Acid reflux occurs when stomach acid flows back into the esophagus, causing heartburn. While not always recognized, acid reflux can sometimes lead to pain that radiates to the left shoulder, a phenomenon known as referred pain.
How Acid Reflux Causes Shoulder Pain
The connection between acid reflux and shoulder pain involves the nervous system. When stomach acid irritates the lower esophagus, it can affect the diaphragm, a muscle separating the chest and abdomen. The diaphragm is innervated by the phrenic nerve, which originates from the cervical spine in the neck.
These nerve segments also supply sensation to the shoulder and neck. When the diaphragm is irritated by acid reflux, the brain can misinterpret these signals. It perceives the discomfort as coming from the shoulder due to shared nerve pathways. This “referred pain” explains how an issue in one part of the body can manifest as pain in a seemingly unrelated area.
Distinguishing Reflux Pain from Other Causes
Understanding the characteristics of acid reflux-related shoulder pain is important for differentiating it from other conditions. Pain caused by acid reflux often presents as a burning sensation, sometimes sharp, typically felt in the central chest, which may then spread to the back or shoulder. This discomfort often accompanies classic heartburn, a sour taste in the mouth, or regurgitation of food or liquid. The pain may worsen after eating certain trigger foods, when lying down, or bending over. Relief often comes with antacids.
In contrast, cardiac pain, such as from a heart attack, typically feels like pressure, tightness, or squeezing, rather than burning. It can radiate to the left arm, jaw, neck, or back. Cardiac pain is frequently accompanied by shortness of breath, sweating, nausea, or dizziness, and may be triggered by exertion or stress. Unlike reflux pain, it usually does not improve quickly with antacids. Any chest pain with these cardiac symptoms requires immediate medical attention as it could signal a heart attack.
Other Symptoms and When to Seek Help
Beyond shoulder pain, acid reflux commonly manifests with other symptoms. These include a persistent dry cough, hoarseness, difficulty swallowing, or a sensation of a lump in the throat. Some individuals experience non-cardiac chest pain, nausea, or bloating. These accompanying symptoms can help in identifying if your shoulder discomfort might be linked to acid reflux.
Seek medical evaluation for left shoulder pain, particularly if severe, new, worsening, or unexplained. Prompt medical attention is warranted if the pain is accompanied by chest tightness, shortness of breath, or dizziness. If the pain is a result of a fall or trauma, or if there is visible deformity, swelling, redness, or a loss of sensation or function in the arm, professional medical assessment is necessary.
Addressing Acid Reflux
Managing acid reflux often involves lifestyle adjustments and over-the-counter remedies. Dietary changes play a significant role, such as avoiding trigger foods like fatty or spicy meals, citrus fruits, chocolate, coffee, and alcohol. Eating smaller, more frequent meals and avoiding lying down for at least two to three hours after eating can help reduce symptoms. Elevating the head of the bed by six to eight inches during sleep can prevent nighttime reflux.
Over-the-counter options for symptom relief include antacids, which quickly neutralize stomach acid. H2 blockers reduce acid production, while proton pump inhibitors (PPIs) are stronger medications that block acid production and promote healing of esophageal tissue. If acid reflux is indeed the cause of your shoulder pain, effectively managing the reflux should lead to an alleviation of the referred pain. Consulting a healthcare provider is always recommended for proper diagnosis and a tailored treatment plan.