You may associate shoulder pain with a physical injury. Shoulder pain can also be a symptom of lung cancer, and it may be the first symptom of it.

Lung cancer can cause shoulder pain in different ways. A cancer growth in the top half of the lung called a Pancoast’s tumor can pinch certain nerves that supply the:

  • shoulders
  • arms
  • spine
  • head

This can cause a cluster of symptoms referred to as Horner’s syndrome. symptoms of Horner’s syndrome include:

  • severe shoulder pain, which is one of the most common symptoms
  • weakness in one eyelid
  • reduced pupil size in one eye
  • reduced sweating on the affected side of the face

Shoulder pain can also occur due to a tumor in the lung that spreads to bones in and around the shoulder or spine. If a tumor in the lung is large, it can press on other nearby structures and contribute to shoulder pain. This is called mass effect.

Some shoulder pain occurs when the tumor puts pressure on the phrenic nerve in the lungs. The brain interprets this as coming from the shoulder even though the nerve is in the lungs. This is known as “referred pain.”

Shoulder pain from lung cancer is quite similar to other forms of shoulder pain. It might be difficult to determine the cause of your shoulder pain. If you’ve recently fallen or injured your shoulder in some way, lung cancer is unlikely to be the cause of your shoulder pain. Lung cancer may be the cause of your pain, especially if you’re a smoker and your pain:

  • occurs during rest
  • isn’t associated with any strenuous activity involving the shoulder
  • happens at night
  • doesn’t resolve itself after a few weeks

Lung cancer frequently causes chest pain as well. Sometimes, this chest pain is a result of forceful and prolonged coughing. In other cases, the pain of lung cancer is a result of a large tumor pressing on other structures or growing into the chest wall and ribs. Tumors in the lungs can also press on blood vessels and lymph nodes. That causes a buildup of fluid in the lining of the lung, and it can cause pain or shortness of breath.

The symptoms of lung cancer are hard to pinpoint. It can sometimes take months or even years for telltale signs to develop.

Many symptoms of lung cancer occur in the chest. They include:

  • shortness of breath, or dyspnea
  • a harsh, grating sound with each breath, or stridor
  • persistent, intense coughing
  • chronic lung problems including pneumonia and bronchitis
  • coughing up blood, phlegm, or mucus
  • chest or back pain
  • changes in voice, such as hoarseness
  • a shift in color or volume of sputum, which is a mixture of saliva and mucus

Discomfort in the lungs and chest area can also occur due to respiratory issues such as bronchitis and emphysema.

In more advanced stages of lung cancer, the original cancer may spread to other parts of the body. These include the:

  • liver
  • bones
  • lymph nodes
  • brain
  • nervous system
  • adrenal glands

Other symptoms of lung cancer include:

  • fatigue
  • exhaustion
  • weight loss
  • muscle wasting, or cachexia
  • blood clots
  • excess bleeding
  • swelling of the face and neck
  • bone fractures
  • headaches
  • pain in the bones and joints
  • neurological issues, such as memory loss and poor gait

If you have shoulder pain, odds are you don’t have lung cancer. A variety of health conditions cause shoulder pain including:

  • minor injury
  • poor posture when sitting or standing
  • a frozen shoulder
  • a broken arm of broken collarbone
  • disorders of the rotator cuff
  • tendonitis
  • osteoarthritis
  • a dislocated shoulder
  • problems with acromioclavicular joint
  • bursitis
  • an overactive thyroid, or hyperthyroidism

What causes shoulder pain? 32 possible conditions »

If you experience shoulder pain, your doctor will most likely perform a shoulder exam. This will help determine the source of your pain. Additionally, your doctor will review your other symptoms to put the results of the exam in context and better understand the whole picture.

Your doctor will first review your symptoms. Next, if they think lung cancer may be a possibility, they’ll use a screening procedure such as a CT or positron emission tomography scan to get an internal image of your lungs. This gives a clearer picture of any potentially cancerous growths.

If they still suspect lung cancer following your screening, they may ask to take a small piece of tissue from the lungs to examine it closely for cancer cells. This is called a biopsy.

Doctors can perform lung biopsies in two different ways. They may pass a needle through the skin to your lungs and remove a small amount of tissue. This is called a needle biopsy. Alternatively, your doctors may use a bronchoscopy to perform the biopsy. In this case, your doctor inserts a small tube with an attached light through your nose or mouth and into your lungs to remove a small tissue sample.

If they find cancer cells, your doctor may conduct a genetic test. This can help your doctor determine what type of lung cancer you have and possibly identify underlying causes, such as genetic mutations. It also guides what’s the most effective treatment.

If you have lung cancer, your doctor may use a variety of treatments, including:

  • surgery
  • chemotherapy
  • radiation
  • targeted drugs
  • immunotherapy

Doctors will often use more than one method to treat lung cancer. For example, they might prescribe chemotherapy or radiation to shrink a tumor before surgery. They may also try a different method if another one doesn’t work. Some of these treatments have side effects. You can manage side effects with proper planning and education.

You can manage shoulder pain properly if you deal with its underlying cause. If your doctor diagnoses you with lung cancer, it’s important to get the best treatment available.

If your shoulder pain isn’t due to lung cancer, it’s important to determine the cause. This will help your doctor come up with a treatment plan. For example, they may recommend physical therapy if you have shoulder pain due to tendonitis. If you have shoulder pain due to diabetes, your doctor may recommend a combination of glucose-lowering drugs and a low-carbohydrate diet.

You can try home treatments while you’re waiting to see your doctor:

  • Avoid using your injured shoulder.
  • Try icing your shoulder for 15 to 20 minutes at a time. This may help reduce pain and swelling.
  • Try wrapping your shoulder with an elastic bandage. Using compression can help you avoid overusing your shoulder.
  • Elevate your shoulder above your heart as much as possible. You can use pillows to help you with this.

Most forms of shoulder pain aren’t symptoms of lung cancer. Other possible causes include tendonitis, diabetes, and bad posture. Shoulder pain is a commonly overlooked symptom of lung cancer, though. If you experience shoulder pain and have other symptoms of lung cancer or are at high risk for it, don’t delay in seeing your doctor. Early diagnosis is the key to getting effective treatment for lung cancer.