger the release of hormones, like adrenaline and cortisol. This can increase your heart rate and blood pressure as well as make breathing difficult. Your throat may also constrict and your chest muscles might tighten. All of these can cause pain in the chest.

What are the symptoms of a heart problem in a woman? ›

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  • Neck, jaw, shoulder, upper back or upper belly (abdomen) discomfort.
  • Shortness of breath.
  • Pain in one or both arms.
  • Nausea or vomiting.
  • Sweating.
  • Lightheadedness or dizziness.
  • Unusual fatigue.
  • Heartburn (indigestion)

How can you tell the difference between cardiac and non cardiac chest pain? ›

Classically, cardiac chest pain is in the left chest. However, it may occur in the center or right chest. Non-cardiac chest pain may have many of the above symptoms. However, non-cardiac chest pain may change with respiration, cough, or position.

How long does chest muscle pain last? ›

If your strain is mild, expect it to resolve within a few days or weeks. Severe strains can take 2 months or longer to heal. If your chest pain sticks around for more than twelve weeks, it's considered chronic and may be resulting from long-term activities and repetitive motions.

Can sleeping position cause chest pain? ›

If the muscles and bones of your chest wall have been strained or injured in some way, any type of movement of your torso can cause pain. As a result, you may experience chest pain while you are sleeping, particularly if you frequently change positions or fall asleep on your chest.

Is shoulder pain a symptom of cholesterol? ›

A study published online Dec. 20, 2016, by the Journal of Occupational and Environmental Medicine found a connection between heart disease risk factors (such as high cholesterol, high blood pressure, and diabetes) and shoulder problems (such as joint pain or rotator cuff tendinitis or tear).

Does shoulder pain indicate heart failure? ›

The 36 participants who had the most heart disease risk factors were 4.6 times more likely to have shoulder joint pain and six times more likely to have a second shoulder condition, rotator cuff tendinopathy, when compared with those who had zero risk factors.

Does high blood pressure cause shoulder pain? ›

The more heart disease risk factors that each of the study participants had racked up -- including high blood pressure, high cholesterol, diabetes -- the more likely they were to have had shoulder trouble.

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