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Published on: 9/30/2024

Why Do I Have Pain Only in My Right Shoulder?

Pain in the shoulder is often due to issues in the joints of the shoulder or neck. Less commonly, right shoulder pain may be caused by diseases of internal organs such as the heart, lungs or gallbladder.

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Explanation

The causes of right shoulder pain can be due to issues with the muscles or bones around the shoulder, or less commonly due to causes in areas other than the shoulder itself.

Shoulder and neck problems

When the pain intensifies upon moving the right shoulder, it is often due to issues with the muscles or bones around the shoulder joint. Pain can also radiate from the neck into the shoulder due to a pinched nerve or tight muscle in the neck.

Frozen shoulder

Frozen shoulder can lead to pain because the capsule covering the shoulder joint gets stiff. As a result, you can lose movement in the shoulder due to the all the inflammation. It can take several months for the shoulder to “thaw” and get back to normal range of motion.

Fracture

Fractures of the humerus, scapula, or clavicle cause acute severe pain in the shoulder.

Cervical disc hernia

When the cushions (intervertebral discs) between the neck bones are damaged, it can lead to pain or even compression of the nerves leaving the spine. While the pain originates from a problem in the neck it ends up causing shoulder pain.

Problems with Internal Organs

Less commonly, right shoulder pain may result from what is known as “referred pain”. Referred pain is pain coming from a deeper internal organ that ends up causing pain in another part of the body. Disease of the heart, lungs and gallbladder are known to lead to right shoulder pain.

Heart disease

In diseases where the blood flow to the heart worsens, such as angina and myocardial infarction, you may feel severe pain in your shoulder. In the case of aortic dissection, a condition where the aorta tears, you may similarly feel intense pain in your shoulder as a result of referred pain.

Lung disease

There are cases where diseases of the right lung, such as pneumonia, lung cancer, or pneumothorax (air in the chest cavity that compresses the lung) are the cause.

Gallbladder disease

The gallbladder is located under the liver on the right side of the body under the rib cage. Gallstones, are a common disease that can lead to right shoulder pain. The gallstones get stuck in the gallbladder leading to pressure buildup in the gallbladder or even infection. This leads to referred pain in the right shoulder.

(References)

  • Greenberg DL. Evaluation and treatment of shoulder pain. Med Clin North Am. 2014 May;98(3):487-504. doi: 10.1016/j.mcna.2014.01.016. Epub 2014 Mar 22. PMID: 24758957.

  • Littlefield A, Lenahan C. Cholelithiasis: Presentation and Management. J Midwifery Womens Health. 2019 May;64(3):289-297. doi: 10.1111/jmwh.12959. Epub 2019 Mar 25. PMID: 30908805.

  • Storari L, Barbari V, Brindisino F, Testa M, Filippo M. An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report. Arch Physiother. 2021 Feb 15;11(1):5. doi: 10.1186/s40945-021-00099-x. PMID: 33583432; PMCID: PMC7883431.

  • Petchkrua W, Harris SA. Shoulder pain as an unusual presentation of pneumonia in a stroke patient: a case report. Arch Phys Med Rehabil. 2000 Jun;81(6):827-9. doi: 10.1016/s0003-9993(00)90119-9. PMID: 10857532.

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Dr. Kenji Taylor

Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Kenji Taylor, MD

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